Seeing your doctor about an anal problem

Almost everyone is embarrassed about seeing the doctor about an anal problem, such as anal pain, wind, or anal itching. It is important that you get over this worry, so that you get treatment for the problem. Value your own health and think of your doctor simply as someone who is helping to maintain your health. Bowel or anal symptoms, such as constipation or bleeding, can sometimes be serious. People are literally dying of embarrassment because they do not see their doctor when bowel symptoms start, often because of a fear of examination of their back passage (rectal examination). Therefore they may reach their doctor only when bowel cancer is quite advanced. Although bowel cancer is much less common than piles, it is always a possibility and can be treated very successfully at an early stage.

Take control

Remind yourself that you are in charge of the consultation with your doctor. He or she cannot examine you without your permission. Therefore it is perfectly OK for you to visit your doctor and say ‘I have such-and-such a problem. At the moment I just want to discuss it. I don’t want to be examined’. When you have got over the hurdle of talking about the problem you may later feel quite alright about being examined, but it is your decision.

Think the problem through

What do you think will be going on in your doctor’s mind while you are being examined? Are you imagining your doctor will be mentally rating and criticizing your appearance? In fact, in this situation your doctor is interested in your insides, not your outsides. By the time he or she becomes a GP, your doctor will have seen literally thousands of backsides and is not interested in their appearance. In fact, he or she will be thinking about the symptoms you have described, and whether they match up with the findings on examination.

Take a friend

Would it help to have a friend with you? You might feel this would make it worse, but the right person can be reassuring, perhaps someone who has had a lot of medical treatment themselves and so is matter-of-fact about being examined.

What is involved in the examination

If you are a female and the doctor is male, he will ask a female nurse to be present during the examination. Like any other part of the examination, examination of the back passage is methodical, and all doctors are taught the following procedure.

The patient is asked to lie on the left side with the knees drawn up to the chest; this position helps to relax the muscles around the back passage. If you are feeling tense, breathe slowly and deeply with your mouth open. The doctor puts on a pair of gloves and separates the buttocks slightly to look for abnormalities such as piles, cracks in the wall of the anus (anal fissure), skin tags or warts. The doctor then puts some lubricant on the gloved finger, and places the fingertip on the anus, pressing slightly. When the anal muscle relaxes, the finger is inserted slowly and the tip is rotated gently to feel for lumps and bumps and specific structures (such as the prostate in men).The finger is withdrawn slowly and then the doctor inspects the glove for blood or pus. It is not painful, so if you experience any pain, tell your doctor. You may just experience a feeling of rectal fullness during the examination, as if you wish to have your bowels open.

Your GP might suggest inserting a short hollow instrument (proctoscope) to separate the walls of the bowel so that they can be seen clearly as the instrument is withdrawn. Again, this is not painful and your GP will not do this without your permission and explaining it to you.

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Friday, February 26th 2010

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Comments on this article

Posted by Optional on 15/07/2010 at 01:04:27 am

what kind of doctor can i see for anal pain

Posted by Optional on 14/07/2010 at 12:14:20 pm

after 2 ops still bleeding and sore no idea what to do now

Posted by Optional on 09/07/2010 at 03:34:31 am

i have lived with anal itching for about 2 years now and my wife doesnt complain as having the same problem and after reading this document i think i have to see my doctor for parasital exams.

Posted by happy on 08/07/2010 at 06:45:38 am

i was also suffering from anal problems like fissure and piles both. for some relaxation, take some hot water and sit in this pressuring outside ur anal so that water goes in for atleast 20mins.this is really helpfull aftr that u can use any cream.

Posted by Justine on 07/07/2010 at 03:27:54 pm

This is still scaring me. I have problems facing up to my fears, Please, somebody...anybody please help me. I need to make sure my body's healthy. :'(

Posted by Optional on 07/07/2010 at 10:07:51 am

Please let me know whether to go and consult a skin doctor for anal problems or we have a separate specialization.

Posted by Optional on 30/06/2010 at 05:17:22 am

my daughter is suffering first degree of piles . it can be cured. now started taking fruits lot. how long it will take to get cured. after passing toilet tiny paticle coming out. now iam pushing it to go in. so please advice she does not have any constipation problem. iam more worried in her young age she is suffering.

Posted by robert on 18/05/2010 at 08:59:01 pm

i practice anal sex and i think my anus is ripped. the skin below my anus (nearer to the spine) has ripped and has formed something like a flap. when i defecate, sometimes there's blood (but not always). it doesn't hurt. can you tell me which kind of doctor i should go to? thanks.

Posted by haseeb beg on 16/05/2010 at 04:29:54 am

I want to the exact period of pile reconvery

Posted by Optional on 14/05/2010 at 03:44:02 am

i think i m facing the problem of piles. But do tell me when should i consult a problem because i donot bleed regularly. actually i saw bleeding three times, Ist- one and a half year ago, second time do not remember exactly and third time yesterday

Posted by AnGeLtEdDy on 05/05/2010 at 12:46:16 pm

which doctor do you have to see in order to check you anal itch.........cuz i have had this problem for years so i need to get rid of it....please help

Posted by Optional on 14/04/2010 at 08:00:51 am

what kind of doctor should i go to?

Posted by Optional on 05/04/2010 at 01:59:51 pm

i have recently developed a soreness around the inside of my bum cheeks, and around the inside of my legs/scrotum, any ideas what it could be, i have been using sudo cream but dosnt seem to be working

Posted by Optional on 02/04/2010 at 02:45:20 am

when i had a poo there was blood all over my poo and i have aching in my lower back is this a pile problem. i have had blood on my poo before but not amount

Posted by Optional on 27/03/2010 at 01:42:44 am

Thanks. It's helpful to know the steps of how the doctors would examine this problem.

Posted by Sanjay on 20/03/2010 at 01:09:55 pm

I have prob with my anus i dont know what is that, when i came after toilet after 30 or 50 mins i feel something is leaking and when i use tissue there are some drop or potty it is happening with me since more then two year but i was avoiding because it was earlier happend some times but these days i m getting these prob very seriously and in big amount. i m new in uk and right now i m not registered with any gp , pls advice me if any once can do

Posted by Optional on 15/03/2010 at 02:43:25 pm

Yes this was helpful

Posted by RAKESH on 27/02/2010 at 10:55:15 pm

I am suffering since last 8 months and don't know the right doctor to consult

Posted by Stella on 27/02/2010 at 03:07:34 am

I EXPIRENCE A PAIN IN MY ANU, I HAVE SEEN A DOCTOR, HE GAVE ME DRUGS THAT COULD HELP MY STOOL TO BE SOFT BECAUSE IT STATED WITH HEARD STOOL. STILL THE PAINS CONTINUED. NOW THIS IS THE THIRD MONTH I AM STILL HAVING THE PAINS ESPECIALLY WHEN I GO TO TOILET. THE PAINS LAST FOR 25 TO 35 MINUTES. I AM WORRIED ABOUT IT.

Posted by Alfred Goring on 24/02/2010 at 08:33:21 am

this was very informative and hope to continue to read it thank u for alaying my fears about anal fisure

Posted by worried on 21/02/2010 at 06:18:36 am

still have concerns and the embarrassment

Posted by Optional on 20/02/2010 at 01:02:01 am

Been having anal itch for months so after reading all this information have realised I have been using every cream under the sun without success, only makes it worse. Have decided to go to Dr and have proper examination to relieve my anxiety.

Posted by Anonymous on 10/02/2010 at 07:42:00 pm

i have been having anal bleeding for about 2 months. sometimes the bleeding is within the faeces and sometimes the toilet is filled with blood. i have a sharp pain when i try to poo and i be on toilet for like half an hour because it is soo painful. it's just so embarrising for a doctor to see your backside, i dont know wot to do?

Posted by dina on 07/02/2010 at 09:45:00 am

ive been having this fissure since last year and after injecting the botox, it become more painful and the skin tags become red and swollen like a grape

Posted by kevin bridge on 02/02/2010 at 11:33:00 am

as well as itchy i get alot of pain sometimes its so bad i cant walk

Posted by jo on 01/02/2010 at 12:04:00 pm

hello i have bleeding too from my anal but its not every time i go to move my bowels its just now an then,it is bright red should i see my doctor 1/2/2010

Posted by Anonymous on 27/01/2010 at 10:02:00 pm

After looking on the nhs website i believe i havean anal fissure. i find it difficult to talk to people even close family and friends. i have several issues concerning my body, which is causing other mental health issues eg depression, stress, and possible an eating disorder. i dont feel i could talk to my doctor or even close family and friends as writing this is hard enough. is there any way i can treat any of the problems mentioned without having to see a doctor

Posted by ned on 26/01/2010 at 09:32:00 am

To ease a fisure..when in the bathroom squeeze bottom cheeks together while passing waste it improves quickly.

Posted by Kalemire Paul on 21/01/2010 at 11:09:00 am

Dear Editor, Thanks you for the information. I now have the idea and courage to face the doctor should a similar problem come up. Thanks

Posted by rukiye hassan on 19/01/2010 at 10:27:00 am

large piles and blooding

Posted by AJW on 18/01/2010 at 10:18:00 am

family has problem - starts with ithing anus week or so, have all been wormed, after itching eases passing of poo really burns and anus is sore to wipe, to look at does not look sore. After passing some bright blood, 4 members of family have a same time.. nothing is really helping dr say fissure - how can it be passed on to other family members? Been going on for over 4 weeks - help

Posted by Anonymous on 17/01/2010 at 12:45:00 am

i have just been having pain every now and then in the anal area and red in my stool which doesnt appear to be blood because it doesnt turn the toliet water any color when it touches the water

Posted by Chichi on 16/01/2010 at 11:08:00 pm

i am 16 and have been having stabbing pains in my anal for a few years now, happened about a few times a year (not that often), but this morning i woke up to extreme stabbing pains in my anal and when i tried to walk i experienced more pain. my pains are really extreme and i cannot stand there acting as if its not happening, i end up holding my but, getting on my toes, bending weirdly and making weird noises to how painful it is. i am not going out in public today as i feel i would experience extreme embarrassment if i happened to have one of these pains when people are watching. i am a bit embarrassed to see a doctor about my problem but i really don't want it to be serious and get worse so i want it checked asap.

Posted by KRK koi choda star nhi on 10/01/2010 at 10:30:00 am

in the morning i saw that blood coming with my shit...is it piles related problem..m also feeling pain in my anal... what is this? KrK

Posted by Helen on 10/01/2010 at 06:22:00 am

what type of doctor should i seek help regarding anal matter??

Posted by adelaide on 31/12/2009 at 05:02:00 am

i have an anal pain that passes through my vagina and the pain sometimes feel like period pains should i be worried?

Posted by Jacky zarju on 14/12/2009 at 11:29:00 pm

I got my baby 3mnths ago via c section and since then,i strain alt wen pasin bowel n also fil a sharp pain,several hrs later i have pains tht so uncomfrtable to sit,walk and sleep

Posted by marem ali on 17/10/2009 at 12:23:00 am

anal pain what is the pain and why ?

Posted by Rita Joyce on 04/10/2009 at 09:52:00 pm

much discomfort in my anal area sitting and wearing trousers, most uncomfortable when i pass motion as some of it stays in the anel area after i finish so i must wash my self many times and put some sudocream as i seem very dry not sore to touch but uncomfortable, ive had a colan procedure which showed a lazy gut i eat a very healthy diet high in fiber it has not helped, have back and leg pain which has been diagnosed as wear and tear in two of my discs i wonder if there is a connection have been, recommended to see osteopath hope you can show some light on my problem,thank you.

Posted by Me on 27/09/2009 at 09:47:00 pm

I feel my stools are just too big to pass sometimes. I feel them scratching out and have to hold onto something! Once it's out there is loads of bright red blood. for the rest of the day it throbs and is generally sore. After reading this I will make an appointment with a female GP. Thanks!

Posted by Anonymous on 17/09/2009 at 12:46:00 pm

HAVE SEVERE PAIN IN THE ANUS AFTER EVACUATION.pART OF ANUS PAD PROTRUDES OUT AND HAS TO BE PUSHED BACK WHICH CAUSES PAIN FOR SOME TIME.THIS HAPPENS MORE WHEN I EAT OUT.ANY REMEDY FOR THIS KIND OF PROBLEM.

Posted by jim on 03/09/2009 at 10:27:00 am

This is a very helpful site and has put my mind at rest. Thank you

Posted by Anonymous on 17/08/2009 at 10:12:00 pm

Hi for quite a while now i seem to ear when i pass a large stool. it is never a lot of blood but i am worried that constant bleeding in that area could lead to an infection. i have a same pea sided lump where the bleeding comes from, I thought this was the body trying to protect itself but now I am not so sure. Is this something I should be worried be about?

Posted by westlondon on 14/08/2009 at 09:44:00 am

I had a very itchy anus a few years ago, i was going insane in the end it turn out to be an allergy to milk, when i completely avoided milk and dairy products the problem went

Posted by first time on 19/07/2009 at 06:59:00 pm

hi i just pulled down my underwear to use the toilet and there was a blood stain on the back part, must've been alot because i chacked my trouser and it had gotten through my underwear slightly and stained my trouser aswel, i didnt feel any pain, or realise i could've been bleeding antil i saw the stain, and the stain looked like it had been there a while, when i checked with a tissue i wasn't bleeding so it had stopped, sometimes when i use the toilet the skin around the anus cracks and little tiny drops of blood come to the surface, is any of this serious? im worried about the blood stain, it hasn't happened before

Posted by shay guy on 17/07/2009 at 08:22:00 am

hi since last two day when i go do laterin , i get pain (while pressuring laterin), pls advise what to do

Posted by karen on 11/07/2009 at 09:52:00 pm

Ie had had stomache have had a bad stomache since thursday morning, but started bleeding on the evening, I dont have pain, but i am a bit sore now, and have had tummy ache. I am still going to the toilet but only passing blood, is this normal because of tummy bug

Posted by Anonymous on 08/07/2009 at 02:45:00 pm

hi my boyfriend is bleedin really heavly when he goes for a poo, its like a pink couler, he has no pain only when the lump inside his bum comes out and then he is in pain, i dont know what to do please help he wont go to the doctors!!!!!!!!!

Posted by Anonymous on 01/07/2009 at 01:16:00 pm

It seems that most comments come from men. Please talk to your wife about it! I am a wife, and I promise you that your wife would rather you told her. Yes, she will probably give you the confidence to go to the doctor, but you will have made that decision together. What a relief that will be!

Posted by Anonymous on 29/06/2009 at 12:52:00 pm

Your enquiry: hi ,i will start from the begining, up until about 4-5 days ago i could go to the toilet fine,stools were normal size.but now its hard to go and the stools are about 1/10 of the normal size pencil thin and its hard to go i have to strain ,and i try not to for ovious reasons,i think its constapation,but i am unsure and i dont go to doctors ever,people i have spoke to say you cant take a stool at all if constapatied, so it might not be that as i can still go a little bit ,this is really starting to worry me as i have never had constapation before ,also i am male and 24,and just before i had constaration,i tried to give up smoking and drinking it lasted 4-5 and this was just before this all happened and i was eating more fruit,any help would be much appreciated i have mailed before and you said to ring,but i couldnt,i cant go doctors even thou i no i should,i have been reading up online,and am very worried ,and dont no what to do .please any advice would help

Posted by Anonymous on 23/06/2009 at 11:55:00 am

I have had anal bleeding for the last six months! maybe longer! it has actually become so bad that i am scared to go out with friends and just feel normal? If i do i have to wear a pad because the bleeding just happens at any time without warning. I do suffer with a lot of pain with this problem and some days sit in agony. I am a very active person and

Posted by Anonymous on 15/06/2009 at 08:05:00 am

a few times i have had trouble passing feaces, to get it out i have had to hook it out with my finger (disgusting i know) but if i didnt it would feel very uncomfortable. on several occasions blood has come out too, today it happened again this time loads of dark red blood came out and fiiled the toilet, do u think i have anything to worry about?

Posted by Anonymous on 14/06/2009 at 09:31:00 pm

i have bleeding from the anal passage but no pain the bleeding has been for the last 5 days

Posted by keith on 14/05/2009 at 06:40:00 pm

i have anal spotting sometimes when i empty my bowels but not all the time it seems to be when i go to the toilet more than once but i dont spot all the time could it be bowel cancer?

Posted by Anonymous on 26/04/2009 at 05:39:00 pm

over the weekend i have been finding fresh red blood on the toilet paper i dont strain when i go to the toilet as i never have the need to, sometimes i have a mucus should i be worried

Posted by Triece on 20/04/2009 at 06:16:00 am

I have had some stomach problems recently that lead me to being a little constipated and then over the past 3 days, I have been bleeding analy. I fill up the toilet with blood as I am having a bowel movement and then over the past 2 days I have noticed small blood clots as well. One of the blood clots was the size of a tootsie roll and the others are pea size. I also have some bloody mucuous looking stuff when I wipe. I am not on my cycle and no where near it, but I feel like I am with the cramping stomach and all the blood, only it is coming from my anus. Could you give me any advice? I hate going to the doctors.

Posted by anonymous on 19/04/2009 at 06:38:00 pm

I have suffered from external piles for a few years and creams have worked fine if i have had a flare up. However for some months now i have had quite a severe pain in the anus after bowel movement which lasts for several hours during the morning and afternoon. It only dies down by the evening and thankfully during the night so i do sleep ok. But once i go to the loo again in the morning, im back to square one again. I thought after reading sites like this i had anal fissures and have tried suppositories and ive even had fibre gel drinks to soften the stools even though i do not have trouble normally, going to the loo. Some days the pain is worse than others, and some days it lasts longer into the day than others. Im scared to go to the doctor, because the thoughts of anything going up my back passage to examine me, makes me feel quite panicky to say the least. But by the same token, im also scared i may NOT have internal piles/fissures and may have cancer or something, as yesterday i felt a lump (which isnt seeming to be IN the anus) but to the side of it. When i feel it,i have to press and i can feel something under the skin inside.it does feel a bit like a needle prick feeling sometimes when i do this. Is this what is putting pressure on my anus wall and causing the fissures? im really worried about it, but keep putting up with it hoping it will go away but ive had this for about 8 or 9 months now with hardly a day out of discomfort, so it aint going anywhere i know...please help

Posted by Anonymous on 16/04/2009 at 05:29:00 am

I am embarassed about the apperence of my anus. can i ask my gyno about it or do i have to go to a specialist?

Posted by barbara on 11/04/2009 at 02:52:00 am

last august i noticed blood when i passed waste, but it only happened twice in a few days, i went to the toilet this evening and the same things happened but there was quiet a bit of blood but not that much, should i go to the doctors or leave it?

Posted by Anonymous on 23/03/2009 at 09:23:00 pm

I have been to the docs to have an anal bleeding problem looked at already. I was told that there was nothing to be seen but was given a prescription for it 'just in case it came back'. It has stayed away for a month but I now have another appointment, different doctor, for the same problem, only this time slightly worse. I find blood on the stool, and on the tissue after I wipe. Not a good look, or comfortable, or confidence building. I would say to anyone reading this, you are probably reading it for a reason. Get yourself to the docs - you never know until the experts have a look. This site has put my mind at rest slightly with some useful information. Thank you.

Posted by Clay on 07/03/2009 at 11:33:00 pm

I could never go through any of the embarrassing process unless I know that no female medical workers will ever be involved at any point. Is this possible?

Posted by Anonymous on 06/03/2009 at 10:24:00 pm

often i notice small bits of stool around the anus. Why is this not eliminated.? I have internal piles Is this a reason?

Posted by darrell on 06/03/2009 at 06:32:00 pm

I have a problem with my back passage tearing when i pass a motion .I also loose blood when this happens and i have a throbbing sensation allday even when i break wind I have had operation for fistula piles and a polip non of which as solved the problem HELP PLEASE

Posted by sad and in pain a lot =[ on 04/03/2009 at 01:27:00 pm

i am 20 years old female and not pregnant i noticed my anus had become itchy two three months ago and ignored it, i now hav stage 3 piles =[[ (i kno ikno ouch!) i just wish i had gone to the doctor earlier i am in so much pain it is unreal and cream only soothes the pain for a short while go to the doctor get checked out otherwise u are condemning urself to days of pain an mysery i hope it goes soon! had it since saturday night!!!

Posted by Anonymous on 09/02/2009 at 06:02:00 pm

thank you, this is a great site

Posted by Anonymous on 25/01/2009 at 06:36:00 pm

very helpful thankyou

Posted by Mrs C on 23/01/2009 at 04:56:00 pm

PLease please go to the doctor, tell the receptionist you do not wish to discuss with them they have no right to make you tell them, same goes for a phone call, say I am in an open plan office and wish to discuss it face to face with a doctor. It is your right demand it! Most conditions are very easily treated and most likely to be worms or thrush (very common around the bottom). However, the wrong "self-help" can just make it worse, most creams (especially anything with hydrocortisone or local anaesthestic) and excessive cleaning especially soap or wipes make it worse. Gentle washing 2-4 times a day preferably without soap (use very dilute baby soap and rinse really well) dry with a hairdryer and most of all try not to rub or scratch. An ice pack wrapped in a clean cloth can really help too.

Posted by JOCELYN on 20/01/2009 at 04:06:00 pm

HI I HAVE HAD A PROBLEM WITH ANAL ODOR FOR SEVERAL MONTHS NOW....I HAVE BEEN TO DOCTORS SO MUCH THAT I GAVE UP.....ONE DOCTOR SUGGESTED THAT I WAS TOO BIG TO CLEAN MYSELF PROPERLY BUT I BEG TO DIFFER ALTHOUGH I AM OVER WEIGHT AS WHICH I HAVE BEEN ALL MY LIFE I DOUBT THATS THE CAUSE OR THE PROBLEM.....HE ALSO ADVISED THAT I SHOULD DIET...NOW I WAS WONDERING IS THERE ANY WAY THAT I CAN SOLVE THIS PROBLEM AND DOES DIETING REALLY WORK????

Posted by Anonymous on 15/01/2009 at 04:35:00 pm

I have had anal itching for about 2 weeks or so and it's drivin me mad ! its now become sore de to scratching and has now become VERY irritating ! I don't want to visit a doctor and just want some way to make it stop ! Any suggestions ?

Posted by BobT on 11/01/2009 at 12:32:00 pm

I find the worst part of any doctor's visit is getting past the receptionist. "Whats the problem" is not an easy one to answer, and it's stopped me for years from getting something done. I have no problem discussing with the Doctor, but NOT the receptionist!

Posted by Anonymous on 23/12/2008 at 05:22:00 pm

I have had excessive sweating for years. I have hade a colonoscopy and found to be clear. However, the sweating and itching is constant. The scratching has sometimes been so intense that I have caused the sking to bleed. Sometimes any anal discharge causes great pain as if the fecal discharge was acid like causing a burning sensation. Sometime my bowel movements are solid and sometimes they are liquid during the course of a day. I have tried powders and washing on a regular basis but with no luck. I feel that the sweating is excessive compared to other parts of my body.

Posted by Anonymous on 23/12/2008 at 10:17:00 am

Your article talks about discussing symptoms with a doctor in a surgery. How do you actually get to that situation? I am offered a phone call to me when I am sat in an opne plan office - so I refuse this then sit and worry because I can't easily get help.

Posted by faheem on 20/12/2008 at 07:14:00 pm

nearly 2 years i have bowl problem some time bleeding from my bowl,discomfort and after come back from toilet feeling bowl is not empty properly i am realy worried this situtation is on off plz help me

Posted by Oh bugger on 16/12/2008 at 12:30:00 pm

I've had tiny amounts of anal bleeding, only evident after pooing, for years on and off. It was always worse after a heavy week of drinking. It was that infrequent it never really concerned me. All though if I'm honest, I was probably just burying my head in the sand and hoping it would go away. Which it always has, for a while anyway. Things have taken a turn for the more serious today. It seemed like I lost a lot of blood at work today. (in the wc) it's really sacred me. I decided to google anal bleeding and I found this page. I'm now reading about the possibility of bowel cancer, and I'm really sacred. Has putting it off and hoping it will fix it's self all this time given me advanced cancer? Or do I just have bad piles? Either way I'm glad I've recently taken out life insurance, so I know my partner and baby boy will be ok. Off to the docs tomorrow, and not before time...