AskDocQ: Don’t Be Embarrassed About Talking To Your Doctor About Butt Stuff

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Anal problems are very common, but people are often too embarrassed to get help and let their problems grow before finally going to the doctor.

Anal itch is a good example. If you have an itch that won’t go away, it could be due to dermatitis or sensitivity to soap, or it could be a fungal or bacterial infection or even herpes.

Anal pain is another common symptom. If you also have a discharge then it could be rectal gonorrhoea. There are some other STIs that can cause pain, including herpes, chlamydia and syphilis. If you get these symptoms you should always go straight to the doctor.

Haemorrhoids or piles

Haemorrhoids or piles are another common problem. They can be caused by chronic constipation, weight-lifting, and anal sex. Internal haemorrhoids usually cause bleeding when you go to the toilet, but don’t tend to be painful.

An external haemorrhoid will often appear suddenly as a painful lump around the anal opening, and it rapidly swells in size and becomes so painful you might not be able to sit down. There might be some bleeding too. It’s basically a blood clot in a swollen vein close to the skin’s surface. First aid for this is an ice pack and an over-the-counter haemorrhoid cream.

I knew of someone who used a carefully placed frozen oven chip to do the trick (thick cut of course)! If it’s very small then this may be enough, but larger haemorrhoids will need more serious intervention. I’m talking about cutting open the lump and getting the blood clot out.

It’s not exactly a fun procedure, but with some local anaesthetic it’s generally tolerable and provides instant relief. The alternative is to do nothing and wait painfully for weeks or months until the lump goes down.

Anal fissure

Another cause of painful bleeding from the bum is an anal fissure. This is a tear in the edge of the anus. The bleeding from this can be quite spectacular and seem to fill the toilet bowl. Unfortunately, they can take weeks or months to heal, and you will need to avoid anal sex during this time. There is a cream you can get from the pharmacy which helps relax the anal sphincter and speed up the healing process, but for stubborn fissures, surgery is sometimes needed.

Anal warts, especially internal warts which you might not even be aware of, can also cause bleeding. These can be treated by freezing at the doctor’s office, or application of a cream. Warts are contagious so need to be treated before you can have sex again. There is a vaccine against the wart virus which I highly recommend to protect you from both warts and anal cancer.

Anal cancer is another possible cause of bleeding and another reason why you should always go to the doctor if you get symptoms. If detected early enough it can be treated

You should never feel embarrassed to talk to your doctor about anal problems – honestly, when you see as many bums as I do every day, it’s no big deal, and usually, there is a solution for your problem. Instead of worrying and suffering, get your bum a check-up!

Dr Fiona Bisshop specialises in LGBTIQ health. For more by DocQ Dr Fiona Bisshop visit, follow @DrFionaBisshop on Twitter, or send your health questions to

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Dr Fiona Bisshop

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