Anal Pain After Radiation Therapy

Radiation therapy can be used to treat local rectal and anal tumors. It is the foremost treatment modality for people with stage 0 anal cancer, and is frequently used along with chemotherapy to treat rectal cancers. However, like almost every treatment option, there is the risk of adverse effects with any amount of radiation therapy. 

After your initial course of radiation therapy you may endure some transient anal pain, which some people describe as a "stabbing pressure".

If you haven't already discussed this symptom with your doctor, don't hesitate to bring it up. Your radiation oncologist might be able to make subtle changes to your radiation dose, frequency and targeted area if the anal pain is precluding your desire for treatment.

It is also not uncommon to experience anal pain from radiation weeks or months after your therapy is completed. In some cases, there is little to no discomfort throughout radiation therapy, but the pain can start as late as months following your treatment and become chronic -- although this is not common. Diagnosed as radiation proctitis, chronic rectum and anal pain after therapy is rare.

Avoid Constipation

During radiation treatment you may experience diarrhea, which means you can pass frequent, non-formed or liquid and uncomfortable stools. Try to avoid over zealous use of toilet paper to cleanse your bottom, as it can only increase your discomfort in the area.

You could try using a disposable warm water bottle with a nozzle-top as a makeshift bidet for the frequent cleansing, or pre-moistened towelettes that can be flushed. 

Your diet can play a part during therapy and certain foods might increase your discomfort. Try avoiding high residue foods such as seeds, beans and nuts, as well as very acidic foods like chocolate or tomatoes.

If you have a certain trigger food that upsets your stomach, avoid it as well. A food diary can help you discern which foods (if any) impact your bowels and anal comfort the most over time. 

Perianal Care for Comfort

The delicate tissues of your anus require gentle treatment during and after your therapy. Your anal tissue is sensitive to begin with -- it becomes even more delicate after weeks of radiation treatment, which can irritate, thin and dry out the skin. Read the labels before using any products on the skin nearby and avoid anything including alcohol or perfumes in the ingredient list. Alcohol can hide under many guises to include:

  • Isopropyl 
  • Ethyl 
  • Ethanol 

Likewise, if the listed ingredients include any type of fragrance, there is a perfume in the product and it should be avoided.

Keep It Clean and Dry 

Avoid harsh antibacterial soaps and stick with warm water and gentle soaps -- such as glycerin based soaps. You might also consider using baby soap or body wash. A gentle pat dry is all that is needed -- excessive rubbing will further irritate the skin.

Health care providers have mixed opinions on whether or not to use sitz baths for anal discomfort after radiation. Although the gentle soaking of the anal tissues can help promote cleanliness, you might further irritate or excoriate the skin with moisture. 

If you are incontinent, make sure to change your brief frequently and keep the perianal area dry. Constant exposure to urine to irritate the anal tissues and eventually lead to skin break down in the area. Report any open areas of skin to your doctor without delay. 

Avoid Steroid Creams

Do not try to self medicate and apply any over the counter creams or lotions to the area. Some creams, such as topical steroid creams for minor irritations, can make the discomfort worse. What you might try using is a small, donut shaped cushion for sitting. The shape of the cushion removes pressure for your anal tissues and rectum and may improve your comfort. 


American Cancer Society. (n.d.). Radiation Treatment for Colorectal Cancer. Accessed online April 24, 2015.

International Foundation for Functional Gastrointestinal Disorders. (n.d.). Radiation Induced Injury to the Colon and Rectum. Accessed online April 26, 2015.

National Cancer Institute. (n.d.). Anal Cancer Treatment. Accessed online April 26, 2015.

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