What is it about ?
Pain in the area of the anus or rectum is a very common symptom. People sometimes wait a long time to see a doctor, out of shame and fear of the test.
In most cases, anal pain is caused by a mild condition. The 2 most common causes are anal fissures and the hemorrhoids.
A anal fissure is a tear in the lining of the anus, usually caused by passing hard stools. There is often a contraction (spasm) of the circular muscle (sphincter) during or after having a bowel movement, which is obviously very painful with each bowel movement.
The hemorrhoids correspond to dilated blood vessels (varicose veins) in and around the anus.
Other possible causes of anal pain are a abscess, a inflammation of the colon or rectum, a tumor, the pelvic floor spastic syndrome and a descent of the rectum through the anus (rectal prolapse).
How to recognize them?
You may only experience anal pain when you have a bowel movement, but you may also have it all the time. You may have other symptoms, such as itching, from bleeding, diarrhea, need to have a bowel movement, uncontrolled loss of stool (faecal incontinence) or cramps.
The pain can come on very suddenly or develop over time. If you suffer from abscess, you may also have a fever. A chronic diarrhea or cancer is often accompanied by weightloss.
How is the diagnosis made?
The doctor will start by asking you questions about the pain and the associated symptoms. It is possible that he will perform a digital rectal examination. Try to relax as much as possible so that the doctor can examine you as well as possible.
He will first examine whether the cause of the pain is visible from the outside, as in the case of anal fissures orhemorrhoids. Then, if the pain permits, the doctor will perform a digital rectal examination. The examination consists of inserting a finger into the anus in order to palpate certain internal organs, the wall of the last part of the colon and to estimate the tone of the anal sphincter.
If deemed necessary, the doctor will perform a rectoscopy (or anoscopy), i.e. an examination of the interior of the anus by means of a camera.
What can you do ?
Drink enough, choose foods high in fiber, and get enough exercise to promote healthy bowel movements. In many cases, this is enough to prevent the development of a condition in the anal area. If you still feel pain, see a doctor for the correct diagnosis.
What can your doctor do?
Treatment for anal pain depends on its cause. When complaints are severe, surgery is needed in most cases. It is rare that local application of ointments or medication is sufficient. Except in case of anal fissures, for which you can use an ointment that helps relax the sphincter.
Ointments for hemorrhoids alleviate symptoms, but do not cure hemorrhoids. If you suffer from hemorrhoids, first of all try to encourage loose stools and follow certain hygiene measures.
In case of excessive sphincter contraction, treatment with muscle relaxants or a physical therapy exercise program may provide some relief.
Want to know more?
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