What is an anal injury?

An anal injury is when your anus (bottom) is hurt or damaged.

Your anus is the hole where solid waste leaves your body. Your rectum is found just inside your bottom. It stores your solid waste (faeces, stool or poo) until you are ready to go to the toilet.

Anal injuries can cause:

• pain
• bleeding
• discharge — mucus
• faecal incontinence
• rectal prolapse

What causes anal injuries?

There are many causes of anal injuries, such as:

• changes in bowel function
• sexual activity
• giving birth
• accidental damage during surgery

Changes in bowel function

Changes in bowel function such as ongoing diarrhoea or constipation can cause anal fissures (tears) or haemorrhoids.

Sometimes the muscles around your anus can spasm (cramp). This makes passing stool (poo) painful.

An anal fistula is a small tunnel between the end of your bowel and the skin near your anus. It's often caused by an anal abscess.

Anal injuries caused by giving birth

Obstetric anal sphincter injury (OASIS) is an anal injury that happens when giving birth.

It's a perineal tear that involves the anal sphincter and anal tissue. These are also called third- or fourth-degree perineal tears.

Anal injuries due to sexual activity

Anal injuries can be caused by sexual activity. Rubbing, sharp edges and rough behaviour can tear the sensitive skin around your anus and rectum.

This may be from putting things in your anus, such as:

• fingers
• a penis
• sex toys
• other objects

Sexual assault and rape can also cause anal injuries.

What if I suspect that my child has been sexually abused?

If you believe your child is in immediate danger, call the police on triple zero (000).

If you think that your child has an anal injury caused by sexual abuse, you should take them to hospital.

You should also report your concerns to the relevant authority in your state or territory. Find contact details to report abuse in your state and territory.

Learn more about the signs of child abuse.

When should I see my doctor?

Call triple zero (000) and ask for an ambulance if you have an anal injury and are bleeding heavily, unable to move or feel faint.

See a doctor if you have:

• pain in your bottom
• bleeding from your bottom or blood in your poo
• discharge or poo leaking from your bottom
• any new or unusual lumps near your anus
• an itchy bottom that is not getting better
• difficulty controlling your bowel movements

It can be distressing when there are problems with your anal function.

When to seek urgent care

If you have an object stuck in your bottom, go to the nearest emergency department (ED).

It's important to have the object removed by someone who is medically trained. This helps to stop more damage.

Do not leave the object inside you. This can lead to severe injury.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How are anal injuries treated?

Your treatment will depend on what has caused your anal injury.

Self-care at home

Some anal injuries, such as those caused by anal fissures and haemorrhoids, will improve with good anal care. This includes:

• eating a high-fibre diet
• drinking lots of water
• not straining when doing a poo
• careful anal hygiene

Gently wash and dry your anus after pooing and before bed. Use wet toilet paper or a wet washcloth. Use water only or an unscented soap.

Do not use the following products on or near your anus:

• scented soaps
• bubble bath
• perfumes
• talcum powder
• deodorant

Wear cotton underwear that isn't tight fitting.

You can use an ice pack to ease the pain and swelling caused by haemorrhoids. Don't keep the ice pack on the area for more than 20 minutes.

Stop anal sex if you have any pain or bleeding from your anus, until you have seen a doctor.

Medicines for anal injuries

If you are in pain, ask your pharmacist which pain relief medicines you can use.

If you have an anal fissure, laxatives may help to soften your stool (poo). A sitz bath (a warm, shallow bath) may ease your discomfort.

Other treatment options for anal injuries

Treatment for foreign bodies involves removing any object in your rectum or anus. This can prevent serious complications.

The method used to remove the object will depend on where the object is. An object close to your anus may be removed in the emergency department. If the object is deep inside you, you may need surgery.

You may need surgery to treat:

• bad haemorrhoids
• severe anal fissures
• an anal fistula

What are the complications of anal injuries?

When the tissue around your anus is damaged, you may get an infection.

It can also cause anaemia if you're losing a lot of blood.

Can anal injuries be prevented?

You can prevent conditions that injure your anus by:

• practicing good anal care
• drinking plenty of water
• eating fibre-rich foods

When having anal sex, use plenty of water-based lubricant. To prevent injuries during anal sex, ask your sexual partners to remove any rings and trim their fingernails.

Having anal sex is a personal choice. Only engage in activities that you feel comfortable with.

Having anal sex when your skin is broken increases your chance of getting a sexually transmitted infection (STI), including HIV.

Resources and support

If you are concerned about an anal injury, speak with your doctor, or a health professional at a sexual health clinic.

Learn more about pelvic floor training for males and females.

For support with faecal incontinence, call Continence Health Australia on 1800 33 00 66.

Read the information sheet on anal health and injuries at Sexual Health Quarters.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.