Pain from Prolonged Sitting: Anal Issues Explained

Pain in the anus due to prolonged sitting?

Hello Doctor, I previously had an anal fissure on the right side and after healing, I noticed some discomfort in the anal area after prolonged sitting.
I consulted another doctor who mentioned that there is slight swelling in the anal region due to poor blood circulation, and I have a small internal hemorrhoid.
(I underwent a digital rectal examination.) The doctor advised me to apply some medication.
However, after applying it for several weeks, I found that if I don't apply the medication, I experience slight pain in the anal area after sitting for a long time.
If I don't use a cushion, it becomes somewhat uncomfortable to sit or stand, but the pain is not severe.
When I press on the area with my hand, it is only slightly painful.
If I avoid sitting or standing for long periods, there is no discomfort.
What could this be? What should I do? Thank you.

Xiao Gua, 20~29 year old female. Ask Date: 2018/05/12

Dr. Ke Fangxu reply Surgery

The typical symptoms of anal fissures include pain during bowel movements accompanied by slight bleeding.
The common causes are often constipation or diarrhea.
The fundamental treatment is to improve bowel habits along with warm sitz baths.
If there are poor bowel habits, symptoms may persist long-term or even progress to chronic anal fissures.
Prolonged sitting or standing should be minimized.
If symptoms continue without improvement, it is advisable to consult a physician for evaluation.

Reply Date: 2018/05/12

More Info

It sounds like you're experiencing discomfort related to prolonged sitting, particularly in the anal region, which can be quite distressing. Based on your description, it seems that you have a history of anal fissures and possibly some mild hemorrhoidal issues. Let's break down the potential causes and management strategies for your symptoms.

Understanding Your Symptoms
1. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools or straining during bowel movements. Even after healing, the area can remain sensitive, especially if you engage in activities that put pressure on the anal region, such as sitting for long periods.

2. Hemorrhoids: You mentioned that a doctor noted some internal hemorrhoids. Hemorrhoids can cause discomfort, especially when sitting, as the pressure can exacerbate the swelling and sensitivity in the area. They can also lead to a feeling of fullness or discomfort, particularly after prolonged sitting.

3. Poor Circulation: Sitting for extended periods can impede blood flow to the pelvic region, potentially leading to swelling and discomfort. This is particularly true if you have any underlying vascular issues or if your sitting posture is not optimal.

4. Muscle Tension: Prolonged sitting can lead to muscle tension in the pelvic floor, which may contribute to discomfort. The muscles around the anus can become tight and sensitive, leading to pain or discomfort when sitting.

Management Strategies
1. Positioning: Ensure that you are sitting in a supportive chair that promotes good posture. Consider using a cushion designed for sitting, which can help alleviate pressure on the anal area.

2. Frequent Breaks: If possible, take regular breaks to stand up, stretch, and walk around. This can help improve circulation and reduce pressure on the anal region.

3. Topical Treatments: Continue using any topical medications as prescribed by your doctor. These may include hydrocortisone creams or other soothing ointments that can help reduce inflammation and discomfort.

4. Dietary Adjustments: Ensure that you are consuming a high-fiber diet to prevent constipation and straining during bowel movements. Staying hydrated is also crucial for maintaining soft stools.

5. Warm Baths: Soaking in a warm bath can help soothe the area and promote relaxation of the pelvic muscles. This can be particularly beneficial after sitting for long periods.

6. Physical Therapy: If your symptoms persist, consider consulting a physical therapist who specializes in pelvic floor therapy. They can provide exercises and techniques to help relieve tension and improve circulation in the area.

7. Follow-Up with Your Doctor: Since your symptoms have not improved significantly, it may be beneficial to follow up with your healthcare provider. They can reassess your condition and determine if further interventions, such as additional imaging or a different treatment approach, are necessary.

When to Seek Immediate Care
If you experience severe pain, bleeding, or any other concerning symptoms, it is important to seek medical attention promptly. These could indicate a more serious condition that requires immediate evaluation.

Conclusion
While your symptoms may be related to previous anal fissures and mild hemorrhoids, they can also be exacerbated by prolonged sitting and poor circulation. Implementing the strategies mentioned above can help alleviate your discomfort. However, ongoing symptoms warrant further evaluation by a healthcare professional to ensure there are no underlying issues that need to be addressed.

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