Anal Swelling – What Causes It? What is the Treatment?

anal swelling - causes and treatment options

Some of you might remember the digestive system diagram that you were taught and asked to redraw during your school. The lower part of the digestive tract includes the large intestine (also called the colon), followed by the rectum, and then the anus.

The rectum sits between the large intestine and the anus. The rectum consists of controlling muscles called the ‘sphincter muscles" that control the outflow of stool. When the colon is full and wants to empty, it sends a signal to the brain, and then the brain orders the rectum to relax and open. That’s when the stool passes out of the anus.  The anus is the end portion consisting of glands, nerve endings, blood vessels, muscles, etc.

Have you ever had a feeling like a burning sensation or a warm feeling the next day after you ate some spicy food? This is quite common and one need not worry about it. But, if you notice some blood or pus coming out of the anus, severe pain, fever, or any kind of anal discharge you must immediately see a urologist near you.

What causes Anal Swelling?

The causes of anal swelling can range from very minor and ignorable issues to life-threatening problems such as cancer. Did you know that colon cancer can also leave streaks of blood on your stools? Common causes of anal swelling include:

  1. Anusitis
  2. External Hemorrhoids/piles
  3. Anal Fissure
  4. Anal Abscess
  5. Anal Fistula
  6. Perianal Crohn’s disease
  7. Anal Sex and play (it can be the first time or rough usage of toys).


Inflammation of the anal lining is called Anusitis. This is a very common condition that happens when you consume excess spicy foods or foods that causes the release of acids in the stomach. When the acids, coffee or citrus items are being sent out, they may cause inflammation of the inner lining of the anus. Sometimes discharge or blood may also be seen coming through the anus.

You need to tell your doctor about your symptoms and a good urologist does a physical examination and may also ask to get some tests done to confirm that the problem is just in the anus and not piles or cancer in the colon.

External Hemorrhoids / External Piles

Hemorrhoids or piles are swollen tissues or blood vessels in the lining of the anus or near the end of the anus. Depending on the location of piles, they are termed as internal or external.  Piles that originate around the anal opening are called external piles.

Piles may be caused due to:

  1. Severe constipation (People tend to pressurize the area during constipation which can hurt the tissues and blood vessels)
  2. Low fiber consumption can cause constipation
  3. Severe diarrhoea

Typically anal fissures can be painful, itchy, bloody, and may hurt when you sit on a chair or flat surfaces. People with piles use donut pillows to sit without putting pressure or weight around the anal opening. Piles are a common problem, don’t hesitate to see a good urologist when you have any inflammation/ redness, swelling, and itching in the anal region. Dont hesitate to book an appointment with the piles hospital near your location to get to know the treatment and surgery options for piles.

Anal Fissure

A fissure is an opening/tear in the lining of the anus. This can be caused by

  1. Hard stools that are difficult to pass
  2. Diarrhoea
  3. IBS – Irritable Bowel Syndrome
  4. Tight anal spinchter muscle that doesn’t allow free passage for stools
  5. Tumor in the anal lining or any infection.

Anal Abscess

Any abscess is a result of a gland getting infected and getting clogged. An anal abscess is no different. As we have mentioned already, the anal region consists of many glands along with nerve endings and tissues, etc. If any of the glands gets clogged and infected, an abscess will be formed. Like all other abscess, this too has to be flushed and cleaned and then treated with antibiotics.

An abscess can cause swelling (obviously), pain, looks like a lump around the anus and when the infection is higher, fever may follow. As per a study by Harvard Health, men are more likely to get anal abscess than women.

Anal fistula

The anal fistula is like a pathway that starts from the inside of the anus, passes through the muscles of the buttocks, and exits near the anal opening. People suffering from an anal abscess are at higher risk of developing a fistula. Symptoms of anal fistula include:

  1. Swelling near the anus
  2. Irritation
  3. Pain and Itching
  4. Leakage of stool through the opening near the anus.

Perianal Crohn’s disease

Crohn’s disease is a condition when the digestive tract gets inflamed. This is believed to be a hereditary problem. Typically Crohn’s disease affects the smaller intestines but in some people, large intestine and anus may also get affected.

Symptoms of perianal Crohn’s disease include anal fissures and fistulas.

Anal sex and play

Trying anal sex for the first time or using sex toys roughly can result in inflammation, pain, and even bleeding in the anal area.

When the anus swells, the rectum gets affected too!

As the rectum and anus are closely connected, there are chances of the rectum getting inflamed when anal swelling is seen. Certain medical conditions that cause swelling of the rectum and anus are:

  1. Internal Hemorrhoids/piles.
  2. Crohn’s disease
  3. Sexually Transmitted Infections such as gonorrhea, herpes, and HPV (Human PapillomaVirus).

How is anal swelling diagnosed?

When you present yourself to your urologist with symptoms, he/she will first do a physical examination of the area. The doctor will insert a gloved finger into the anal canal to look for piles or anything unusual. Later the following tests may be done:

  1. Anoscopy – If the doctor is not able to find anything with his/her finger, a small tube with a camera and light, called an anoscope will be inserted to look on the inside of the anal canal.
  2. Sigmoidoscopy – In this procedure, a more flexible tube with a camera and light is used to look at the lower intestinal tract. Your doctor will be able to see if there is any kind of inflammation (Crohn’s disease) in the lower digestive tract.
  3. Colonoscopy – In this procedure, a longer flexible tube is used to take a look at the rectum and also the colon. Using colonoscopy, an experienced urologist will be able to detect any unusual tumor formation that is a precursor to cancer or even cancer itself.

Treatment of Anal Swelling

Once your urologist is able to determine the root cause of the problem, appropriate treatment will be provided. You may have to change your lifestyle and food habits if you have been suffering from anusitis for some time. Piles may be treated with or without surgery as the case may be. In 90% of the cases, piles wouldn’t need surgery. Botox injections may be used for anal fissures in most cases. The anal abscess will be drained off and you will be put on antibiotics. Anal fistula will be plugged and sutured to close the tunnel that has formed after cleaning it. This procedure has to be done carefully with no or minimal damage to the sphincter muscles. In some cases, treatment of anal fistula may result in fecal incontinence. Perianal Crohn’s disease may be treated with anti-inflammatory medicine, antibiotics, or even surgery in severe cases.

Dr. Karthik Gunasekaran