The anus is made up of the last few centimetres of the bowel (anal canal) and the anal opening, through which stool (poo or faeces) leave your body. During a bowel movement, the anal muscles (the sphincters) relax to release stool. It can be distressing when there are problems with anal functions.

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

What conditions affect the anus?

A variety of conditions can affect the anus. These include:

Anal fissures: small tears in the lining of the anus that are often caused by passing hard stool. They can also occur after childbirth or a bout of 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. Antibiotics may be needed.

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.

When to see a doctor

Most problems with the anus will improve if you look after yourself. But if you have severe pain, the pain doesn’t improve in a few days, or you bleed from your bottom, it is important to seek medical advice.

Ways to manage and prevent 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.
• 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 put off the urge to go to the toilet.
• Try not to strain when going to the toilet as this can irritate the anal area and lead to serious complications. Don’t sit on the toilet for more than a few minutes.

Relieving anal discomfort:

• To help relieve anal pain and discomfort, sit in a shallow bath of warm water for 10 to 20 minutes, several times a day, if possible.
• 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.
• 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.

If you are in pain, get advice on pain relief medicines you can take.

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.

Not sure what to do next?

If you are still concerned about your anus, check your symptoms with healthdirect’s online Symptom Checker to get advice on when to seek medical attention.

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).