A coloproctologist named 10 possible causes of rectal pain

Head of the Coloproctology Department, coloproctologist, oncologist, FNAC FMBA of Russia

“Diseases of the rectum are quite common, faced by both men and women. You can suspect pathology by a characteristic symptom – pain in the area of the anus. Such a sign may indicate the development of a serious disease”.

The nature of the pain

Pain in the area of the anus can have a different character: blunt and aching, burning, sharp, piercing, spasmodic, irradiating (spreading) to the abdomen, coccyx or perineum.

Often painful sensations are present when walking, sitting for a long time, emptying the rectum or after. Also discomfort can be accompanied by itching and burning in the rectal area and bleeding during defecation.

Causes

When a patient has painful sensations in the area of the anus, then first of all the doctor will consider diseases of the rectum. The specialist will also study the nature of pain, accompanying symptoms (incomplete emptying after defecation, discomfort and itching). However, such a clinical picture can also indicate other diseases.

Hemorrhoids

Painful sensations with hemorrhoids are bothered only with complications of the disease. This can be prolapse and thrombosis of the hemorrhoidal node.

As a rule, this disease is inherited, when abusing laxatives, enemas or can develop due to an improper lifestyle. We are talking about sedentary work, regular hot baths, lifting weights and even restricting the movement of clothes. All this leads to venous stasis in the pelvic area. As a result, hemorrhoidal nodes are formed.

Node prolapse occurs due to lack of fluid and dietary fiber in the diet. Because of this, the fecal masses are too dense. Over time, it hurts a person not only to sit, but also to walk, to stay in an upright position.

Anal fissure

This is a defect in the mucous membrane of the anal canal, adjacent to the anus. It occurs in different shapes: straight, oval or triangular. Reaches sizes up to 2 cm. There is also an anterior, lateral (located in the area of the perineum) and posterior fissure (located in the direction of the coccyx).

Can be acute and chronic. The first – bothers for four weeks. The second – has thickened edges, scars or other changes.

To the main cause of the appearance of this ailment refers to the presence of trauma. It can be as a result of anal intimate contact, chronic constipation, the presence of a foreign body in the rectum, diagnosis with the use of instruments, the use of incorrect toilet paper. Also as a consequence of exacerbation of hemorrhoids.

Inflammation of the rectum

The disease is formed with the multiplication of pathogenic or conditionally pathogenic microflora in the area of the rectum. The presence of this disease will be indicated by frequent urges to defecation, painful sensations and burning in the area of the anus. Pathology can occur in patients of different ages and sexes.

Moreover, the disease begins with ordinary redness, and can reach ulcers. In order not to bring it to a serious stage, it is important to see a doctor in time.

It can be accompanied by itching, insomnia, problems with defecation. It also affects the emotional state of a person. Significantly reduces his quality of life.

Malignant neoplasms

Cancer of the rectum is rare, but it is impossible to exclude such a disease with pain in the anus. It is very difficult to detect, since it has similar symptoms with hemorrhoids and anal fissure. These include: painful sensations and itching in the area of the anus, the presence of mucus or blood clots, thickening in the area of the anus, liquid or loose stools, fecal incontinence.

Malignant tumor is formed from the epithelial tissue of the lower rectum (between the upper edge of the anorectal line and the transition of the anoderm to the perianal skin).

Acute paraproctitis

This is a purulent inflammation of the fiber in the area of the rectum. The presence of paraproctitis is indicated by pain, swelling in the area of the anus, an increase in body temperature.

If you do not turn to a doctor for help in time, then in 90% of cases the disease passes into a chronic form. With all subsequent exacerbations, there is a risk of fistula formation. They can open both outward and into the abdominal cavity. This is very dangerous.

Epithelial coccygeal passage

This disease is characterized by pain in the sacrum (in the presence of an inflammatory process). This is a congenital defect. It looks like a narrow channel with a hair bulb and sebaceous glands.

As a rule, the patient is not bothered by this problem, since it is asymptomatic. There is only an aesthetic defect in the inter buttock area. It is mainly located 5 cm from the coccyx. The patient turns to the doctor already with inflammation, which is accompanied by purulent discharge.

Coccygodynia

This is inflammation in the coccyx area, formed due to trauma after a blow or fall. It can be as a result of severe childbirth or against the background of the development of osteochondrosis. In other words, this is a spasm of the deep muscles of the pelvic floor. Pain is manifested when bending or acts of defecation. And has a burning, aching and attack-like character.

Distinctive symptoms are pallor of the skin and profuse sweating. This is due to the reaction of the autonomic nervous system. This can negatively affect the emotional state of a person. Up to the development of depression.

Prostatitis

Prostatitis is an inflammatory process in which the tissues of the prostate gland are affected. It occurs in men of any age, but more often apply to patients of the middle age group.

Rarely, but discomfort in the anus occurs in acute prostatitis, which always arises suddenly. It is accompanied by sharp pain in the perineum, groin and in the area of the anus, high fever. Also characterized by painful urination and defecation. Inflammation can last for several months. If there are subsequent relapses, then the disease acquires a chronic stage.

Anal fistula

This is an infectious disease. With it, pus accumulates in the subcutaneous fatty tissue in the area of the rectum. After which it comes out through the canal near the anus. Along with throbbing pain, the patient is tormented by irritation and swelling of the skin near the anus, discharge of blood, mucus and pus.

It can develop as a result of Crohn’s disease (inflammation of the intestines), acute paraproctitis, diverticulitis, purulent hidradenitis, trauma, infectious disease (tuberculosis, AIDS, autoimmune diseases, STDs).

Sphincteritis

This is an inflammation of the mucous membrane of the circular hindlimb muscle. As a rule, the disease is formed in the presence of problems with the gastrointestinal tract. These include pancreatitis, gastric and duodenal ulcer, chronic gastritis, duodenitis, irritable rectum syndrome.

Additional symptoms: constipation or diarrhea, burning and itching. With this disease is characterized by false urges to void, purulent discharge. Often the painful sensations go to the perineum and neighboring organs.

Pain in the rectum in pregnancy

With pathologies of the rectum can be encountered during pregnancy. This is facilitated by hormonal changes in the woman’s body and the increasing size of the uterus. It will press on the intestine and the inferior vena cava.

Future moms often face such a problem as hemorrhoids. The clinical picture is as follows – itching, pain, bleeding and swelling in the anus area. Prevention of this disease is the maintenance of a healthy lifestyle. This is a balanced diet, and regular physical activity. Prolonged sitting or standing is not recommended.

Pain in the rectum in children

Children can also complain of pain in the anus. Gender does not matter here. Rarely encountered at the age of less than five years. This is due to the fact that their feces are liquid.

As a rule, the child has pain due to anal fissure. The causes are:

• Tearing of tissues due to the passage of too thick fecal masses;
• errors in the use of cleansing enemas or gas drainage tubes;
• incorrectly performed surgical interventions;
• congenital malformations of the rectum.

Another cause is paraproctitis. In this case, this disease is diagnosed in boys twice as often as in girls. Inflammation of the fiber around the rectum occurs due to the penetration of pathogenic flora in the soft tissues in the area of the anal opening.

It is important to remember that in children such diseases rapidly progress. This is due to a not yet developed immune system. You can not delay with medical help. Otherwise, the disease will acquire a chronic stage, which is dangerous with the formation of fistulous passages.

Which doctor to consult and when

Only a doctor-coloproctologist can identify the disease. If a child complains of pain, he should be taken to a pediatric proctologist or surgeon.

If the pain is agonizing for longer than two days, it is necessary to immediately seek help from a specialist. Also, if there are strong painful sensations that do not stop after using painkillers, make an appointment.

Remember, do not self-medicate, it is important to see a doctor. This will reduce the risk of developing a chronic phase and severe consequences. If the disease is accompanied by the release of blood or pus, fever, then you need to urgently show yourself to a proctologist.

Diagnosis and treatment

During visual inspection and finger rectal examination, the specialist assesses the condition of the anus mucosa and the contractility of the sphincter. For a more detailed study, the patient may be offered to undergo anoscopy or rectomanoscopy. They involve a deeper inspection of the rectum.

Based on it and the nature of the pain, the doctor prescribes treatment. It can be both conservative and surgical. Conservative methods include the use of rectal suppositories and taking medications. Such as hormonal agents, antibiotics and phleboprotectors.

Obligatory is the observance of diet – the patient must refuse spicy, salty and fatty foods and limit the consumption of fiber. In case of ineffectiveness of drug treatment, the patient may be shown surgical intervention. Preference is given to the use of minimally traumatic techniques that ensure rapid rehabilitation and overall safety of the process.