Anal Pain: Causes, Treatments, and When to Seek Help

Anal issues

Hello Doctor, I recently engaged in anal intercourse with a friend, but due to a lack of lubrication, I have been experiencing significant pain in the anal area for about four days.
I have noticed many small wounds around the anus, so I used a medication called "Kuaijing" (which forms a protective film over the wounds to prevent bacterial contact, typically used for oral ulcers but can also be applied to external injuries).
The outer area of the anus has healed, but there seems to be a larger wound on the inner side above the anal opening that is still quite painful, although it is noticeably better than before.
Occasionally, I experience some itching.
Should I continue applying the medication? Additionally, I feel that the larger inner wound has developed a small soft growth that is not painful or itchy.
It seems to enlarge when the wound is more painful but gradually decreases afterward.
Currently, there is no bleeding from the wounds; they are just painful, especially during bowel movements and while showering.
Could this be an anal fissure, or is it just a regular tear? I would appreciate your assistance.
Thank you.

John, 20~29 year old female. Ask Date: 2016/05/19

Dr. Ke Fangxu reply Surgery

1.
If there is no pain anymore, then it is not a concern; the wound will gradually heal, so there is no need to worry.
2.
The anal mass is likely a hemorrhoid; if it appears at the site of a fissure, it may be a perianal polyp caused by anal fissures.
If there is no bleeding or discomfort, treatment is also not necessary.

Reply Date: 2016/05/19

More Info

Anal pain can arise from various causes, especially following anal intercourse, particularly if lubrication was insufficient. The symptoms you describe, including pain, small wounds, and the presence of a soft, non-painful "bump," suggest a few possible conditions, including anal fissures, hemorrhoids, or simple skin irritation.

Understanding Anal Pain
1. Anal Fissures: These are small tears in the lining of the anus, often caused by trauma, such as from anal intercourse without adequate lubrication. Symptoms typically include sharp pain during bowel movements, bleeding, and sometimes a visible tear. The presence of a "bump" could be a sentinel pile, which is a small skin tag that can develop as a result of the fissure.

2. Hemorrhoids: These are swollen veins in the rectal area that can cause pain, itching, and discomfort. They can be internal or external. If the bump you feel is soft and not painful, it might be an external hemorrhoid or a thrombosed hemorrhoid, which can occur after trauma.

3. Skin Irritation or Infection: The use of topical medications like 克潰淨 (which is typically used for oral ulcers) may help protect the area from infection, but it is essential to ensure that the product is appropriate for anal use. If the area is not healing or if you notice signs of infection (increased redness, swelling, or discharge), it may require a different treatment approach.

Treatment and Management
- Continue Using Topical Treatments: If you find that the medication is helping and there are no adverse reactions, you may continue applying it. However, ensure that it is safe for anal use. If you notice any irritation from the medication, discontinue use and consult a healthcare provider.

- Increase Lubrication: For future anal intercourse, always use a generous amount of lubricant to prevent trauma. Water-based or silicone-based lubricants are generally recommended.

- Warm Sitz Baths: Taking warm baths can help soothe the area and promote healing. This can also help with pain relief during bowel movements.

- Dietary Adjustments: Ensure you are consuming a high-fiber diet to prevent constipation, which can exacerbate anal pain and fissures. Staying hydrated is also crucial.

When to Seek Help
You should seek medical attention if:
- The pain persists or worsens despite home treatment.

- You notice significant swelling, redness, or discharge from the area.

- There is any bleeding that is more than a small amount.

- The "bump" increases in size or becomes painful.

A healthcare provider can perform a thorough examination to determine the exact cause of your symptoms and recommend appropriate treatment. They may also provide guidance on proper techniques for anal intercourse to prevent future injuries.

Conclusion
While your symptoms may suggest an anal fissure or irritation from trauma, it is essential to monitor your condition closely. If you experience any worsening symptoms or if the pain does not resolve, do not hesitate to consult a healthcare professional. They can provide a definitive diagnosis and tailored treatment plan to ensure your comfort and health.

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