Gastrointestinal tract

Anus pain (anus pain) - causes, therapy and symptoms

Anus pain (anus pain) - causes, therapy and symptoms

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Anus pain or anus pain is the name given to complaints in the area of ​​the anus, which is responsible for controlling the emptying of the stool and the continence of the rectum as an opening in the intestine at the bottom. The causes of anus complaints are diverse and range from problems with bowel movements to improper intimate hygiene to various diseases such as an abscess, hemorrhoids or an anal thrombosis.

Pain in the anus area is a common problem, which unfortunately is often kept hidden due to shame and accordingly is often not clarified until late or not at all by a doctor. Even if anus pain usually turns out to be harmless, a doctor should always be consulted as a precaution, especially in the case of persistent pain and / or accompanying symptoms such as blood in the stool or fever, because these can certainly indicate serious diseases.


Symptoms in the area of ​​the anus on the buttocks and rectum are usually summarized under the term anus pain or anus pain. In medicine, this is referred to as "proctalgia", the corresponding medical sub-area, which deals with diseases of the rectum and anal canal, is called "proctology" or "coloproctology" (from Greek proktos for "anus", colon for "intestine") "And" -logie "for teaching).

The anus or anus is the posterior opening of the intestinal tract or the exit opening of the intestine, the task of which is to control defecation (defecation). The anus is primarily formed by two important circular muscles: the sphincter ani internus muscle, which prevents the involuntary loss of stool, and the sphincter ani externus muscle, which closes the anus.

Causes and symptoms

Pain in the anus occurs relatively frequently and can be attributed to a variety of causes. In many cases, there are digestive problems such as constipation or diarrhea, excessive or insufficient intimate hygiene or certain ingredients in intimate hygiene products or skin-irritating laundry that are responsible for complaints in this area. However, various diseases in the anus area can also be considered, such as hemorrhoids or anal fistulas. The causes are explained below.


Hemorrhoidal disease is often the cause of anal pain. Hemorrhoids or hemorrhoids are arteriovenous vascular cushions that line the anal canal like a cushion from the inside and thus act as a “fine seal” in the anus area, so to speak. Hemorrhoids are therefore a normal part of the digestive system - they only become pathological when the blood builds up in them and can no longer drain properly. As a result, the hemorrhoids enlarge and there are typical symptoms such as anus pain, anus itching, bleeding, an uncomfortable pressure pain and anus burning. In many cases there is a feeling of incomplete emptying as well as a disturbance of the so-called "fine continence", which in turn can lead to greasing, wetting and dirty laundry. Hemorrhoidal disease is often caused by a lack of exercise or persistent constipation (often due to a low-fiber diet), which results in hard bowel movements and the need for heavy pressing. Hemorrhoidal disease can also quickly develop during childbirth; overweight (obesity) and constant sedentary activities also seem to have a positive effect.

Anal thrombosis

An anal thrombosis (also "fake hemorrhoids") can be the cause of anal pain. This is usually characterized by several blue-reddish nodules, which, in contrast to hemorrhoids, are not in the anus but on the edge of the anus. The trigger of the anal thrombosis is a blood clot in the superficial veins, which can be caused, among other things, by intensive physical activity, long sitting on cold surfaces, hormonal changes (period, pregnancy, birth) or by excessive consumption of alcohol, coffee and hot spices. In addition to a sudden painful bulge on the anus edge, it can also cause itching, a feeling of tension or burning. When checking with a mirror, different numbers of knots covered by skin can appear, some of which are barely visible, but in other cases can also reach cherry pit size or, more rarely, plum size.

Pain in the anus after bowel movements

If the pain in the anus is very severe and stinging or boring and occurs especially during and after defecation, an anal fissure can also be the cause, which is sometimes also referred to as an “anal tear”. This is an elongated tear in the mucous membrane of the anal canal, which usually occurs in the area towards the coccyx. The severe pain often means that those affected can hardly sit, and there may also be blood in the stool or traces of blood on the toilet paper. Exactly what causes such an anus tear has not yet been clearly clarified - however, it seems to be beneficial for hard bowel movements, but also persistent diarrhea or a hemorrhoidal disease, and sexual practices such as anal sex or the insertion of objects into the anus can also lead to a tear in the mucous membrane. In addition, fissures can also occur as a result of various underlying diseases such as inflammatory bowel diseases (Crohn's disease, ulcerative colitis) or infectious diseases (e.g. syphilis, tuberculosis) (secondary anal fissure).

Anal fistulas and abscesses

If inflammatory changes in the area of ​​the "after glands" (proctodeal glands) lead to an encapsulated purulent inflammation (abscess), this can also be the reason for a sometimes very painful swelling and reddening on the edge of the anus. In order to prevent the inflammation from spreading, such an abscess is usually opened surgically for pus drainage - but sometimes this bursts spontaneously and foul-smelling pus escapes through the skin.

If such an abscess is deeper, it is usually difficult to detect and is often only discovered when there is a general feeling of illness or fever. After an abscess has escaped to the outside, a so-called “anal fistula” can remain, which is a narrow, tubular duct that connects the inflamed after gland to the skin. Pain in the anus area is also characteristic of an anal fistula; chronic oozing and purulent secretions are also typical, which can often be seen in underwear and are often accompanied by itching and skin irritation.

If there is suspicion of a fistula, treatment should be carried out as quickly as possible, because if left untreated it can expand further and cause damage to the sphincter muscles. However, since anal fistulas do not normally heal on their own, the usual course of treatment is an operation in which the fistula is split open (fistulotomy) and the entire inflammatory material of the proctodeal gland is removed by scraping (curettage) the fistula floor.

Treatment for anal pain

Since complaints of the anus are often due to relatively “harmless” reasons, some behavioral changes (change in diet, more exercise and fluids etc.), home remedies or ointments or creams from the pharmacy often help to relieve the pain and other symptoms. Nevertheless, accompanying symptoms such as blood in the stool, severe pain during bowel movements and persistent constipation can also be a serious illness - so medical clarification is essential here!

If you have a hemorrhoidal disease, you should first make sure that constipations are loosened in order to avoid pressing hard during bowel movements. In this context, it is essential to ensure a balanced, high-fiber diet, sufficient exercise and fluids, and a number of other home remedies for constipation help to alleviate the symptoms. In lighter cases, ointments or suppositories from the pharmacy can help against the pain and itching - but if the symptoms persist or skin irritation occurs, consultation with the doctor should be made in any case. In more severe cases, depending on the stage, the hemorrhoids can be sclerosed or tied with rubber rings (rubber ligature treatment); in advanced cases, surgery is usually required.

Even with an acute anal fissure, those affected should urgently pay attention to regulating their bowel movements, since the complaints also very often arise from constipation or hard feces. In addition to this, locally anesthetic ointments can also be used to relieve the pain, sometimes the anesthetic is also injected directly under the anal tear. In the case of a chronic anal fissure, drugs such as glycerol trinitrate or nifedipine are used, but in more severe cases an operation may also be necessary to avoid possible complications and to relieve the affected person of the pain.
An anal thrombosis usually resolves on its own within a few days or a few weeks, so treatment can be dispensed with in the case of minor pain or painkillers (e.g. ibuprofen, diclofenac) can be used for mild pain and pressure. However, those affected should pay attention to strict bed rest during the healing process and promote soft bowel movements by eating a high-fiber diet and drinking enough. In the case of severe complaints, the thrombosis is either removed completely by surgery under local anesthesia or an incision is made in the node so that the thrombus can be cleared out.

Naturopathy for anus pains

In order to alleviate the symptoms of a hemorrhoidal disease or anal fissure, a central step is to ensure that the stool is soft and well-shaped to avoid pressing during emptying. For this, a balanced and high-fiber diet with lots of vegetables and fruit as well as sufficient exercise and hydration (min. 2 liters a day) is essential. Dried figs, for example, are delicious and healthy here, which contain soluble and insoluble fiber, both of which work as gentle "intestinal cleaners", and dried unsulphurized prunes from the organic market are also very suitable as digestive aids: soaked in water five times a night and The next morning, fasting with plain yoghurt, can be a real boon for constipation.

Herbal baths can also alleviate the symptoms, as itching and skin irritation often occur in diseases in the anal area. You can choose between a hip bath in warm water or a steam bath in which the affected areas are exposed to hot steam. However, the steam bath in particular has the advantage that the painful areas are reached more gently than when sitting directly in the tub and therefore not soften as much - recommended especially for severe skin irritation or more pronounced hemorrhoids, fissures, etc. To avoid the painful ones To "steam" places, boiling water is put into a container with 500 grams of oak bark or about 15 drops of real lavender oil, which can carry your own body weight (tub or bucket made of metal or similar). This is followed by a stable board on which the anus is placed directly above the steam - of course, the distance should be kept so that the heat is not perceived as unpleasant.

As an alternative to the baths, envelopes or pads are also very suitable for after-complaints. These can be soaked with ointments or oils, for example, or filled with herbs and then placed on the affected area for some time. Anti-inflammatory and wound-healing herbs such as real lavender, St. John's wort or oak bark are also recommended. (No)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Social Science Nina Reese, Barbara Schindewolf-Lensch


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