Conditions And Treatments

Home / Areas Of Specialty / Anal Pain

Anal Pain

Anal pain or Rectal pain may or may not be related to bowel movements. It can vary from mild discomfort to severe pain which can affect your work, lifestyle and activities. If you have anal pain and it does not improve by itself within a day or two then you should definitely seek an opinion from a colorectal surgeon. There are many causes of anal pain. Few common conditions can be as below:

1. Anal fissure as a common cause for painful anus

Anal fissure is a small tear or cut in the lining of the anal canal. It is a common condition and you may feel like a paper cut in the anal area causing sharp pain. However, this can often be confused with other conditions like hemorrhoids. Its usually caused by constipation, diarrhea or other changes in the bowel habits and occasionally with the trauma. Finally, the common modality of treatment is with the high-fiber diet, local medications and sometimes sitz baths.

2. Thrombosed external hemorrhoid as a cause for Rectal pain

A thrombosed external hemorrhoid will appear like a lump at the anal area. However, you may feel sudden appearance of this lump at the anal area. Another key point, this condition happens from formation of a blood clot within the hemorrhoid. It can cause severe anal rectal pain. It can be related to straining during the bowel movements. lifting heavy weight or could be related to change in bowel habits. You should seek consultation from colorectal surgeon for this condition as most of these can be treated in the office with a minor procedure under local anesthesia. 

Anal Fissure can cause severe anal pain

3. Internal hemorrhoids

Undoubtedly, internal hemorrhoids can cause anal rectal pain, when they are swollen or enlarged and inflamed. Common treatment modality include diet, lifestyle changes and local medications. Hemorrhoid rubber banding also known as a rubber band ligation of internal hemorrhoid is another procedure that can be performed to shrink internal hemorrhoids in the office. Moreover, other treatment options include injections with sclerosing agents, infrared coagulation and surgery as a last resort.

Enlarged Hemorrhoids causing painful anus
Understanding causes of anal problems and anal pain

4. Can grade 4 prolapsed internal hemorrhoids cause rectal pain?

Occasionally, internal hemorrhoids become enlarged and prolapse out of the anus, they can cause significant pain, discomfort and bleeding. Moreover, this condition can be confused with the prolapsed rectum. Certainly, you should seek an urgent consultation from a colorectal surgeon for evaluation and treatment. Many a times, an urgent surgical intervention may be needed.

5. Anal rectal abscess

An abscess is an infected cavity filled with the pus near the anus. You may feel a lump or mass at the anal area causing significant pain and sometimes drainage. It can also cause fever and occasionally can lead to sepsis especially in diabetic or immunosuppressed patients. Patients may need a surgical intervention. Generally, colorectal surgeons can perform drainage of the abscess in the office under local anesthesia or in a surgical center under sedation depending upon the extent of the disease. Finally, under certain conditions you may need antibiotics.

6. Anal fistula

Anal fistula is a condition which usually forms after the resolution of anal rectal abscess. A fistula is a tunnel that forms under the skin around the anal area. Another key point, most common reason for the fistula formation is infection of the glands in the anal canal. However, certain other conditions like Crohn’s disease can also cause anal fistula formation. Anal fistula can be simple, or complex based on its location and sphincter muscle involvement. However, surgery is the only treatment modality for the anal fistula.

Anorectal abscesses and Fistulas causing painful anus

7. Sexually transmitted infections (STD”s)

Different sexually transmitted diseases like Chlamydia, Gonorrhea, herpes, syphilis, HPV can cause anal pain.

8. Anal warts and HPV

Anal warts are caused by human papilloma virus. This is also known as Condyloma Acuminata. Moreover, this is a DNA virus infection. It can form lesions around the anus and also cause pain, itching and bleeding.

9. Skin conditions causing anal pain

Different skin conditions like eczema, dermatitis, psoriasis and lighting sclerosis can also cause pain and discomfort.

10. Crohn’s disease

It is a chronic inflammatory disease of the bowel which can involve the whole intestinal tract from mouth to anus. Basically, it can also cause abscess and fistula formation in the anus.

11. Ulcerative colitis

Ulcerative colitis is a inflammatory condition involving the colon and rectum and can rarely cause anal rectal pain.

12. Levator ani syndrome and Proctalgia fugax

Spasm of the levator muscles around the anorectal area can cause rectal pain. Occasionally, patients may have spasmodic pain in the rectal and pelvic area.

13. Anal cancer and Rectal cancer as a cause of rectal paain

Certainly, anal and rectal cancers can also cause pain in the anal rectal area. However, patients may also have other symptoms like bleeding, difficulty with passage of stool and a sensation of lump in the anal area.

14. Pruritus ani

Itchy anus is a condition where patients may have significant burning and itching at the anal area. Additionally, this condition may require further evaluation and discussion with your colorectal surgeon for treatment.

15. Proctitis

This is an inflammation involving the rectal and anal area. This can happen as a result of different reasons like infection, medications, radiation and inflammatory bowel disease. However, treatment is based on the underlying condition.

16. Fungal infections

Fungal infections around the skin of the anal area can cause significant pain and itching in the anal area.

17. Rectal Prolapse

Rectal prolapse is a condition in which the full thickness of the rectum protrudes out of the anus. However, It can form a bulge at the anus and can cause significant pain and bleeding and other symptoms. Occasionally Hemorrhoidal prolapse can appear like a rectal prolapse. You should seek a consultation from a colorectal surgeon for this condition. 

What is a colon and Rectal Surgeon? Is Dr Singh a Board-certified Colorectal surgeon? and where does he perform his procedures.

Colon and rectal surgeons are experts in the surgical and non-surgical treatment of diseases of the colon, rectum, and anus. They have completed advanced surgical training in the treatment of these diseases, as well as full general surgical training. They are well versed in the treatment of both benign and malignant diseases of the colon, rectum, and anus and are able to perform routine screening examinations and surgically treat conditions as and if needed. Dr Singh is a double board certified in Colon and Rectal Surgery and General surgery. His practice is located in Phoenix, Glendale and Scottsdale, AZ.

For more information please visit:

Anal Pain | ASCRS (

Dr Neeraj Singh – Colon & Rectal Care Center of Phoenix (

Scroll to Top