Anal Pain: Causes, Diagnosis & Treatment

Overview

The digestive system, including the rectum and anus

What is anal pain?

Anal pain is pain that occurs in or around the anus and rectum (the last section of the large intestine that ends in the anus). Pain and bleeding from the rectum often accompany anal pain. People may feel embarrassed to ask their doctor about anal pain, but it is a common symptom of many different medical conditions and is usually easily treated.

Symptoms and Causes

What causes anal pain?

Many different conditions can cause anal pain. Most symptoms are minor and will go away quickly with treatment. In rare cases, anal pain is a symptom of a more serious condition, such as anal cancer.

Common causes of anal pain include:

• Anal abscess: An infected cavity caused by a blockage of glands in the anus
• Anal fistula: A small tunnel connecting the infected gland in the anus to an opening on the skin around the anus
• Anal fissure: Small tear in the lining of the anus, like a paper cut
• Hemorrhoids: Swollen veins in the rectum or anus
• Infections: Bacteria or viruses, including fungal infections and sexually transmitted diseases
• Inflammatory bowel disease: Conditions such as Crohn’s disease (the intestine becomes inflamed and marked with sores) or ulcerative colitis (tiny ulcers in the colon and rectum that flare up periodically and cause bloody stools and diarrhea)
• Levator ani syndrome: Muscle spasms and pain around the anus
• Pelvic floor dysfunction: When the muscles of the pelvic floor don’t relax properly
• Skin conditions: Disorders such as psoriasis and warts

Diagnosis and Tests

How is anal pain diagnosed?

Doctors diagnose anal pain in several ways:

• The patient’s medical history, including symptoms
• Physical examination
• Rectal exam: A doctor inserts a finger into the rectum to feel for abnormalities.
• Endoscopy: The doctor uses a thin, flexible tube with a camera to look at the lining of the rectum.

Management and Treatment

How is anal pain treated?

Treatment for anal pain depends on the cause, and includes:

• Medicines such as pain relievers, stool softeners and antibiotics (if there is an infection)
• A high-fiber diet to help ensure soft bowel movements
• Sitz baths with warm water to clean the anal area and relieve pain
• Surgery for muscle spasms and to repair fistulas

Other methods that may help manage the pain include the following:

• To protect the skin, avoid wiping too vigorously after a bowel movement.
• Don’t use perfumed soaps or scented detergents. These may irritate the skin.
• Don’t wear tight clothing so that the anal area can “breathe.”
• To help prevent hemorrhoids, try not to sit for too long.

Living With

When should I call the doctor about anal pain?

Many causes of anal pain do not need to be treated by a doctor. Contact your doctor about anal pain that:

• Accompanies a lump or mass;
• Does not feel better after 3 or 4 days;
• Occurs with bleeding from the rectum;
• Is severe enough to interfere with daily activities or wake you at night;
• Returns after going away.

Anal Pain: Causes, Diagnosis & Treatment

Overview

The digestive system, including the rectum and anus

What is anal pain?

Anal pain is pain that occurs in or around the anus and rectum (the last section of the large intestine that ends in the anus). Pain and bleeding from the rectum often accompany anal pain. People may feel embarrassed to ask their doctor about anal pain, but it is a common symptom of many different medical conditions and is usually easily treated.

Symptoms and Causes

What causes anal pain?

Many different conditions can cause anal pain. Most symptoms are minor and will go away quickly with treatment. In rare cases, anal pain is a symptom of a more serious condition, such as anal cancer.

Common causes of anal pain include:

• Anal abscess: An infected cavity caused by a blockage of glands in the anus
• Anal fistula: A small tunnel connecting the infected gland in the anus to an opening on the skin around the anus
• Anal fissure: Small tear in the lining of the anus, like a paper cut
• Hemorrhoids: Swollen veins in the rectum or anus
• Infections: Bacteria or viruses, including fungal infections and sexually transmitted diseases
• Inflammatory bowel disease: Conditions such as Crohn’s disease (the intestine becomes inflamed and marked with sores) or ulcerative colitis (tiny ulcers in the colon and rectum that flare up periodically and cause bloody stools and diarrhea)
• Levator ani syndrome: Muscle spasms and pain around the anus
• Pelvic floor dysfunction: When the muscles of the pelvic floor don’t relax properly
• Skin conditions: Disorders such as psoriasis and warts

Diagnosis and Tests

How is anal pain diagnosed?

Doctors diagnose anal pain in several ways:

• The patient’s medical history, including symptoms
• Physical examination
• Rectal exam: A doctor inserts a finger into the rectum to feel for abnormalities.
• Endoscopy: The doctor uses a thin, flexible tube with a camera to look at the lining of the rectum.

Management and Treatment

How is anal pain treated?

Treatment for anal pain depends on the cause, and includes:

• Medicines such as pain relievers, stool softeners and antibiotics (if there is an infection)
• A high-fiber diet to help ensure soft bowel movements
• Sitz baths with warm water to clean the anal area and relieve pain
• Surgery for muscle spasms and to repair fistulas

Other methods that may help manage the pain include the following:

• To protect the skin, avoid wiping too vigorously after a bowel movement.
• Don’t use perfumed soaps or scented detergents. These may irritate the skin.
• Don’t wear tight clothing so that the anal area can “breathe.”
• To help prevent hemorrhoids, try not to sit for too long.

Living With

When should I call the doctor about anal pain?

Many causes of anal pain do not need to be treated by a doctor. Contact your doctor about anal pain that:

• Accompanies a lump or mass;
• Does not feel better after 3 or 4 days;
• Occurs with bleeding from the rectum;
• Is severe enough to interfere with daily activities or wake you at night;
• Returns after going away.

Anal Pain: Causes, Diagnosis & Treatment

Overview

The digestive system, including the rectum and anus

What is anal pain?

Anal pain is pain that occurs in or around the anus and rectum (the last section of the large intestine that ends in the anus). Pain and bleeding from the rectum often accompany anal pain. People may feel embarrassed to ask their doctor about anal pain, but it is a common symptom of many different medical conditions and is usually easily treated.

Symptoms and Causes

What causes anal pain?

Many different conditions can cause anal pain. Most symptoms are minor and will go away quickly with treatment. In rare cases, anal pain is a symptom of a more serious condition, such as anal cancer.

Common causes of anal pain include:

• Anal abscess: An infected cavity caused by a blockage of glands in the anus
• Anal fistula: A small tunnel connecting the infected gland in the anus to an opening on the skin around the anus
• Anal fissure: Small tear in the lining of the anus, like a paper cut
• Hemorrhoids: Swollen veins in the rectum or anus
• Infections: Bacteria or viruses, including fungal infections and sexually transmitted diseases
• Inflammatory bowel disease: Conditions such as Crohn’s disease (the intestine becomes inflamed and marked with sores) or ulcerative colitis (tiny ulcers in the colon and rectum that flare up periodically and cause bloody stools and diarrhea)
• Levator ani syndrome: Muscle spasms and pain around the anus
• Pelvic floor dysfunction: When the muscles of the pelvic floor don’t relax properly
• Skin conditions: Disorders such as psoriasis and warts

Diagnosis and Tests

How is anal pain diagnosed?

Doctors diagnose anal pain in several ways:

• The patient’s medical history, including symptoms
• Physical examination
• Rectal exam: A doctor inserts a finger into the rectum to feel for abnormalities.
• Endoscopy: The doctor uses a thin, flexible tube with a camera to look at the lining of the rectum.

Management and Treatment

How is anal pain treated?

Treatment for anal pain depends on the cause, and includes:

• Medicines such as pain relievers, stool softeners and antibiotics (if there is an infection)
• A high-fiber diet to help ensure soft bowel movements
• Sitz baths with warm water to clean the anal area and relieve pain
• Surgery for muscle spasms and to repair fistulas

Other methods that may help manage the pain include the following:

• To protect the skin, avoid wiping too vigorously after a bowel movement.
• Don’t use perfumed soaps or scented detergents. These may irritate the skin.
• Don’t wear tight clothing so that the anal area can “breathe.”
• To help prevent hemorrhoids, try not to sit for too long.

Living With

When should I call the doctor about anal pain?

Many causes of anal pain do not need to be treated by a doctor. Contact your doctor about anal pain that:

• Accompanies a lump or mass;
• Does not feel better after 3 or 4 days;
• Occurs with bleeding from the rectum;
• Is severe enough to interfere with daily activities or wake you at night;
• Returns after going away.

Soothing Relief for Anal Discomfort

Treating Diarrhea and Constipation

If you’re dealing with anal discomfort due to diarrhea or constipation, treating those conditions will also relieve anal itch or pain. Work with your doctor on dietary changes, dietary supplementation, or a trial of medication.

“Fiber supplements can be helpful and you can use them every day but I don’t recommend taking more than the suggested dose, as that can cause bloating in some people,” says Arun Swaminath, MD, director of the Inflammatory Bowel Disease Program at Lenox Hill Hospital in New York City.”

You may also be advised to try:

• Anti-diarrheal medications
• Boosting dietary fiber intake with whole-grain foods and more vegetables and fruits

Relieving Anal Discomfort

There are also steps you can take to relieve anal discomfort quickly. Try these tips:

• Keep the area clean. It’s important to keep the anus clean of any fecal matter, but avoid using soaps that can further irritate sensitive skin. Warm water can work wonders. Try taking a sitz bath, sitting in a shallow tub of warm water for 15 minutes several times a day when the anus is irritated. Allow the area to air-dry or gently dab with a clean towel rather than rubbing.
• Apply a cream or ointment that creates a protective barrier. Protecting your sensitive, sore skin from exposure to feces with a cream barrier can ease anal discomfort and itch. Your doctor may recommend a prescription cream or an over-the-counter ointment.
• Sprinkle it with powder. Apply a little dusting of cornstarch or unmedicated talcum powder to the area to keep it comfortable.
• Let the air in. Moisture can further irritate the thin skin of the anal area. Wearing loose-fitting clothing and cotton underwear can allow air to circulate, which can be soothing.
• Don’t wipe with dry toilet tissue. Instead, try a moist towelette that slides along the skin and doesn’t pull at it. Make sure it doesn’t contain alcohol, which is drying and can further aggravate skin.
• Soothe with a numbing agent. Rubbing in a cream or ointment that contains witch hazel can numb sore hemorrhoids and relieve anal discomfort, while hydrocortisone creams can alleviate anal itch. However, check with your doctor before using these types of creams.
• Avoid re-injury. If you’re still straining to have a bowel movement while your hemorrhoids or anal fissures are healing, you’ll probably be in significant pain. You also run the risk of getting another hemorrhoid or re-opening your anal fissure before it is healed. Taking a stool softener can make bowel movements easier to pass while anal fissures and hemorrhoids heal.
• Apply an ice pack. Not only will this reduce anal discomfort, it will also help to alleviate the painful swelling of hemorrhoids.
• Take a pain reliever. Using an over-the-counter pain-relieving medication, like ibuprofen or acetaminophen, can help manage anal discomfort and pain.

These fixes can only temporarily relieve anal discomfort, itch, and pain. You’ll need to identify the cause of the pain and resolve your digestive health issue to effectively treat the source of your anal discomfort.

Read more: Hemorrhoids: What to Know

Anal pain – NHS

Common causes of anal pain

Anal fissures

An anal fissure is a small tear in the skin of the anus that can be caused by passing a large or hard poo.

Symptoms of an anal fissure include:

• a severe, sharp pain when doing a poo
• a burning or gnawing pain that lasts several hours after doing a poo
• rectal bleeding – you may notice a small amount of blood on the toilet paper after you wipe

Anal fissures can be very painful, but many heal on their own in a few weeks.

Eating more fibre, drinking plenty of fluids and taking laxatives and over-the-counter painkillers can help.

If the pain persists, you may need special ointment that relaxes the ring of muscle around your anus.

Occasionally, you may need surgery to help the fissure heal.

Read more about treatments for anal fissures.

Piles (haemorrhoids) 

Piles) are swollen blood vessels that are found inside or around your bottom (anus). They’re often thought to be caused by straining on the toilet as a result of constipation.

In many cases, piles do not cause symptoms. If you do have symptoms, they may include:

• bleeding after doing a poo
• an itchy bottom
• feeling like there’s a lump in or around your anus
• soreness and redness around your anus
• anal pain, if the blood supply to the pile becomes blocked

The symptoms often pass after a few days. Eating more fibre, drinking plenty of fluids and taking laxatives and over-the-counter painkillers can help.

If the blood supply to the pile has been blocked by a clot, a simple procedure can be carried out to remove the clot under local anaesthetic (where the area is numbed).

Read more about treatments for haemorrhoids. 

Anal fistulas and abscesses

An anal fistula is a small tunnel that develops between the end of the bowel and the skin near the anus. It’s usually caused by an infection near the anus resulting in a collection of pus (an abscess).

Symptoms of an anal fistula or abscess can include:

• a constant, throbbing pain that may be worse when you sit down
• skin irritation around the anus
• passing pus or blood when you poo
• swelling and redness around your anus
• a high temperature

Your GP may prescribe antibiotics if an abscess is picked up early on. If it persists, it may need to be drained in hospital, possibly under general anaesthetic (while you’re asleep).

If a fistula develops, you’ll usually need surgery because they rarely heal by themselves.

Read more about treatments for anal fistulas.

When to get medical advice

Many common causes of anal pain improve with simple self-care treatments, so you do not always need to see your GP.

But it’s a good idea to see your GP if:

• your pain is severe
• your pain does not improve after a few days
• you have rectal bleeding

Do not feel embarrassed to see your GP – anal pain is a common problem that they’re used to seeing. Your GP can try to work out what the problem is and give you treatment advice.

They’ll probably ask to see your bottom and may carry out a rectal examination (where they gently insert a gloved finger into your bottom) to check for any abnormalities.

If the cause is not immediately obvious, they may refer you to a specialist for advice and further tests.

Rectal Problems in Women – American College of Gastroenterology

Overview

The rectum refers to the last four or five inches of the digestive tract. The rectal outlet or opening is called the anal canal or anus. Problems in this area are common, but many adults are too shy or embarrassed to ask their doctor about them. Fortunately, most of these problems are treatable when recognized early and properly diagnosed. Remember that symptoms of rectal pain or bleeding should always be thoroughly evaluated by your doctor.

Hemorrhoids

• What are hemorrhoids?

  Hemorrhoids are veins in the anal canal that can become swollen or stretched. Just like varicose veins in the lower legs, hemorrhoids often cause no problems.




• What are the different types of hemorrhoids?

  There are two types of hemorrhoids: external and internal.

  External hemorrhoids: are swollen veins that can be seen and often felt under the skin outside the anal canal. Usually they look like a small bulge and are the same color as the skin.

  Internal hemorrhoids are swollen veins that arise from inside the rectum. When internal hemorrhoids become large, they may prolapse (stick out) through the anal canal. The most common sign of hemorrhoids is bright red blood on toilet paper or drops of blood in the toilet bowel. A thrombosed hemorrhoid contains a blood clot and may cause painful burning, pressure, or even an intense urge to scratch the area.




• How do hemorrhoids develop?

  Hemorrhoids are very common. About half the American population has hemorrhoids by the age of 50 years. Hemorrhoids develop due to increased pressure often caused by straining to have a bowel movement. Hemorrhoids frequently develop in women during pregnancy when the developing fetus causes increased pressure on the rectal area. Chronic constipation, diarrhea, genetic factors, and aging may also lead to hemorrhoids.




• How are hemorrhoids diagnosed?

  As with all conditions involving the anal canal or rectum, the diagnosis is made by examining the anus visually and by performing a rectal examination (with a gloved finger). Following this, a lighted instrument is inserted into the canal so that the inside of the rectum may be visualized. This lighted tube may be an anoscope (a short tube which can examine the last few inches of the rectum) or a sigmoidoscope (a longer flexible tube that can also examine the lower part of the large intestine).




• How are hemorrhoids medically treated?

  Eliminate constipation: Bowel movements should be soft and should pass without need to strain. Constipation is usually caused by insufficient bulk in the bowel movement. Increasing water intake, dietary fiber (see table below) and exercise are often effective remedies.

  Creams and suppositories: Preparation-H^® or Anusol^®.

  Sitz baths: Sit in a tub of warm water several times a day, then gently blot the anal area dry.

  Gentle cleaning after a bowel movement: For instance, cotton balls soaked in witch hazel, a moist wash cloth, or moist towelettes can be used.

  Things to avoid: irritating soaps, spicy foods and coffee.

  Sources of Dietary Fiber

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  Sources of Fiber	Serving	Gm/serving
  Vegetables & Beans
  Green beans	½ cup	2
  Kidney beans	½ cup	5
  Broccoli	½ cup	2.5
  Brussel sprouts	½ cup	3.5
  Carrots	½ cup	2.5
  Corn	½ cup	3.0
  Green peas	½ cup	3.5
  Lettuce	½ cup	0.5
  Potato (with skin)	½ cup	2. 0
  Fruits
  Apple	medium	2.5
  Banana	1	2.0
  Blackberries	1 cup	2.0
  Cantaloupe	1 wedge	1.0
  Dry Figs	3.5 ounces	18
  Grapefruit	medium	3.5
  Grapes	1 cup	1
  Orange	1 medium	3
  Pear	1 medium	4.5
  Prunes	1 cup	13.5
  Raspberries	1 cup	6.0
  Strawberries	1 cup	3.5
  Grain Products
  Bread, white	1 slice	0. 5
  Bread, whole wheat	1 slice	2.0
  Kellogg’s All-Bran®	1 ounce	9-14
  General Mills Fiber®	1 ounce	12
  Kellogg’s Bran Flakes®	1 ounce	4
  Cereal, Cornflakes®	1 ounce	0.5
  Cereal, oat bran	1 ounce	4
  Shredded wheat	1 ounce	2.5
  Crackers, Graham®	4 squares	1
  Crackers, Saltine®	10 regular	1
  Rice, brown	½ cup	5
  Rice, white	½ cup	1.5
  Spaghetti	2 ounces	2. 5
  Fiber Supplements
  Psyllium (i.e., Metamucil®, Konsyl®)	1 tsp	3.4-6
  Polycarbophil (i.e., Fibercon®, Perdiem®)	1 tsp	4.0

  The goal is 30-35 grams of fiber per day. The average American diet contains only 10-20 grams.

  Endoscopic & Surgical Treatment for Hemorrhoids

  When hemorrhoids bleed excessively or are very painful they can be treated with surgery.

  • Banding: a rubber band is placed around the hemorrhoid and causes strangulation followed by scarring.
  • Sclerotherapy: injection of a chemical solution into the hemorrhoid causing them to shrink.
  • Infrared coagulation: a special device used to destroy the internal hemorrhoid.
  • Radiofrequency ablation: a device that uses high-intensity sound waves to close off the hemorrhoids.
  • Hemorrhoidectomy: surgical removal of hemorrhoid veins (commonly requires hospitalization).

Anal Fissure

• What is an anal fissure?

  This is a fairly common condition in which the lining of the anal canal becomes torn. This generally produces pain or a burning sensation, especially with passage of a bowel movement. Bleeding may also occur. A fissure usually occurs after the passage of a large, hard bowel movement.




• How is a fissure diagnosed?

  When an anal fissure is present, a digital examination is usually painful. The fissure can usually be visualized by external inspection of the anus, or a small scope (anoscope) can be used to determine the extent of the tear.




• How is an anal fissure treated?

  The best treatment is prevention; ingestion of a high-fiber diet to promote bowel regularity is of utmost importance.

  • Sitz baths several times day
  • Stool softeners
  • Creams and/or suppositories (i. e., Preparation- H^® or Anusol^®)
  • Some doctors will recommend nitroglycerine ointment or injection of botulinum toxin (Botox^®)

  Most fissures will heal within several weeks, but surgery may be necessary if symptoms persist. Surgery consists of cutting a portion of the anal sphincter muscle. This reduces tension of the anal sphincter and promotes healing. Risks of surgery include loss of bowel control, or accidental incontinence of stool.

Anal Abscess or Fistula

• What is an anal abscess/fistula?

  An abscess is a cavity filled with pus. This usually results from a blockage of the anal glands located just inside the anus. A fistula is a connection or tunnel between the anal gland and the buttocks, usually very close to the anal opening. An anal fistula is almost always the result of an anal abscess. There are other problems, such as Crohn’s disease, which may be the underlying cause of the fistula.




• What are the symptoms of an anal abscess/fistula?

  An abscess produces considerable pain and swelling just adjacent to the anal opening. Fever may also be present. A fistula produces drainage from the anal canal to the opening of the fistula on the buttocks.




• How is a fistula treated?

  Medical Treatment: When a fistula is caused by Crohn’s disease, your doctor may recommend treatment with medicines such as metronidazole azathioprine, or biological agents such as infliximab (Remicade^®) or Adalimnunab (Humira^®) or newer agents.

  Surgical Treatment: Generally, the sphincter muscle is cut to open the tunnel, thereby connecting the internal and external openings of the fistula. A groove is formed, which then slowly heals and forms scar tissue. During the healing process, stool softeners and Sitz baths are frequently recommended.

Fecal Incontinence

• What is fecal incontinence?

  Fecal incontinence is the accidental loss of stool. Causes of fecal incontinence in adults include back trauma, sphincter disruption as a result of accidents, anorectal surgery, or obstetrical trauma, and medical illness such as multiple sclerosis and diabetes mellitus. Many women have suffered nerve or muscle injury to the anal sphincter caused by forceps-assisted delivery, prolonged labor, or delivery of a large baby, and this can contribute to fecal incontinence.




• How is incontinence evaluated?

  The doctor should look at the anorectal area to see if there are any changes, scarring, fissures or prolapse (protrusion) of the rectum. A digital examination with the doctor inserting a finger into the rectum should be performed to determine if there is an impaction of stool, to assess muscle tone at rest and with squeeze effort, and to exclude a rectal mass.

  Anal manometry is a specialized test that can measure the pressures generated by the anal sphincter muscles at rest and with maximal squeeze effort. X-rays may identify physical abnormalities of muscle function. This examination involves the placement of barium paste simulating stool into the rectum and asking the patient to defecate, strain or squeeze while taking x-ray pictures. Ultrasound can be used to evaluate the muscles and other structures of the anal area.




• How is incontinence treated?

  Treatments for incontinence include dietary modification, medicines, biofeedback and surgery. Avoid foods that promote production of gas, and foods containing ingredients such as lactose, fructose and sorbitol. Fiber supplements can increase bulk and add form to the bowel movement and result in improved control. Kegel exercises to strengthen the pelvic floor muscles may improve anorectal control. Loperamide or diphenoxylate HCl may decrease stool volume and frequency, improve stool consistency, or perhaps directly affect the sphincter muscles.




• What is biofeedback?

  Biofeedback is a conditioning technique. Patients are taught how to work and strengthen the sphincter muscles. For successful results, the patient must be motivated, have some degree of rectal sensation, and intact nerve and muscle function of the anal sphincter.




• Is surgery helpful?

  Surgery is often considered as primary therapy if rectal prolapse is the cause of incontinence. Obstetrical injuries, trauma and disruption of the sphincter are usually managed by primary repair of the defect. Pre-operative testing of nerve and muscle function may help to identify those who may benefit from surgery.

Rectal Pain

• What are the causes of rectal pain?

  Rectal pain may result from structural conditions such as hemorrhoids, fissures, fistula or abscess.




• What is levator syndrome?

  The levator syndrome presents with an aching rectal pain related to spasm of the pelvic floor muscles. It is important for the doctor to evaluate the area to exclude inflammation or even an infectious problem. The levator syndrome is more commonly seen in women. The tenderness is often on the left side. Treatment consists of reassurance, application of heat, and local massage. Electro-galvanic stimulation may break the spasm pain cycle by delivering a high voltage-pulsed current using a rectal probe. Biofeedback has also been suggested for some patients.




• Are there other causes of rectal pain which should be ruled out?

  Another unusual cause of rectal pain is coccygodynia (pain in the tail bone). This may be the result of traumatic arthritis or may even result from child birth. This pain may be triggered by bowel movements. Other rare causes of rectal pain include tumors of the spine, pelvis and rectum and endometriosis.

Pruritus Ani

• What is pruritus ani?

  This refers to itching around the anal area. It is often most troublesome at night or following a bowel movement.




• What causes pruritus ani?

  Excessive cleaning or wiping of the anal area is common cause. Excessive sweating in the area around the anus is another cause. Certain beverages, including alcohol, citrus, and caffeine-containing drinks may aggravate the problem. Rarely, infectious and skin conditions can cause pruritus ani. Poor hygiene is usually NOT the cause. Unfortunately, when the problem develops, individuals often compound the problem by excessively washing and cleaning the anal area, only to aggravate the symptoms.




• How is pruritus ani treated?

  Avoid irritating soaps, especially those containing perfumes. Gently blot the area clean with a moist wash cloth, never excessively rub or scratch, and keep dry with powder. Eliminate irritating foods and beverages such as coffee, alcohol and spicy foods. Applying a paste consisting of zinc oxide and menthol can protect the perianal skin area and reduce itching.

  Arnold Wald, MD, MACG, University of Wisconsin School of Medicine and Public Health – Updated Spring 2017

Rectal Pain Specialist – Santa Monica, CA: S. Radi Shamsi, MD: Gastroenterologist: Los Angeles Gastroenterology Clinic

What are the causes of rectal pain?

The most common causes of rectal pain (or anal pain) are hemorrhoids, anal fissures, infections, lodged foreign objects, or bowel diseases, such as colitis, IBD, or IBS. It might even be as simple has a skin sensitivity caused by your laundry detergent, soap, or clothing material. There are other causes of rectal pain as well, so prompt diagnosis and treatment are essential.

Are there other symptoms associated with rectal pain?

The cause of your rectal pain will usually determine the symptoms you’re having. Most hemorrhoids only produce mild itching and discomfort, for instance. But if a clot forms in the hemorrhoidal tissue, severe pain can result.

If you have an anal fissure — which is a small cut or tear in the lining of your intestine or colon — there’s often a sharp pain when the fissure forms. Eventually, this becomes a dull, aching pain. An anal fissure will cause sharp pain during bowel movements, and you’ll sometimes have blood in your stool, on the tissue, or in the toilet bowl.

How is rectal pain diagnosed?

Most causes of rectal pain (or anal pain) can be diagnosed through a visual examination done by Dr. Shamsi during a quick office visit. If additional tests are needed or indicated, he’ll let you know. Usually they aren’t necessary.

Which treatment options are available for rectal pain?

Surgery, expensive medicines, or other costly treatments can often be avoided once Dr. Shamsi has determined the cause of your anal discomfort. Depending on the source, some over-the-counter medications may be recommended. Sometimes treatment such as sitz baths, modifying your diet — to include more fiber-rich foods — or the use of stool softeners, can all be done at home.

If necessary to relieve hemorrhoid discomfort, Dr. Shamsi may need to perform a procedure, such as an infrared coagulation (IRC), during a quick office visit. He might prescribe certain medications that are compounded by a specialized pharmacy. After your examination, he’ll provide you with full details about how to best treat your condition and how to prevent any reoccurrence.

90,000 Pain in the anus – causes, diseases, diagnosis, prevention and treatment – Likar24

Rectal pain may appear in the anus, rectum, or lower gastrointestinal tract. This pain is common and the causes are rarely serious. This often leads to muscle spasm or constipation. Sometimes rectal pain is accompanied by other symptoms. They may include: itching, burning, discharge, bleeding.

Injury

In many cases, trauma to the rectum or anus is the result of anal sex or masturbation.It can also be the result of a particularly hard fall or injury during other physical activity. In addition to rectal pain, minor injuries can cause: bleeding, swelling, difficulty in defecation.

Sexually transmitted diseases

Infectious sexually transmitted diseases can spread from the genitals to the rectum, or the infection can be transmitted during anal sex.

STIs that can cause rectal pain: gonorrhea, chlamydia, herpes, syphilis, human papillomavirus.In addition to rectal pain, anal STIs can cause: minor bleeding, itching, soreness, and discharge.

Hemorrhoids

Hemorrhoids are a very common cause of rectal pain. Symptoms depend on where the hemorrhoids are located. Internal hemorrhoids can develop on the inside of the rectum, but can protrude through the rectum if it is large enough. Hemorrhoids cause only mild discomfort, but pain can become severe if the hemorrhoids become thrombotic.This happens when the blood clots in the hemorrhoid. There is an unpleasant throbbing or stabbing pain that starts suddenly and can last for several days. In addition to rectal pain, hemorrhoids can cause: itching or irritation, swelling around the anus, difficulty defecating, lumps or cystic bumps near the anus.

Anal fissures

Anal fissures are small fissures in thin tissue. Fissures develop when hard or heavy stools stretch the delicate lining of the rectum and tear the skin.They heal slowly because any bowel movements can further irritate the tissues. In addition to rectal pain, anal fissures can cause: bright red blood in the stool, itching around the anus, small lumps that develop at the fissure.

An anal fissure causes a cutting pain when it first occurs and turns into a dull pain that can last for hours.

Muscle spasm (proctalgia fugax)

Proctalgia fugax is rectal pain caused by muscle spasms in the rectal muscles.The pain of proctalgia fugax is sudden and severe, usually lasting less than a minute. But in rare cases, the spasm can last for an hour. The pain is described as sharp, stabbing, or spasmodic. In addition to rectal pain, proctalgia fugax can cause sudden severe spasms.

Anal fistula

The anus is surrounded by small glands that secrete an enzyme to keep anal skin healthy. If one of these glands becomes blocked, an infected cavity (abscess) can form.Nearly half of the abscesses around the anus develop into fistulas, or small tunnels, that connect the infected gland to the opening in the skin of the anus.

In addition to rectal pain, anal fistulas can cause: swelling around the anus and anus, difficulty in defecation, the passage of blood or pus during bowel movements, fever.

Perianal hematoma

Perianal hematomas are sometimes called external hemorrhoids. A perianal hematoma occurs when blood flows into the tissue around the anus.When the blood pulsates, it forms a lump in the anus. In addition to rectal pain, perianal hematoma can cause: lumps in the anus, bleeding, difficulty defecating, difficulty sitting or walking.

Solitary rectal ulcer syndrome

Solitary rectal ulcer syndrome is a condition that leads to the development of ulcers in the rectum. It is still unknown what causes this rare syndrome, but researchers believe it is related to chronic constipation.In addition to rectal pain, solitary rectal ulcer syndrome can cause: constipation, tension when passing feces, bleeding or other discharge, a feeling of fullness or pressure in the pelvis, inability to control bowel movements.

Tenesmus

Tenesmus is rectal pain caused by spasm. It is often associated with inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis. In addition to rectal pain, tenesmus can cause: spasms in and inside the rectum, difficulty in defecation.

Inflammatory bowel disease

This is a group of intestinal disorders that can cause inflammation, pain, and bleeding in the digestive tract, including the rectum. The two most common are Crohn’s disease and ulcerative colitis. Symptoms can change over time. In addition to rectal pain, these diseases can cause: abdominal pain and cramps, blood in the stool, constipation, diarrhea, fever, loss of appetite, weight loss.

Proctite

Proctitis causes inflammation in the lining of the rectum.In addition to rectal pain, proctitis can cause: diarrhea, a feeling of fullness or pressure in the rectum, bleeding or other discharge.

Fecal contamination

Fecal contamination is a common gastrointestinal problem that can lead to rectal pain. In addition to rectal pain, stool damage can cause: abdominal pain, bloating and rectal distention, nausea, and vomiting.

Rectal prolapse

Rectal prolapse occurs when the body loses its ability to hold the rectum in the gastrointestinal tract.When this happens, the rectum can protrude from the anus. In addition to rectal pain, rectal prolapse can cause: feces or mucus passing freely from the anus, constipation, bleeding.

Levator syndrome

Levator Syndrome (Ani Levator Syndrome) is a condition that causes pain in and around the anus. Pain is caused by spasms of the pelvic floor muscles. Pain in Ani’s levator syndrome is a constant dull pain that is felt higher inside the rectal passage.The sensation worsens when sitting and improves when walking or standing. The pain usually lasts about 20 minutes and usually recurs at regular intervals. In addition to rectal pain, levator syndrome can cause: pain in the left abdomen, pain in the vagina, bloating, pain in the bladder, pain when urinating, urinary incontinence.

Cancer

Rectal or anal cancer can also cause rectal pain. However, it is important to recognize other signs of rectal cancer: changes in bowel habits, rectal pain that gets worse or worse, blood in the stool, weight loss.

To diagnose the cause of rectal pain, your doctor will ask your medical history and symptoms that have occurred. He usually does a physical examination of the rectum. For this, palpation of the anus is used. However, further rectal examinations can be applied. This is the use of an instrument called an anoscope or sigmoidoscope, equipped with a camera and light at the end that allows you to see the inside of your intestines.

Imaging tests such as X-ray, CT, or MRI can be used to detect abnormalities such as tumors, abscesses, or fistulas.

Other diagnostic tests include anorectal manometry – a measurement of the mean pressure in the rectum.

Diseases of the rectal opening and gastrointestinal tract, in which rectal pain may occur: abscess, anorectal fistula, benign or malignant tumors, levator syndrome, proctalgia fugax, proctitis, pruritus, rectal prolapse, hemorrhoids, ulcerative colitis, Crohn’s disease.

Occasional rectal pain is rarely a cause of immediate concern.But if you feel regular pain in the rectum, it is worth making an appointment with a doctor. This could be a proctologist or a surgeon. See your doctor immediately if you feel rectal pain that worsens or spreads to the lower half of the body, or if you experience any of the following symptoms:

• fever;
• anal discharge;
• persistent bleeding;
• pain lasts longer than a few days;
• pain becomes severe or spreads to other parts of the body;
• a lump appeared in the anus;
• there was an injury to the anus.

Methods used for the prevention of gastrointestinal and rectal diseases:

• Eat high fiber foods, more fruits, vegetables, and whole grains. This softens the stool and increases its mass, which can help avoid tension, which can worsen symptoms. Add fiber to your diet slowly to avoid gas problems;
• Drink plenty of water, it promotes healthy digestion, helping to cleanse the entire system;
• Use a condom during intercourse to prevent STIs;
• for anal sex, use a special lubricant to moisturize;
• If you are overweight, make lifestyle changes to lose it and maintain a healthy weight;
• Quit smoking and drink less alcohol.

Rectal suppositories “Olestezin” – an effective drug for the conservative treatment of hemorrhoids

The pharmaceutical company “Altayvitamins” offers an effective drug for the conservative treatment of hemorrhoids – suppositories “Olestezin®”.

The complex composition of the drug “Olestezin®” allows you to stop many symptoms of the disease:

• quickly and effectively relieves pain and reduces discomfort;
• eliminates inflammation and restores the elasticity of the capillaries, which ensures the reduction of internal and external hemorrhoids;
• improves the process of blood coagulation and has a hemostatic effect;
• provides healing of cracks and regeneration of the mucous membrane.

Suppositories contain therapeutic components in such ratios that, when used together, provide the most pronounced therapeutic effect, and the used polyethylene oxide base promotes effective release of active active substances and their rapid absorption. At the same time, there are no undesirable effects and contraindications.

The proposed rectal suppositories “Olestezin®” have an additional therapeutic effect in comparison with the prototype: due to the unique selection of biologically active components, they provide relief of pain in the anus; have anti-inflammatory, antibacterial effects; promote the regeneration of epithelial cells.

Thus, the essential differences of the drug “Olestezin®” are:

• the introduction of sea buckthorn oil concentrate into the suppository formulation instead of sea buckthorn oil itself allows increasing the biological activity of suppositories, increasing vitamin nutrition of epithelial cells, which leads to acceleration of the healing process of inflammation foci;
• the introduction of anesthesin and etazole-sodium complex into the suppository formulation gives the finished suppositories anesthetic and bactericidal activity, as a result of which the processes of collagen biosynthesis and catabolism are stabilized; reduce damage to cells of granulation tissue, which ultimately has a positive effect on regeneration processes in the wound;
• the use of polyethylene oxide-1500 (base), tween-80 (emulsion stabilizer) and purified water as the structuring components of the suppository formulation makes it possible to obtain a suppository mass that not only meets the technology requirements, but also has additional healing properties due to the antibacterial properties of the base.

Clinical studies of Olestezin® suppositories were carried out in the clinical laboratory of the Research Institute of Traditional Treatment Methods of the Federal State Institution of the Ministry of Health of the Russian Federation (Moscow).

Rectal suppositories “Olestezin®” are recommended for clinical use of gastroenterological patients (proctosigmoiditis) and proctological patients with erosive sphincteritis, fissures of the anal region of the rectum, with proctitis, solitary ulcers, with normal or chronic (including) in the phase of exacerbation hemorrhoids, as well as after hemorrhoidectomy surgery, excision of anal fissures.

The analysis made it possible to establish that there are no analogs characterized by a set of features identical to all the features of Olestezin® rectal suppositories.

During the course of monotherapy in patients with hemorrhoids, the drug “Olestezin®” effectively relieves the main clinical symptoms of the disease, has a pronounced anti-inflammatory effect, stimulates the reparative processes of the mucous membrane, is well tolerated by patients.

The drug is recommended for medical use on the territory of the Russian Federation.

90,000 treatment and diagnosis of causes, symptoms in Moscow

General description

Anal fissure is a linear defect in the mucous membrane of the anal canal resulting from its hyperextension during the passage of a fecal lump. The ulcer defect causes sphincter spasm and severe pain. This is a common proctological disease, occurring in 20-25 cases per 1000 population. Its share in the structure of colon diseases is 15%.

Reasons

The cause of the appearance of anal fissures is mechanical overstretching or overstrain of the anal sphincter.This situation can arise in the following cases:

• long-term constipation
• repeated diarrhea
• the need to push hard during bowel movements
• pushing during childbirth
• anal sex.

In addition to mechanical factors, anal fissures can accompany inflammatory diseases affecting the anus. Trauma and surgery also increase the risk of anal fissure.

Symptoms of the development of anal fissure

• pain during bowel movement
• Insignificant blood excretion in the form of streaks on feces or paper
• anal itching

The cardinal symptom of anal fissure is pain during the act of defecation. The painful sensations are so intense that the patients cannot find a place for themselves. It lasts from several minutes to 2-3 hours and is provoked by any physical stress.There is a fear of defecation. Discharge of blood is insignificant in the form of streaks on feces or paper. In patients with chronic anal fissure, even after its epithelialization, anal itching may occur due to incontinence and faecal contamination of the skin. Sometimes the inflammatory process develops in the “sentinel” tubercle, simulating an exacerbation of external hemorrhoids. Examination of the patient is difficult due to persistent spasm of the sphincter. An anal fissure has to be differentiated from an incomplete internal fistula of the rectum.With such a fistula, the pain is less pronounced, and there is no sphincter spasm. Purulent discharge from the anus comes to the fore. If pain in the anal canal does not go away within 24 hours, you need to think about an intersphincteric abscess. Cracks can be a specific manifestation of Crohn’s disease, syphilis, tuberculosis, actinomycosis, AIDS.

Diagnostics

Diagnosis of anal fissure, as a rule, does not cause difficulties and is based on visual examination and digital rectal examination.In some cases, you can resort to anoscopy.

Prevention

To avoid the appearance of an anal fissure, it is necessary to minimize the risk factors leading to its occurrence, that is, to normalize the bowel function so that constipation and diarrhea do not occur. To do this, you need to follow a balanced diet with enough fiber and drink the required amount of fluids.

Treatment

Treatment of anal fissure can be medical and surgical.Sharp fissures are usually easy to treat conservatively.

Therapy includes the following items:

• Stool normalization by diet and, if necessary, laxatives,
• maintaining hygiene of the anal area, taking sitz baths after bowel movements (with clean warm water or with the addition of chamomile),
• use of local anesthetics for pain relief,
• Use of ointments based on diltiazem or nitroglycerin to relieve spasm of the anal sphincter.

If conservative treatment is ineffective, the crack does not heal or recurs many times, you can resort to surgical treatment.

The traditional [surgical treatment of fissures] has been replaced by a new technique – laser excision and vaporization. This method is much less traumatic, which means that healing will occur as soon as possible, without leaving a scar at the site of the operation. This technique is unique and is performed only in our clinical center.

Treatment of inflammatory diseases of the colon in the clinic SOYUZ

Inflammatory diseases of the colon are largely due to its anatomical and physiological features. The large intestine is the final section of the digestive system – in it the feces are formed and removed from the body.

Major inflammatory diseases of the colon:

• Proct. Inflammation of the mucous membrane of the rectum and sigmoid colon.It can be acute (it develops very quickly, is characterized by constipation, high fever, severe pain in the abdomen and anus, a feeling of excessive fullness, burning) and chronic (the symptomatic picture is blurred, often there is only slight itching or burning in the anal region, constant weeping, a feeling of discomfort , frequent urge to empty, is characterized by a deeper lesion of the mucous membrane due to a long period of development).
• Paraproctitis. Complicated proctitis – the inflammatory process, in addition to the mucous membrane, includes adipose tissue surrounding the rectum and sphincter.The acute form is characterized by the appearance of abscesses (cavities with pus), with chronic fistulas are formed. The main symptoms are pain in the rectum and lower abdomen, painful bowel movements, high fever, discharge of pus, constant itching.
• Ulcerative colitis. With the disease, inflammation and destruction of the intestinal mucosa occurs, characterized by the appearance of many bleeding ulcers. The specificity of the disease is the absence of obvious reasons for development. Symptoms are “wavy” – periods of exacerbation are replaced by periods of remission (in some cases, it lasts for years).As a rule, there is moderate pain in the abdomen and anus, diarrhea (often with bloody discharge), constipation.
• Crohn’s disease. A chronic inflammatory process, affecting and destroying all layers of the intestine, develops, as a rule, throughout the entire gastrointestinal tract. The symptomatic picture is similar to ulcerative colitis.

The causes of inflammation are various factors, including infections, parasites, toxins, as well as gross disturbances in nutrition (fasting, a small amount of low-carbohydrate and plant foods, the predominance of spicy, fried, smoked foods, etc.).retention of feces (constipation), dysbiosis and much more.

In some cases, the manifestations of the disease are very blurred, in addition, chronic forms of inflammatory diseases are characterized by a latent course and only in the exacerbation phase manifest themselves in full.

Anal ring prolapse

Prolapse of the anal ring (rectal prolapse, rectal prolapse) gives its owner extreme discomfort. Although the situation does not threaten life and health, independent healing is impossible and only a timely visit to a proctologist will return the opportunity to live a normal life.

With prolapse of the anal ring, part of the rectum is outside the anal sphincter. The length of the drop-down segment can be up to 20cm.

Factors provoking prolapse of the anal ring:

• chronic constipation
• severe straining and difficulty in stool
• age-related dystrophy of the anus muscles
• difficult labor.

The disease is relatively rare, most often observed in elderly people, which is certainly associated with age-related changes.
Symptoms of the disease can occur suddenly and are almost always triggered by significant physical exertion, severe cough, persistent constipation. In this case, there is an exit of the distal rectum, accompanied by very severe abdominal pain.

However, much more often prolapse is formed gradually, on the rise. At the initial stage, the protruding part appears only with difficulty in defecation, while it can be easily adjusted on its own. If you do not seek medical attention at this stage, then the loss begins to occur constantly, including with weaker physical exertion – for example, coughing or sneezing.

Symptoms of rectal prolapse:

• pain, discomfort
• fecal and gas incontinence
• feeling of a foreign object in the anus
• Discharge of blood or mucus from the anus
• frequent urge to defecate

Why is rectal prolapse dangerous? If left untreated, the risk of an infringement of the rectum is quite high. And this is a violation of tissue nutrition, and as a result, necrosis of the restrained area. Often, rectal prolapse turns into peritonitis or acute intestinal obstruction – and these are conditions that require emergency hospitalization.

Ointments and rectal suppositories provide relief. But they do not cure, but only temporarily relieve pain! Only the help of an experienced proctologist and no self-medication!
Let’s treat ourselves with love and care! And no matter how intimate the problems may seem, it is always better to solve them at the very initial stage.

Anal fissure treatment in the EMC clinic in Moscow

What is anal fissure (anal fissure)?

An anal fissure is a rupture of the mucous membrane of the anal canal (the anal canal is the final section of the large intestine between the rectum and the anus).A fissure usually forms at the border of the skin and mucous membrane at the site of the so-called posterior adhesion; predominantly in women, cracks are formed on the anterior surface of the anal canal.

Anal fissures are more common in women (especially during pregnancy and after childbirth) than in men, but the age, regardless of gender, is approximately the same – from 20 to 60 years. Anal fissure is one of the most common diseases in proctology, but it is often confused with other causes of pain and bleeding, such as hemorrhoids.

How does anal fissure manifest?

The main signs of anal fissure are sharp, tearing pain, burning during or after defecation, associated with sphincter spasm. As a rule, people describe their sensations as if something burst in the anus. Pain can spread to the sacrum, back, perineum, lower abdomen, and continue after a bowel movement. A typical manifestation of a crack is bright scarlet blood on toilet paper or in the stool. Bleeding always scares the patient, but, as a rule, it is not strong and stops quickly, which should be taken into account in the diagnosis as the difference between a crack and other diseases.Some patients complain of itching in the anus and / or skin irritation.

Why does anal fissure occur?

One of the most common causes of anal fissures is the violation of bowel movements. Constant constipation leads to the fact that the stool becomes hard and bulky, thereby causing tears and cracks in the anus. Also among the common causes are various irritants: diarrhea for several days, the use of spicy food, alcohol, and some medications.Fissures are also the result of trauma or anal sex.

Factors that increase the risk of anal fissure formation – inflammation in the anus and rectum in Crohn’s disease, ulcerative colitis, sexually transmitted infections (syphilis, gonorrhea, herpes simplex virus, cytomegalovirus, HIV), hemorrhoidal disease, proctitis, with cancer of the rectum and anus. The inflammatory process leads to the replacement of normal tissues of the anus with scarred, inelastic, which is a predisposing factor for the formation of a crack that does not heal even after proper treatment.

Acute or chronic anal fissure?

Anal fissure can be acute (recent) or chronic (more than 8-12 weeks). In half of the cases, acute fissures heal in patients after stool normalization within 4-6 weeks. If it does not heal, the fissure in the anus can become chronic, causing inflammation and scar tissue that looks like a crease or bump. The duration of the crack will be considered by the doctor when prescribing treatment.

Contact your EMC coloproctologist!

Symptoms of anal fissure are similar to those of other, more serious proctological diseases, including cancer. Therefore, at the first symptoms of anal fissure, it is necessary to seek advice from a coloproctologist.

First of all, the doctor finds out the patient’s complaints (the symptoms of anal fissure are very specific), and examines the area of ​​the anus and, if possible, makes a digital examination of the rectum to assess the severity of the spasm.In most cases, these manipulations are sufficient to make a diagnosis.

Anal fissure must be distinguished from hemorrhoids and inflammatory bowel diseases (proctitis, paraproctitis, ulcerative colitis, Crohn’s disease), as well as from cancer of the anal canal and rectum. To exclude bowel pathology, sigmoidoscopy or colonoscopy can be prescribed, these studies allow you to identify changes in the mucous membrane of the rectum or, if necessary, throughout the large intestine.You may need to consult a dermatovenerologist to identify sexually transmitted infections.

Anal fissure treatment

What is required of the patient?

• Stool should be normalized by diet. Eat fiber-rich foods to help promote soft, crack-free stools. Fresh vegetables, fruits, dried fruits (dried apricots, prunes, figs), cereals and grain bread are useful.

• Drink at least 2 liters of water a day.

• Maintain an adequate level of physical activity for your health. Hiking for at least 30 minutes, elementary gymnastics in the morning – a must, every day!

• Observe hygiene: keep the anus clean and dry; replace regular toilet paper with a cold hygienic shower after a bowel movement.

• Observe the rules of going to the toilet: do not sit on the toilet – if the body has “changed its mind”, do not push, it is better to postpone the process until the urge appears; never suppress the urge to defecate, go to the toilet immediately.

• Take a stool softener as directed by your doctor; even if you feel better, do not stop taking it until your next doctor’s appointment. The decision to cancel medications is made only by a doctor!

• Do not take medications (including medicinal herbs) without talking to your doctor.

• Call a doctor if symptoms persist or worsen with treatment, or if new symptoms develop.

• Call a doctor immediately if profuse and persistent rectal bleeding occurs.

What can a doctor prescribe?

Anal fissures usually heal with simple, but specific treatment, subject to lifestyle recommendations.

At the consultation, the coloproctologist decides on the appointment of specific drug therapy or surgical treatment (mainly, this concerns chronic, persistent cracks).

In order to reduce spasm of the anus, relieve pain, you can topically apply a thin layer of anesthetic, nitroglycerin or diltiazem ointment. Rectal suppositories with anesthetic and components that accelerate wound healing are also often used. There are many types of rectal suppositories and ointments – your doctor will decide which ones are right for you. The treatment is combined with warm sitz baths for 2-3 consecutive weeks. Sitting baths should be used after bowel movements and hygiene procedures: heat relaxes the muscles, thereby reducing the spasm of the sphincter, the pain subsides.

If the anal fissure does not heal after adequate drug therapy for 4-8 weeks, the doctor may recommend surgery – excision of the anal fissure and / or sphincterotomy (incision of the internal anal sphincter to relieve spasm). Surgeries usually require hospitalization for 1 day. Your coloproctologist will assess the risks and benefits of surgery and decide if the procedure is right for you.

IMPORTANT:

Even if pain and bleeding no longer bother you, stick to good dietary and lifestyle habits and be alert to your body’s signals as anal fissure may recur.

Contact your EMC coloproctologist if

• you experience pain during and after a bowel movement;

• you find blood on toilet paper or stool;

• you have been treating an anal fissure on your own for a long time, but the treatment does not help, or the fissure appears again and again;

• You are over 50 or have a relative with colorectal cancer in your family (colorectal cancer screening is recommended at this age).

The Coloproctology Department of the EMC Surgical Clinic treats anal fissure and other coloproctological diseases in accordance with European and American standards.

Possibilities of round-the-clock diagnostics using state-of-the-art endoscopic equipment, as well as radiation research methods, allow you to quickly establish an accurate diagnosis and prescribe an effective therapy.

The EMC Surgical Clinic has a wide range of possibilities for the surgical treatment of diseases and tumors of the rectum, colon and anus in cooperation with the EMC Clinic of Oncology and Hematology.

Proctitis symptoms and treatment – Medical Center

Proctitis is an inflammation of the rectal mucosa and anal mucosa.

Reasons: There are different reasons, but more often of an alimentary nature associated with malnutrition. Infections are more common than gonorrheal genesis.Prolonged constipation. Radiation proctitis – appears after radiation therapy for cancer of the prostate and female organs. Parasites. Hemorrhoids and cracks contribute to the development of proctitis.

Symptoms characteristic of proctitis

According to the clinical course, proctitis is divided into acute and chronic.

Acute proctitis has a sudden onset, accompanied by an increase in body temperature, chills, tenesmus (false desires) against a background of constipation, a feeling of heaviness in the rectum, a strong burning sensation in it.Acute proctitis is uncommon, but, having arisen, it is difficult due to pronounced subjective local sensations.

Acute proctitis can manifest itself in various morphological forms. The catarrhal-hemorrhagic form is characterized by hyperemia of the intestinal mucosa and punctate disseminated hemorrhages. With a catarrhal-purulent form, there is a hyperemia of the mucous membrane with the presence of pus on its surface. The catarrhal-mucous form is manifested by hyperemia of the rectal mucosa with the presence of mucus on its surface.With a polyposis form, polypoid formations are detected on the intestinal mucosa. Erosive proctitis is characterized by the presence of erosions on the intestinal mucosa, ulcerative proctitis by the formation of ulcerative defects.

Ulcerative proctitis is characterized by the presence of multiple erosions or even ulcers on the rectal mucosa. Ulcerative proctitis is a form of ulcerative colitis. However, the clinical course and treatment methods for ulcerative proctitis differ. In case of ulcerative proctitis, the process that has invaded a segment or the entire rectum may not spread higher.The clinical manifestations of the disease are very characteristic. Blood suddenly appears in droplets on the surface of the stool. It can be either bright or dark, in the form of minor clumps. In the future, bloody or bloody-mucous discharge appears before stool or with a false urge. Bowel function is not impaired. The patient usually does not experience any pain. The burning and itching sensation characteristic of proctitis is rare. Radiation ulcerative proctitis often does not develop immediately, but several months after X-ray therapy for a tumor of the prostate gland or female genital organs.Patients have bloody discharge from the rectum, a feeling of heaviness, pressure in the intestine, frequent false desires.

Chronic proctitis , unlike acute proctitis, is very common.

Occurs imperceptibly, gradually. There are almost no general symptoms. Local symptoms are also mild: either only itching in the anal area, or oozing, or burning. Sometimes all these phenomena are observed simultaneously.

Often, the manifestations of chronic proctitis are so mild that the patient avoids going to the doctor, uses home remedies and continues to lead a normal life.In the meantime, the process develops: when eating spicy food, burning sensation in the rectum intensifies, mucous or mucopurulent discharge appears, sometimes sharp itching in the anus area comes to the fore. Bowel function is usually not impaired in this case.

Chronic proctitis can occur in hypertrophic, normotrophic and atrophic forms. With hypertrophic proctitis, the folds of the mucous membrane are thickened, loose, with normotrophic proctitis, they have a normal appearance, with atrophic proctitis, they are smoothed, the mucous membrane is thinned.Determined by varying degrees of hyperemia and edema of the mucous membrane, sometimes its contact vulnerability.

Proctitis complications

Narrowing of the rectum can be one of the complications.

Prevention of proctitis

Prevention of proctitis is reduced to the timely treatment of diseases that contribute to its appearance.

Forecast

Acute proctitis with proper treatment ends with recovery.In chronic proctitis, the prognosis is aggravated by more or less frequent exacerbations, discomfort and itching in the anus.

What can a doctor do?

The doctor makes a diagnosis based on the history, examination data, rectal examination and rectoscopy (sigmoidoscopy). To determine the degree and nature of inflammatory changes, a cytological examination of the intestinal contents, sowing of feces in order to determine the composition of the intestinal microflora, and a biopsy of the mucous membrane are carried out.

In severe forms of acute proctitis (catarrhal-purulent, erosive, polyposis, ulcerative), treatment is carried out in a hospital. Shown are bed rest, a diet with a limited amount of fiber, excluding spicy, fried foods, spices and alcohol. Anti-inflammatory therapy (antibiotics, sulfonamides) is prescribed taking into account the results of feces culture and the sensitivity of microflora to drugs. Microclysters with collargol, chamomile infusion are used locally. When the phenomena of acute inflammation subside, oily microclysters, sitz baths with 0.01% potassium permanganate, and a warm perineal shower are prescribed.In severe forms of nonspecific ulcerative proctitis, the use of corticosteroids gives a beneficial effect.

Treatment of chronic proctitis can be carried out on an outpatient basis, using the same means as for the treatment of acute proctitis. Spa treatment is advisable. Prescribe mud therapy, intestinal lavages with warm alkaline water such as Borjomi, Essentuki, which promote mucus rejection and activate the motor function of the large intestine. A complex of therapeutic measures is used to combat constipation (massage, abdominal gymnastics to develop a fixation of the reflex to defecate), but laxatives should not be used.