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anal discomfort 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 healthcare provider will need more information. These questions may be asked of the person. 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? Has there been any bleeding from the anus? Does he or she engage in anal intercourse? Has he or she ever had a sexually transmitted disease, or STD? What are the person's bathing and washing habits? Does he or she have any other medical conditions? What medicines 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: anal fissure, which is a small erosion or wearing away of the lining on the inside of the anus anal fistula, which is an abnormal connection between two areas of the body cancer or a tumor involving the anus, such as anal cancer hemorrhoids, which are enlarged veins in the anal area infections, including sexually transmitted diseases (STD) such as gonorrhea, herpes, and chlamydia inflammatory bowel disease, which is a condition that causes inflammation of the bowel for unknown reasons irritation of the anal skin or lining, which can be caused by excessive washing or an allergic reaction pruritis ani, which is a general term for itchiness of the anus that often has no known cause tenesmus, which is an urgent desire to move the bowels trauma, which may be caused by anal sex 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 medical history and physical exam. 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 lab 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, anoscopy 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. Anal discomfort from diarrhea usually goes away without treatment and has no long-term effects. Inflammatory bowel disease can cause serious problems throughout the body. These may include damage to the intestines, joint pain, and visual impairments. Anal cancer can sometimes cause death. What are the risks to others? Anal discomfort 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. Most STDs can be treated with antibiotics. Inflammatory bowel disease is often treated with medicines such as prednisone to reduce inflammation. Medicine or hemorrhoid surgery may be used for hemorrhoids. 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 sulfasalazine may cause allergic reactions or stomach upset. Surgery can cause bleeding, infection, or allergic reactions to anesthesia. What happens after treatment for the condition? Outcomes after treatment are related to the cause. A person with diarrhea 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. A person with anal cancer may die if treatment fails. How is the condition monitored? Any new or worsening symptoms should be reported to the healthcare provider.

Author: Adam Brochert, MD Date Written: 07/02/00 Reviewer: Melissa Sanders, PharmD Date Reviewed: 09/17/01 Potential conflict of interest information for reviewers available on request