What your BUM can reveal about your health – from ‘silent killers’ to agonising hip and back pain

IT turns out there’s more to your bum than meets the eye - and we’re not just talking about those backsides hitting the headlines.

Whether it’s Kim Kardashian’s ‘internet-breaking’ derrière or J.Lo’s iconic posterior that’s inspired gym-goers, society is rather fascinated with what’s behind us. 

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But beyond aesthetics, your bum is a key player in your overall health, we’ll have you know.

Whether it’s an incessant itch, blood on the toilet paper or uncomfortable toilet trips, it’s important to listen to your butt, especially if your symptoms are embarrassing.

It might not be the most glamorous of topics, and certainly one you might dread taking to your GP.

But as the late Sun columnist and bowel cancer campaigner Dame Deborah James told us time and again "don't die because you're shy".

The mum-of-two who died of bowel cancer in June 2022 spent the years between her diagnosis and death urging the world to to talk about poo (and where it comes from, for that matter) - to break the taboo, and ensure people seek help when they have symptoms of cancer.

Because when it comes to cancer - and other serious diseases - if you catch it early enough, it could save your life.

The NHS advises seeking an urgent GP appointment if you notice blood in your poo or bleeding from your bottom for more than three weeks.

This, as well as changes to your loo habits (going more or less, constipation or diarrhoea), weight loss, extreme tiredness and a lump or pain are all signs of bowel cancer.

You should also make an appointment if you have haemorrhoids, a very high temperature or you feel hot and shivery and generally unwell.

Pus leaking from your piles and severe anal pain are also signs to seek urgent medical help.

So, let’s take a look at what your behind might be trying to tell you…

1. RED ALERT

NOTICED blood coming from your bottom? 

It could be a sign of haemorrhoids, also known as piles, or an anal fissure - that’s a small tear, to you and I.

Lucy Allen, ’s consultant pelvic floor specialist and physiotherapist, says that haemorrhoids are very common.

They are small, pea-sized lumps found either just inside, or around the outside of your anus - in some cases you can grab them.

“To prevent getting them, don't spend too long on the toilet (and avoid taking your phone to the loo!) and don’t strain repeatedly,” Lucy says.

“If you do suffer from haemorrhoids, over-the-counter treatments such as Anusol can help settle the inflammation and itchiness within a week.”

An anal fissure is a tear or open sore (ulcer) that develops in the lining of the large intestine, near the anus, which can also cause bright red blood to appear either in poo or on the toilet paper. 

It can also cause a sharp pain when you poo that lasts for hours afterwards.

There are several causes of an anal fissure, from persistent diarrhoea to childbirth and an STI.

Look at your diet and ensure you’re having plenty of fibre including more seeds, nuts and pulses to help things along

Lucy AllenWype’s consultant pelvic floor specialist & physiotherapist

But the main one is constipation, with hard stools causing tears.

See your GP (they are used to dealing with these issues) who can check it out and prescribe medicines to help you ‘go’ easier, allowing for the tear to heal. But they may refer you to a specialist, too.

To shift constipation, up your fibre intake with legumes like chickpeas and lentils, whole grains such as oats and veg such as broccoli, carrots and potatoes.

Whatever you do, don’t ignore blood - it is a red-flag symptom of potential bowel cancer. 

Sarah Sweenie, health information and evidence manager for , says: “Bowel cancer is the fourth most common cancer in the UK but it’s treatable and curable if diagnosed at an early stage. 

“That’s why it’s so important that you know which signs and symptoms to look out for so you can go to your GP.

“Symptoms can include bleeding from your bottom, blood in your poo, a change in how often you poo, or regularly having diarrhoea or constipation, losing weight, feeling very tired all the time and a pain or lump in your tummy.”

Don’t just keep a look out for bright red blood either, darker brown or black traces of blood, can be a sign of tumours further up the digestive tract. 

Any changes, or worries, see your GP for a check up.

2. FEELING FLAT

FROM the ‘bubble butts’ of Kim Kardashian and J-Lo to the more slender behinds of Taylor Swift and Miley Cyrus, bottoms come in all shapes and sizes.

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And some can actually give insights into your health.

For example, a flatter bum can signal weak glute muscles, which in turn can end up causing knee, ankle, lower back and even hip pain. 

This is because the glute muscles aren’t doing their job properly, so more stress is placed on other muscles which ends up leading to aches and strains. 

“A flat bum can be an indicator of low overall strength,” says a plastic and craniofacial surgeon and co-founder of Healthspan Digital and Beautyspan.

On the other hand, a peachy, perky, round bottom “suggests someone who has spent time over years exercising their core, leg and buttock muscles”, says Dr Goldberg.

“This is a good indicator for long-term strength, stability, hormone levels, and brain function.”

He explains that muscles are an endocrine organ, meaning that they secrete hormones.

Plus, muscle mass can actually have a positive impact on many areas of health, which contributes to cognitive function - yes, your brain!

“It has been shown that following an exercise program is actually very effective at reversing the symptoms of Alzheimer's disease and dementia.”

He adds: “In men, poorly developed trunk muscles, which includes the glutes, can indicate low testosterone levels and low muscle mass also is a cause of long-term cognitive decline.

“The largest muscles have the most impact on testosterone and other hormone levels, so these ones are particularly important.”

To boost your muscle mass, lower body weight-bearing exercises can help.

If you have a wide bum, with fat on the outer hips, Dr Goldberg says this may indicate you have high body fat (as opposed to muscle).

“This could cause insulin resistance and eventually type 2 diabetes,” he warns.

Working towards losing excess weight can be helpful here; limit processed foods and alcohol, and look to eat a diet that consists of whole grains, lean proteins (such as chicken, turkey, fish, eggs, beans and tofu) and plenty of colourful fruits and vegetables.

On the other hand, if your bum seems to be hanging low with excess skin and sagging, this can be a typical sign of ageing.

“This often also means low muscle mass,” says Dr Goldberg.

Resistance-based exercises can help bolster the bottom, whether with your own bodyweight, resistance bands or dumbbells.

Squats, lunges and deadlifts are particularly beneficial for the glutes and legs generally.

Not sure exactly how to do them? YouTube videos can be a useful starting point.

3. ITCH YOU CAN’T SCRATCH

GOT ants in your pants?

“An itchy bottom (anus) can cause genuine misery if not properly treated,” says James Kinross, chief medical officer at Wype and leading consultant colorectal surgeon at , London.

According to James, the two most common reasons for an itchy anus are haemorrhoids or dermatitis of the skin around the anus.

If you think you’re suffering from anal dermatitis, there are some things you can do to help.

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Gently wash and dry the anus after going for a number two, and before bed - but only use water or an unscented soap, because typical body washes can be drying on the skin.

It’s also important to wear loose, cotton underwear. 

A pharmacist can recommend products too, but see a GP if things don’t improve. 

Other than dermatitis, causes can include threadworms (though this is more commonly seen in children) or an STI.

Lucy says that itching can be caused by tiny fragments of stool that have been left behind.

She says: “This is particularly common when the stool is looser or stickier and needs lots of wiping. 

“It's really important that we're not over-wiping with dry toilet tissue because that's just going to make that dryness and irritation worse.”

Excessively using wet wipes won’t help either, the NHS says. 

4. PELLET POOS

HEALTHY stools are those that are classed as a Type 3 or 4 on the Bristol Stool Chart.

To put it simply, it should look like a sausage (smooth and soft or with some crack on it).

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“This means an ideal stool should be well-formed, but soft and you should not have to strain to pass it,” says James.

“The key thing is that you feel satisfied after passing it,” adds Lucy. 

“Hard dry large or pellet-like stools that aren’t easy to pass could be a sign that the poo has been hanging around too long in the bowel.”

Turn your pellet poo into a healthier stool by drinking at least two litres of water each day. 

Lucy says: “Keeping active will also help with regularity. 

“Look at your diet and ensure you’re having plenty of fibre including more seeds, nuts and pulses to help things along.”

Prunes and dried fruit are high in fibre, too.

If hitting the daily recommended 30g of fibre per day is tricky, James suggests using add-ons to your meals, for example, put flaxseeds onto yoghurt.

“If this doesn’t work you may need to take an over-the-counter stool softener,” he says.

5. LOOSEN UP

LIQUID or very loose stools are classed as Type 6 or 7 on the Bristol Stool Chart.

If this sounds familiar, you may want to bulk out your number twos with a few dietary tweaks.

James says: “Try and bulk your stools with some psyllium husk (a natural dietary fibre powder).”

You’ll want to focus on soluble fibre, which helps make your stools firmer (yes, you’ll want to try fibre, even if it feels like that will make you go ‘more’!)

This type of fibre creates a gel-like substance in the digestive system which binds stool together more.

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Examples include oats, ripe bananas, carrots, rice, white bread and apples and potatoes without the skin.

Think of the acronym BRAT for loose stools: bananas, rice, apples and toast.

James says: “Avoid foods that make it worse such as foods high in animal fats, spicy foods and alcohol.”

If your loose stools don’t improve, it’s worth ruling out other medical conditions including coeliac disease or an autoimmune disease triggered by gluten. 

Book an appointment with your GP who can guide you on the next steps. 

6. FEELING THE STRAIN?

PUSHING on the toilet but finding that you still can’t poo? 

If this is a change in your usual bowel habits, then James says it’s best to seek help from your GP. 

Lucy suggests increasing your fibre intake which can make stools easier to pass. 

Regular exercise and also stress reduction can also impact how comfortably you go for a number two. 

James says: “In both men and women the reflexes that initiate defecation can also stop working, or the muscles can become too tight.

“Straining and constipation can also be caused by problems in the pelvic floor.”

Visit your GP who may refer you to a pelvic floor specialist, but give at-home exercises a try too.

There are now apps, such as the NHS-approved Squeezy (£2.99) that has programmes designed by physiotherapists, with notification reminders.  

Your position on the toilet can also impact how easily you ‘go’.

Lucy explains: “Ensure you’re relaxed, rest forward on your forearms and gently push down into your bottom. 

“So many people strain down but this puts excessive pressure on your pelvic floor. Focus the gentle push into your bottom and it’s much more effective.”

7. BLOWING A GALE 

CAN’T stop farting? According to Lucy, it’s normal to fart anywhere between five and 10 times a day. 

“Some foods give off more gas during digestion,” says Lucy.

Onions, garlic, broccoli, asparagus and cabbage are just some of the foods that can make you gassy.

Foods high in sulphur eggs may also cause particularly smelly farts.

Lucy adds: “If you’re suffering excessive wind, burping or farting and there’s bloating, it can be a sign of SIBO (small intestinal bacterial overgrowth) which can be tested for and treated with antibiotics.”

SIBO is a lesser-known condition that has a range of symptoms that affect daily life, including excess gas, bloating, constipation, weight loss and nutritional deficiencies.

Bacteria grow in excess when digestion slows down.

Selena Gomez, pop star and actress, shared that she has SIBO, responding to trolls who body-shamed her on the red carpet.

Visit your GP if you’re concerned who can advise you on next steps.