Pain Between the Anus and Abdomen: When to Seek Help

There is a sharp pain in the area deep within the anus, extending into the abdominal cavity?

As I age, I've started experiencing a sharp pain deep in the rectum, particularly after eating, when sitting suddenly, riding a motorcycle, straining, or during menstruation.
This pain feels like it's located at the midpoint between the rectum and the abdomen.
Recently, I've also been having issues with urgency, feeling the need to urinate but unable to hold it, often leaking a few drops before I can reach the restroom.
I'm really unsure whether I should consult a gastroenterologist, a gynecologist, or a urologist.
The sharp pain deep in the rectum and the midpoint in the abdomen is particularly concerning, and sometimes even straining causes pain.
I truly don't know which specialist to see! I would appreciate any guidance from a physician.
Thank you.

Ms. Wu, 30~39 year old female. Ask Date: 2016/09/12

Dr. Lin Minghui reply Gastroenterology and Hepatology

Differential diagnoses for deep anal and lower abdominal pain include gynecological, urological, and gastrointestinal issues.
It is recommended to first consult a gynecologist, followed by a family medicine physician or general internist, to arrange appropriate examinations.

Reply Date: 2016/09/12

More Info

Understanding pain in the area between the anus and abdomen can be quite complex, especially as it can involve multiple systems in the body, including gastrointestinal, urological, and gynecological systems. Given your symptoms, it is essential to consider a few key points to help guide you on when to seek medical help and which specialist to consult.

Symptoms and Their Implications
1. Pain Location and Characteristics: The pain you describe as a sharp or stabbing sensation located between the anus and abdomen can be indicative of several conditions. This area is rich in nerves and is involved in various bodily functions, including digestion, urination, and reproductive health. The fact that the pain intensifies with certain activities (like sitting after eating, riding a motorcycle, or during menstruation) suggests that it could be related to muscular, gastrointestinal, or even pelvic floor issues.

2. Urinary Symptoms: The urgency and inability to hold urine, leading to leakage, is particularly concerning. This could indicate a problem with the bladder or pelvic floor muscles. Conditions such as urinary tract infections (UTIs), interstitial cystitis, or pelvic floor dysfunction could be contributing to these symptoms.

3. Menstrual Connection: If you are experiencing this pain in conjunction with your menstrual cycle, it could be related to endometriosis or other gynecological issues. Endometriosis can cause pain in the pelvic region, which may radiate to the lower back, abdomen, and even the rectal area.

When to Seek Help
Given the complexity of your symptoms, it is advisable to seek medical attention sooner rather than later. Here are some guidelines on when to seek help:
- Persistent Pain: If the pain persists for more than a few days or worsens over time, it is essential to consult a healthcare provider.

- Accompanying Symptoms: If you experience additional symptoms such as fever, changes in bowel habits, blood in urine or stool, or significant changes in menstrual cycles, you should seek immediate medical attention.

- Impact on Daily Life: If the pain is affecting your ability to perform daily activities or is causing significant distress, it is crucial to seek help.

Which Specialist to Consult
Given the symptoms you described, you may consider starting with a few specific specialists:
1. Gastroenterologist: If you suspect that your symptoms may be related to digestive issues, such as irritable bowel syndrome (IBS) or other gastrointestinal disorders, a gastroenterologist would be the appropriate specialist to consult.

2. Urologist: Since you are experiencing urinary urgency and leakage, a urologist can evaluate your bladder function and rule out conditions such as UTIs or bladder dysfunction.

3. Gynecologist: If your symptoms are closely tied to your menstrual cycle, or if you suspect a gynecological issue like endometriosis, a gynecologist would be the right choice.

4. Pelvic Floor Specialist: If your symptoms are related to pelvic floor dysfunction, a specialist in pelvic health can provide targeted treatment options.

Conclusion
In summary, the pain you are experiencing between the anus and abdomen, along with urinary urgency, warrants a thorough evaluation. It is essential to consult with a healthcare provider who can take a comprehensive history, perform a physical examination, and possibly order diagnostic tests to determine the underlying cause of your symptoms. Early intervention can lead to better management of your condition and improve your quality of life. Don't hesitate to seek help; your health is paramount.

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