Pain and Swelling Above the Anus: When to Seek Help - Surgery

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Pain and swelling above the anal opening?


Hello, doctor.
I have a question...
Two days ago, I suddenly felt some pain around my anus (it just started hurting while standing, and I didn't bump into anything).
I noticed that there is swelling above the anal opening, and it hurts when I touch it.
It also hurts when sitting or walking.
There are no external injuries, and there is no bleeding or discharge.
I would like to know what might be the cause and if I need to seek medical attention.
If I do need to see a doctor, should I make an appointment with a surgeon?

Xie Yun, 30~39 year old female. Ask Date: 2017/02/14

Dr. Xu Kaixi reply Surgery


Hello: The pain and swelling above the anus may be caused by several conditions, including perianal abscess or inflammation, folliculitis of the perianal skin, hemorrhoidal inflammation, or thrombosis.
It is recommended that you visit a surgical or dermatology clinic for a thorough examination.

Reply Date: 2017/02/14

More Info


Experiencing pain and swelling above the anus can be concerning, and it's important to understand the potential causes and when to seek medical help. Based on your description, there are several possibilities for the symptoms you are experiencing.

1. Hemorrhoids: One of the most common causes of pain and swelling in the anal area is hemorrhoids, which are swollen veins in the lower rectum or anus. They can be internal or external and may cause discomfort, especially when sitting or during bowel movements. Hemorrhoids can be caused by various factors, including straining during bowel movements, prolonged sitting, or increased pressure during pregnancy.

2. Anal Abscess: An anal abscess is a collection of pus that can occur due to an infection in the anal glands. This condition can cause significant pain and swelling and may require drainage by a healthcare professional.

3. Fistula: An anal fistula is a small tunnel that can develop between the end of the bowel and the skin near the anus, often resulting from an abscess. It can cause pain and discomfort and may require surgical intervention.

4. Skin Conditions: Conditions such as dermatitis, infections, or even warts can cause localized swelling and pain in the anal area. These conditions may require topical treatments or other interventions.

5. Other Conditions: Less commonly, conditions such as anal fissures (small tears in the lining of the anus), inflammatory bowel disease (IBD), or even certain sexually transmitted infections (STIs) can lead to similar symptoms.

Given that you are experiencing pain and swelling without any visible external injury, bleeding, or discharge, it is advisable to seek medical attention. While it may not be an emergency, a healthcare provider can evaluate your symptoms more thoroughly.

When to Seek Help
You should consider seeking medical help if:
- The pain persists or worsens.

- You notice any changes in bowel habits, such as constipation or diarrhea.

- You experience fever or chills, which may indicate an infection.

- You have any concerns about the appearance of the swelling or pain.


What to Expect During a Visit
If you decide to see a doctor, you will likely be referred to a specialist, such as a colorectal surgeon or a gastroenterologist. During your appointment, the doctor will:
- Take a detailed medical history, including any previous issues with hemorrhoids or anal pain.

- Perform a physical examination, which may include a visual inspection and possibly a digital rectal exam to assess the area further.

- Discuss potential treatment options based on the diagnosis.


Conclusion
In summary, while your symptoms may be due to a common issue like hemorrhoids, it is essential to have a professional evaluation to rule out more serious conditions. Seeking help early can lead to effective treatment and relief from your symptoms. Remember, it is always better to err on the side of caution when it comes to health concerns, especially those involving pain and swelling in sensitive areas.

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