Anal itching and pain


Itching, burning and pain in the anus relate to subjective sensations, warning about health problems and various disorders. It is a rare case when itching and pain occur simultaneously. Each symptom has its own causes and only in some cases the symptoms are combined.

Causes of anal pain

  • Anal fissures. This pathology relates to various injuries of the rectum mucous membrane (tearing, cuts) which occur as a result of some mechanical trauma. A patient experiences acute pain (if a fissure has just occurred) which disappears when a fissure is healed, or a chronic pain if a fissure is constantly injured and regeneration does not occur. In chronic form acute pain in the anus may be accompanied by itching. The sign which allows to detect anal fissure is insignificant amounts of blood.
  • Hemorrhoidal bolus. Hemorrhoid is a peripheral vascular disease which affects rectal veins. The vessels are blocked with blood clots, they enlarge, bulge and form nodules. Anal pain will occur during the aggravation of the disease or because of inflammation. The disease is aggravated due to excessive physical loads and a diet rich in hot foods. Hemorrhoidal bolus may fall from the rectum causing strong pain. Most often hemorrhoidal bolus fall from the rectum and cause anal pain in women during a delivery.
  • Fall of the hemorrhoidal bolus. This pathology is characterized by a fall of the hemorrhoidal bolus from the rectum. It may be a full fall when it may come out completely or partial when only the mucous membrane falls out. This pathology occurs in elderly women and pediatric patients. Additionally to an acute anal pain in women, they also have some other symptoms such as a foreign body sensation in the anus, bowel incontinence, bleeding due to a mechanical injury.
  • It occurs very rarely and it is one of the forms of such a disease as paraproctitis. The major symptom is acute anal pain. General signs of being sick, such as fever, weakness and asthenia, are also characteristic for this disease. It is not possible to detect the disorder visually and in this case a transrectal ultrasound which will show the area of induration, is required.
  • Oncological diseases. Tumors may develop both in the anus and the rectum. Pain is the main symptom in anus cancer. In rectal cancer, the pain radiating to the anus, appears only at the final stages of cancer. Earlier and very significant symptoms of the disease are bloody, purulent and mucoid discharge from the anus, a foreign body sensation, bowel disorders (diarrhea, constipation).
  • Rectal polyps. Polyp is a common condition affecting any hollow body organ but, predominantly, localizing on the rectal mucous. The polyps have various forms and types. They may be of different sizes. This pathology does not have any particular symptoms but due to tissue growths the rectum may be mechanically injured and it will lead to pain.
  • Pain in the anus area relates to atypical localization of the appendix or transmission of pain impulses through the nerves. However this is a rare case.
  • Anal pain in men may occur due to chronic prostatitis. Actually, the pain is located in the groin area but it radiates to the lower back or anal area. Prostatitis may be identified by a number of other symptoms such as frequent urination, erectile dysfunction and others.
  • Ovarian cyst. The cause of anal pain in women may be neglected ovarian cyst which is manifested in menstruation disorders, discomfort during a sexual intercourse and when the condition is aggravated a woman may experience the signs of general intoxication and the pain radiates to the whole abdomen.
  • The most primitive cause of the anal pain is sitting on hard surfaces for a long period. Such pain does not require any treatment and it will disappear by itself. Pain may also be caused by the injury in the groin area or if a person fell onto the tailbone.
  • Muscle spasms. This is a physiological condition which most often occurs in teenagers. Sphincter muscle contraction causes pain. It should be noted that this disorder occurs and disappears spontaneously but if it is constant and brings discomfort, you should immediately visit

Treatment of anal disorders

If anal pain is caused by the disease of some other organ, for example prostatic gland or ovary, it is necessary to cure the major pathology and the pain will disappear by itself.

If possible, conservative treatment is indicated and a patient is prescribed rectal ointments or suppositories with healing and soothing effect.

If the pain is caused by the injuries of the sphincter or the rectum, then a surgical interference is often required to remove the affected part, seal it, reduce the prolapse of the rectum and other surgical operations.

Diagnosis and causes of anal itching

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Unlike pain, anal itching is an independent nosologic unit. It may be primary (idiopathic) or secondary (due to some disease).

Primary anal itching occurs without any visible reason and it is not related to any disease. There is assumption that itching occurs because the sphincter does not close properly and mucus irritates the anus.





The secondary anal itching may be caused by various pathological conditions:

  • The most harmless reason of anal itching is improper personal hygiene or, on the contrary, excessive hygiene. In both cases irritation occurs and it leads to itching and burning.
  • Excessive physical loads, obesity, high ambient temperature make a person sweat causing itching.
  • Anal itching may be a result of eating certain foods (coffee, wine, spices, chocolate, tomatoes, hot pepper).
  • Pseudo subjective sensations may occur due to psychological disorders, for example, in neurosis but most often in psychosis.
  • Itching may be caused by various anal disorders: hemorrhoidal bolus, anal fissures, sphincter dysfunctions. A common etiology is axillary abscess which manifests itself as inflammation of perspiratory glands in the groin area.
  • Genital warts which are caused by the human papillomavirus and develop into growths in the anal area and cause itching.
  • Psoriasis occurs in the perianal area very rarely. Polymorphous rash consisting of various morphological elements is typical for this disease. There is no evidence concerning the reasons why this pathology occurs. There is no complete therapy for the disease and it is incurable.
  • Lichen ruber planus. This disease is very similar to psoriasis. The conditions are distinguished by the character of eruptions. Lichen planus usually presents with papules. Localization in the perianal area is rare but there are some cases.
  • Atopic eczema and contact dermatitis occur as a result of allergic reactions. However, the first condition is caused by the allergen which entered the body, and the second is caused by its local skin affection. Dysentery may also be the reason of anal itching, however in this disease this symptom will be lost among many others. Itching occurs as a result of a typical presentation of the disease, namely by mucous discharge and anal bleeding.
  • Salmonellosis commonly presents as an intoxication and bowel disorders. Constant diarrhea causes skin irritation in the anal area which leads to burning and itching.
  • Cholera may be the cause of itching for the same reasons as in salmonellosis. However the severity of the disease, its high contagiousness and mortality rate make such a minor symptom as itching obscure. Due to constant and uncontrollable diarrhea a person may lose up to 20 liters of water and that leads to death.
  • Candidiasis occurs rarely, mainly due to immunity decrease (for example, in HIV) and it is characterized by bowel disorders, abdominal pain and stool with white flocks. Itching is a consequence of the skin around the anus.
  • The secondary itching may often be a symptom of helminth infection. Frequently it is the manifestation of ascariasis, opisthorchiasis, enterobiasis and lambliasis. All the diseases cause bowel disorders and, consequently, irritation of the anus. In children itching may be caused by the pinworm infection and it usually occurs at night.

Except all these common pathologies, the secondary anal itching may be caused by any other diseases affecting the bowel functions, skin and mucous membranes.

Anal itching treatment

First of all, the therapy should be oriented towards the elimination of the main reason of itching. It is difficult to treat the primary itching as its etiology is not known yet. The principles of the therapy of the secondary itching:

  1. Proper personal hygiene;
  2. Elimination of excessive perspiration in the anal area;
  3. Healthy diet;
  4. Treatment of the major disease (surgical treatment of hemorrhoid, antihelminthic treatment, use of antibiotics in infections etc.);
  5. Rectal suppositories, ointments, applications;
  6. Soothing baths.

The last two recommendations are useful in case of the primary itching. Frequently, therapy of the major disease completely eliminates discomfort and additional symptomatic treatment is not required.