Pile or perianal symptoms

Causes They are often caused by abrasions or tiny splits in the skin around the anus or perhaps due to a hypersensitivity of the skin to the stools. The symptoms may be caused by rubbing too hard with dry toilet paper. If your main symptom is severe pain when you are passing a motion this could be due to an anal fissure which requires more specific treatments. See 'Other Bowel Conditions and Tests'.  

Treatment If your bottom is sore, itchy, painful or just uncomfortable after going to the toilet - follow these 5 steps to gently clean your bottom:

First wipe should be with wet soft toilet paper


1. Use very warm tap water

2. After wetting the paper, smear it with soap to stop it breaking up. The soap allows the paper to slide over the skin in a gentle manner

3. Strain gently as you wipe. This with the warmth from the water this allows the muscles to relax and helps you clean higher up the anal canal.  

4. Keep wiping until the toilet paper stays clean 

Last wipe should be with dry paper

5. Finally dry the area making sure that bits of paper aren't left on the skin.

After ‘gentle cleaning’, your bottom should be clean and dry and if cleaning is done correctly ‘tram-lining’ of your pants never occurs!

If the soreness and itching occurs at night, clean before going to bed. When you pass wind, this can cause minor leaks of stool requiring further cleaning. 

Itching can be a very difficult symptom to treat and is then called 'pruritis ani'. If gentle cleaning doesn't work it may require treatment with a dilute steroid creams which you can buy from your local pharmacist.   

Note Simple ‘aqueous’ wipes are almost as good for cleaning when you are not at home.  Don't use baby wipes as they contain additives, which could cause an allergy.

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