Where is your anus?

The anal canal is made up of the last few centimetres of the bowel. It stores your solid waste (stool, poo or faeces). The anal opening (the anus) is where the faeces leave your body. During a bowel movement, the anal muscles (the sphincters) relax to release stool.

Diet, digestion, sexual activity and genetic and environmental factors all play a role in your anal health.

What conditions affect the anus?

Many different conditions can affect the anus. These include:

• Anal fissures: small tears in the lining of the anus that may be caused by passing hard stool. They can also occur after childbirth, sex or diarrhoea. Most fissures heal within 1 to 2 months with good self-care, such as eating a high-fibre diet, drinking lots of water and careful anal hygiene to keep the fissure clean.
• Anal abscess: a collection of pus, usually from an infection. A doctor will treat an abscess by draining the pus, using a local anaesthetic. You may need antibiotics.
• An itchy bottom: also called pruritus ani, is a common problem. There are many possible causes, including infections, parasites such as threadworms, skin conditions, haemorrhoids and anal fissures. Ways to ease itching include not scratching the itch and gently cleaning the area without soap.
• Haemorrhoids: lumps that occur in and around the anal passage. They are usually caused by constipation. If you have haemorrhoids, you may notice bright red blood on the toilet paper or in the toilet when you have a bowel motion (poo). Haemorrhoids often go away without any treatment. If you notice blood in your poo, it’s important to see a doctor, to make sure your symptoms are not a sign of something more serious.
• Anal cancer: cancer affecting the tissues of the anus. Most anal cancers are caused by human papillomavirus (HPV). See your doctor if you are worried about anal cancer, and ask about vaccination.

When should I see a doctor?

It can be distressing when there are problems with anal functions. If you have severe pain, or if the pain doesn’t improve in a few days, if you bleed from your bottom or have any new or unusual lumps it is important to seek medical advice.

Tips for managing and preventing anal problems

Good anal hygiene

• Keep the anal area clean by washing with water every day. Don’t use soaps as they will reduce the natural oils that protect the anus and may make the area dry and itchy. Use aqueous cream or a soap-free cleanser instead if you feel you need them.
• Avoid vigorous wiping with toilet paper because this may cause further chafing of the skin, which can become inflamed or infected.
• Avoid cleansing wipes or chemicals.

Good toilet practices

• Don't delay going to the toilet — if you feel the urge, go.
• Try not to strain when going to the toilet, as this can irritate the anal area and lead to complications.
• Sit on the toilet properly:
  • keep your back straight, lean forward
  • rest your forearms on your knees
  • have knees higher than hips by lifting heels or using a footstool keep your legs apart.

Relieving anal discomfort

• If the anal area is extremely painful and swollen, a cold compress or covered ice pack, such as a bag of frozen peas wrapped in a clean towel, may be used to relieve the pain and swelling. Do not keep the ice pack on the area for any more than 30 minutes.
• If your pain continues, get advice on pain relief medicines from your doctor or pharmacist.
• Over-the-counter creams, lotions and ointments may also relieve itching around the anal or rectal area. Follow the instructions or ask your pharmacist for advice.
• Drinking plenty of water and eating fibre-rich foods, such as bran cereals, fruit and vegetables and whole grain bread, will help soften your stool to help prevent anal problems.

Safe

• The best way to practice safe anal sex it to use a condom with water-based lubricant. This can reduce the risk of getting or transmitting sexually transmitted infections (STIs) and viruses like HIV or hepatitis.
• To reduce your risk of anal fissures it is important to ask your sexual partners to remove any rings and trim their fingernails if they’ll be engaging in anal activities. It is also important to understand your own boundaries and only engage in activities that you feel comfortable with, and use plenty of water-based lubricants. Open anal fissures can make it easier to contract STIs because they are a point of entry for infections.
• If you feel pain in your rectum or notice any unusual discharge from your anus, it could be a sign of STIs. It is important to talk to your doctor if you have any of these symptoms.
• ‘Douching’ (using an enema) is not recommended except under medical care, as it can lead to damage of the rectum.

Support and resources

The Symptom Checker guides you to the next appropriate healthcare steps, whether it’s self care, talking to a health professional, going to a hospital or calling triple zero (000).

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

If you are still concerned about your anus, discuss your concerns with your doctor.