Swollen Anus: Symptoms, Causes, and Treatment

The anus is not only our most valuable asset, but it‘s also one of our most delicate. It‘s quite a vulnerable part of the body with very tender, thin skin. When it‘s even the slightest bit irritated or inflamed, you‘re bound to notice. You may be wondering – “Why is my anus swollen?” – and there are many reasons. Below, we’ve created a guide to the possible causes of a swollen anus and explain how Bespoke Surgical diagnoses and handles these problems.

What causes a swollen anus?

The anus is the opening at the end of the rectum and anal canal. Muscle surrounds the anus in a ring known as the anal sphincter. Since the rectum and anus are so close, a swollen rectum and swollen anus are often interchangeable as terms.

Anal swelling can have a number of causes. While some cases of a swollen anus can be an indicator for an underlying disease and others an irritation of the skin, like dermatitis or fungal, bacterial, and viral infections, the majority of anal swelling cases are temporary and harmless. Swollen anus treatment often involves adding high fiber to your diet, a regular bowel regimen and topical ointments, creams, and/or oral medications. Some additional symptoms of an inflamed anus are pains, itching, bleeding, feeling warm or burning around the anus. If the symptoms include bumps, it may be something more serious, like anal warts.

Common causes for a swollen rectum include:

• Irritation of the area or skin, such as dermatitis and fungal, bacterial, or viral infections
• Psoriasis
• Wet wipes
• Proctitis
• Hemorrhoids
• Anal fistula
• Anal abscesses
• Anal fissures
• Anal play or anal sex
• Anal warts

Conditions linked to anal swelling

Proctitis

Proctitis is a disorder where the anal lining or anal canal is inflamed. This is often mistaken for hemorrhoids, as their symptoms are extremely similar and many patients cannot tell the difference with their anus swollen.

The most common cause for proctitis is a diet that contains a lot of acidic or spicy foods, like coffee and citrus. It can also result from infections, diarrhea, or inflammatory bowel disease (IBS), as well as overdouching and STIs. For this reason, I recommend further evaluation, including anal swabbing, bloodwood, and both an external and internal evaluation with an anoscope.

Adding fiber (through foods) or fiber supplements to your diet helps prevent proctitis, along with drinking plenty of water. If you’re adding fiber supplements, I recommend drinking at least 8 fluid ounces of water for every capsule you take. While this may seem like a lot, this will help maximize the efficacy of the fiber.

Hemorrhoids

According to John Hopkins, half of all men and women will have a case of hemorrhoids by 50. Hemorrhoids are veins found in the skin of the anus and around the rectum and general anal area once they‘ve become swollen. Their function is to cushion the sphincter and anal region in order to prevent injury. When hemorrhoids sustain repetitive increased pressure in the veins of the anus, it may cause them to bulge and expand.

Irritated hemorrhoids that are actively swelling can be a cause of anal swelling or rectal swelling. Further symptoms of hemorrhoids include pain and/or bleeding. Depending on an internal or external hemorrhoid, the swollen rectum may be more prominent.

The good news is that more than 90% of hemorrhoids heal without surgery. However, a proper bowel regimen and topical creams can provide relief while the veins heal. Bespoke Surgical has a guide to preventing hemorrhoids that can help with suggestions for avoiding these common issues.

Anal fissure

An anal fissure is a tear in the lining of the anal canal, exposing the muscle and causing pain. Like proctitis, this is often mistaken for hemorrhoids due to their similar symptoms and the anal swelling that occurs in response to irritation of the area. Anal fissures can be caused by hard stools, the trauma of anal sex, and chronic issues like diarrhea and irritable bowl syndrome.

Anal fissures are quite common in those who engage in anal receptive sex (bottoming) and most people will need to be examined by a medical professional. While some cases of anal fissures won‘t need surgical intervention and can be solved with typical swollen anus treatment options such as topical ointments or creams, suppositories and avoiding anal intercourse until it has healed, it‘s best to get it evaluated by an anal expert who can determine if medical and surgical intervention is necessary. There‘s also a test called anorectal manometry, which measures the strength of the muscles in the anus and can help determine if they‘re too tight, too loose, or just right. Some people may experience acute or chronic anal fissures and it‘s important to find out the root of the issue. If you are diagnosed with either acute or chronic anal fissures, the good news is that there are both medical and surgical solutions, depending on its severity and chronicity, and most include anal Botox. One important thing to note is that lateral internal sphincterotomy is a thing of the past and not indicated for those who bottom because it can lead to long term looseness. Fortunately, those suffering from anal fissures and need surgery will see improve with newer, more appropriate techniques, like the ones offered at Bespoke Surgical.

If you‘re worried you may have an anal fissure, Bespoke Surgical covers anal fissures in depth.

Anal abscesses

An anal abscess is a collection of pus around or in the musculature and/or soft tissue of the anus. When an anal gland becomes clogged, it can progress to an infection – which may lead to an anal abscess. The agitation often results in a swollen rectum.

Abscesses can vary in size, duration, and location. Roughly 50% of abscesses will develop into an anal fistula. As with many issues involving anal swelling, anal abscesses are sometimes mistaken for hemorrhoids.

Causes for anal abscesses can include inflammatory bowel disease, STDs, and aggressive enema use and/or overdouching. Extraneous symptoms include pus or blood discharge, constipation, pain with defecation and anal skin irritation. A swollen rectum is another broad symptom of anal abscesses.

Anal fistula

An anal fistula is a tunnel that forms inside the anus and exits through the skin on the buttocks. These are more likely to occur after having a case of an anal abscess.

An inflamed anus is one of many symptoms of an anal fistula. Along with anal swelling, symptoms include a hardened tract leading towards the anal opening. A fistula can sometimes appear like a pimple on the buttocks, but there‘s more than meets the eye and only an anal specialist can help determine if it‘s simply a bout of buttne or if it‘s something more that needs medical attention.

Unlike an abscess, fistulas usually require a fistulotomy. Bespoke Surgical provides an in-depth explanation of the relationship between anal abscesses and anal fistula, as well as treatment options.

The Bottom Line

If you have a swollen, itchy anus, there are a variety of reasons that it could have occurred. Sometimes it‘s something seemingly innocuous, like overdouching or using wet wipes, and other times it can be caused by STIs or anal injuries due to anal sex. If the irritation of your swollen rectum continues after keeping the area clean and dry, seeking relief from over the counter medications, like stool softeners and Epsom salt baths, and increasing fiber and water intake, as well as limiting potential agitation (like anal play), consider consulting a doctor. The sooner you receive a comprehensive exam by an anal specialist, the sooner we can help you get back on the saddle.