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Anal pain is pain that occurs in or around the anus and rectum (the last section of the large intestine that ends in the anus). Causes can include an abscess, hemorrhoids, or Crohn's disease. Diagnosis and treatment are discussed.
American Society of Colon and Rectal Surgeons. Anal Pain. (https://www.fascrs.org/patients/disease-condition/anal-pain) Accessed 2/15/2019.
International Foundation for Gastrointestinal Disorders. Anal Discomfort and How to Deal with it. (https://www.iffgd.org/symptoms-causes/anal-discomfort.html) Accessed 2/15/2019.
Merck Manual Consumer Version. Anal Fissure. (https://www.merckmanuals.com/home/digestive-disorders/anal-and-rectal-disorders/anal-fissure) Accessed 2/15/2019.
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Anal pain is pain that occurs in or around the anus and rectum (the last section of the large intestine that ends in the anus). Pain and bleeding from the rectum often accompany anal pain. People may feel embarrassed to ask their doctor about anal pain, but it is a common symptom of many different medical conditions and is usually easily treated.
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Many different conditions can cause anal pain. Most symptoms are minor and will go away quickly with treatment. In rare cases, anal pain is a symptom of a more serious condition, such as anal cancer .
Common causes of anal pain include:
Doctors diagnose anal pain in several ways:
Treatment for anal pain depends on the cause, and includes:
Other methods that may help manage the pain include the following:
Many causes of anal pain do not need to be treated by a doctor. Contact your doctor about anal pain that:
Last reviewed by a Cleveland Clinic medical professional on 02/14/2019.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.
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Medically Reviewed by Minesh Khatri, MD on June 20, 2022
An anal fistula is a tunnel that runs from inside the anus -- the hole your body uses to get rid of solid waste -- to somewhere in the skin around it. It usually follows an infection that didn’t heal the right way. Your doctor can repair the fistula, but you'll need surgery for that.
Just inside your anus are several glands that make fluid. Sometimes, they get blocked or clogged. When that happens, a bacteria buildup can create a swollen pocket of infected tissue and liquid. Doctors call this an abscess .
If you don’t treat the abscess, it’ll grow. Eventually, it’ll make its way to the outside and punch a hole in the skin somewhere near your anus so the gunk inside it can drain. The fistula is the tunnel that connects the gland to that opening.
Most of the time, an abscess causes a fistula. It’s rare, but they can also come from conditions like tuberculosis , sexually transmitted diseases , or an ongoing illness that affects your bowels, such as Crohn’s disease or ulcerative colitis .
If you have any of these symptoms, call a doctor.
If the doctor thinks you have an anal fistula, they'll ask about your medical history and give you a physical exam .
Some fistulas are easy to spot. Others aren’t. Sometimes they close on their own, then open back up. Your doctor will look for signs of oozing fluid or bleeding. The doctor might stick a finger into your anus during the exam.
The doctor will probably send you to a specialist in colon and rectal problems for more exams or imaging tests like X-rays or a CT scan . You might even need a colonoscopy. For this test, the doctor will put a tube with a camera on the end into your anus to look at the inside of your bowels. You’ll be asleep when this happens.
There’s no medication to fix the condition, so surgery is used. The procedure can usually take place in a doctor’s office or clinic. You won’t have to go to the hospital.
Depending on where the fistula is, your doctor may have to cut into the sphincter muscles that open and close your anus. They'll try not to damage them, but it may be harder to control your bowels after the procedure.
American Society of Colon and Rectal Surgeons: “Abscess and Fistula Expanded Information.”
The Cleveland Clinic: “Anal Fistula,” “Anal Fistula: Management and Treatment.”
Clinics in Colon and Rectal Surgery: “Anorectal Infection: Abscess-Fistula.”
National Institute of Diabetes and Digestive and Kidney Diseases: “Anatomic Problems of the Lower GI Tract.”
University of California San Francisco Center for Colorectal Surgery: “Anal fistula.”
National Institute of Diabetes and Digestive and Kidney Diseases.
World Journal of Gastroenterology : “Why do we have so much trouble treating anal fistula?”
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