Anal Pain: Causes and When to Seek Medical Help

Anal pain or discomfort?

Hello, doctor.
At the beginning of June, I suddenly experienced a mild, prickling discomfort around the anus, occurring about 5-6 times a day without a specific time or action triggering it.
It wasn't just after bowel movements; it felt like a sudden electric shock of pain.
This lasted for about 2-3 days and then subsided.
However, this morning, I suddenly felt sharp pain again, which is more intense than the last time.
The pain is intermittent and occurs more frequently; sometimes I go for several hours without pain, and other times I experience multiple episodes within an hour.
The sharp pain feels like the discomfort from dry, cracked skin, but strangely, it can occur even when I'm sitting still.
I have also touched the area around the anus with my finger, and there was no pain or swelling.
I tried using a cotton swab with some petroleum jelly to gently touch inside the anus, and it didn't hurt.
I'm unsure what could be causing this.
If it were pinworms, wouldn't the itching only occur at night? Thank you for your response.

Yan, 20~29 year old female. Ask Date: 2020/06/14

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.
Warm sitz baths can help alleviate pain, maintain cleanliness, and promote blood circulation.
Over-the-counter hemorrhoid suppositories can also be used.
If one does not work barefoot in the fields, the likelihood of contracting pinworm infections should be minimal.

Reply Date: 2020/06/14

More Info

Understanding anal pain can be complex, as it can arise from various causes, some benign and others requiring medical attention. Based on your description, it seems you are experiencing intermittent sharp pain around the anal area, which can be quite distressing. Let's explore potential causes and when you should consider seeking medical help.

Potential Causes of Anal Pain
1. Hemorrhoids: Swollen veins in the rectal area can cause pain, especially during bowel movements. They may not always be visible or cause external symptoms, which could explain why you don't see any swelling or discomfort upon touching the area.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain, especially during or after bowel movements. The pain can sometimes persist even when not actively using the restroom.

3. Skin Irritation: Conditions such as dermatitis or fungal infections can cause discomfort around the anal area. This irritation can lead to a sensation of sharp pain, especially if the skin is dry or cracked.

4. Infections: Bacterial or viral infections can lead to pain in the anal region. Conditions like abscesses or sexually transmitted infections may present with pain, swelling, or discharge.

5. Nerve Pain: Conditions affecting the nerves in the pelvic region, such as pudendal neuralgia, can cause sharp, shooting pains that may not correlate with bowel movements or physical activity.

6. Pinworms: While you mentioned that pinworms typically cause itching at night, they can also lead to discomfort during the day, especially if the area is irritated.

When to Seek Medical Help
Given that your symptoms have recurred and intensified, it is advisable to consult a healthcare professional, especially if:
- The pain persists or worsens over a few days.

- You experience any bleeding, discharge, or changes in bowel habits.

- You notice any swelling or lumps in the anal area.

- You have associated symptoms like fever, chills, or significant discomfort.

Diagnostic Approach
A healthcare provider may perform a physical examination to assess the area for any visible signs of hemorrhoids, fissures, or other abnormalities. They may also inquire about your bowel habits, diet, and any recent changes in your health or lifestyle. In some cases, further diagnostic tests, such as an anoscopy or colonoscopy, may be warranted to rule out more serious conditions.

Management and Treatment
While waiting for your appointment, consider the following self-care measures:
- Dietary Adjustments: Increase fiber intake to soften stools and reduce straining during bowel movements.

- Hydration: Drink plenty of fluids to help maintain stool consistency.

- Warm Baths: Soaking in warm water can help soothe discomfort and promote relaxation of the anal muscles.

- Topical Treatments: Over-the-counter creams or ointments designed for hemorrhoids or fissures may provide temporary relief.

Conclusion
Anal pain can stem from various causes, and while some may resolve on their own, persistent or severe pain warrants medical evaluation. Early diagnosis and treatment can help alleviate discomfort and address any underlying issues. If your symptoms continue or worsen, please seek medical attention promptly. Your health and comfort are paramount, and a healthcare professional can provide the appropriate care and guidance.

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