Definition The anus is the lowest part of the digestive tract, the opening from which stool is passed out of the body. Anal discomfort includes pain, itching, or burning.
What is going on in the body? Discomfort in the anal area can take many forms, including pain, itching, or burning. It is rarely life threatening, but it can be quite annoying. There are several possible causes.
What are the signs and symptoms of the condition? When a person has anal discomfort, the doctor will need more information. Questions that may be asked of the person include:
When did the discomfort start?
What is an exact description of the discomfort?
How long has the discomfort been occurring?
Is the discomfort constant or does it occur only occasionally?
Is the discomfort made worse by having a bowel movement?
Does he or she have any other other medical conditions?
What medications or drugs is the person taking?
Does the person have any other symptoms?
Other questions may be asked as well.
What are the causes and risks of the condition? Causes of anal discomfort include:
haemorrhoids, which are enlarged veins in anal area
pruritis ani, which is a general term for itchiness of the anus. The condition often has no known cause.
trauma, or injury. This may be caused by vigorous or frequent wiping with toilet paper or by anal sex.
infections, including yeast infection of the anus or STDs such as gonorrhoea, herpes, and chlamydia.
anal fissure, which is a small erosion or wearing away of the lining on the inside of the anus
tenesmus, which is an urgent desire to move the bowels. It occurs along with painful spasms of the anus. It is often caused by bacterial infections that cause diarrhoea, but it can occur with STDs and other conditions.
inflammatory bowel disease, which is a condition that causes inflammation of the digestive tract for unknown reasons
anal fistula. This is an abnormal connection between two areas of the body that are not usually connected, such as between the bladder or vagina and the anus. Causes can include trauma, infection, and inflammatory bowel disease.
irritation of the anal skin or lining. This can be from a reaction to soap or from excessive washing.
cancer or a tumour involving the anus, such as anal cancer
Other causes are also possible. Sometimes, no cause can be found.
What can be done to prevent the condition? Prevention is related to the cause. For example, safer sex practices can help avoid cases from STDs. Avoiding anal sex can prevent cases from trauma due to this cause. Many cases cannot be prevented.
How is the condition diagnosed? Diagnosis begins with a history and physical examination. This may be all that is needed to figure out the cause of the discomfort. In other cases, further tests will be needed.
If an STD is suspected, a culture may be done to determine the exact cause of an infection. A culture is a test in which bacteria or other organisms are grown in the laboratory from a sample of tissue. Tissue is collected by using special cotton swabs to wipe the area around and inside the anus.
If inflammatory bowel disease is suspected, colonoscopy or sigmoidoscopy may be advised. These are special procedures that allow a doctor to view the inside of the intestine. They both involve putting a small instrument into the anus that contains a light and a camera.
What are the long-term effects of the condition? Most long-term effects are related to the cause. Cases due to diarrhoea often go away without treatment and usually have no long-term effects. inflammatory bowel disease can cause serious problems throughout the body. These may include damage to the intestines, joint pain, and vision problems. Anal cancer can sometimes cause death.
What are the risks to others? This condition is not contagious. However, if an infection is the cause, the infection might be contagious.
What are the treatments for the condition? Treatment is directed at the cause. Excessive washing of the anus with soap is discouraged, and often makes the pain worse. Infections can sometimes be treated with antibiotics. Inflammatory bowel disease is often treated with medications such as prednisone to reduce inflammation. Medication or haemorrhoid surgery may be used for haemorrhoids. People with anal cancer may need surgery, chemotherapy, or radiation therapy.
What are the side effects of the treatments? Side effects depend on the treatments. For example, antibiotics and sulphasalazine may cause allergic reactions or stomach upset. Surgery carries a risk of bleeding or infection.
What happens after treatment for the condition? Outcomes after treatment are related to the cause. A person with diarrhoea from an infection often feels better once the infection clears up. A person with inflammatory bowel disease often has repeated flare-ups of the disease. These may require close monitoring for many years. A person with anal cancer may die if treatment fails.
How is the condition monitored? Changes or response to treatment can be reported to the doctor.
Author: Adam Brochert, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
