Rectal Pain: Symptoms, Treatments, and When to Seek Help

Follow-up Inquiry #184284

Dear Dr.
Chang,
Thank you very much for your response to my inquiry in "#184284 Inquiry Consultation".
I would like to ask you further questions.
This past Monday (July 18), I experienced poor sleep and diarrhea.
That evening, I began to feel a sharp pain near my anus while sitting.
Upon touching the area around my anus, I discovered a round protrusion on the lower left side, approximately 0.5 cm in size, which feels slightly hard and causes sharp pain when pressed.
Here are my questions for Dr.
Chang:
Q1.
Based on my description, what do you think the painful round protrusion on the lower left side of my anal area could be?
Q2.
Currently, I occasionally wash the protrusion with warm water and apply an ointment (Hiyu Zhi).
Is this treatment appropriate, or should I seek medical attention immediately?
Q3.
Given my current treatment approach, how long do you think it will take to heal? Additionally, will there be any lasting effects after healing?
Q4.
As mentioned in "#184284 Inquiry Consultation", I have a health check-up planned soon.
Given my current condition, is it advisable to proceed with the health check-up, or should I wait until my anal issue has resolved? (I am mainly concerned that my body is in an inflammatory state, which may affect the results of the health check-up.)
Thank you, Dr.
Chang.

Axiang, 40~49 year old female. Ask Date: 2022/07/20

Dr. Zhang Shuhao reply Surgery

1.
If there is diarrhea and staying up late, it is most likely an exacerbation of hemorrhoids, specifically the formation of a subcutaneous thrombus due to internal bleeding from the hemorrhoids.

2.
It is not advisable to wash directly; instead, a warm sitz bath can be used, supplemented with hemorrhoid ointment.
During this period, it is important to stay hydrated, avoid smoking and irritating foods, and refrain from prolonged standing or sitting, as the thrombus will gradually be absorbed on its own.

3.
Improvement in swelling and pain is expected in about a week, but a small, painless lump may remain.
If episodes occur frequently, surgical treatment should be considered.

4.
It will not affect health check-ups, but undergoing a colonoscopy during an exacerbation of hemorrhoids may be uncomfortable, and taking laxatives before the examination can exacerbate symptoms.

Reply Date: 2022/07/20

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding rectal pain and the associated symptoms you are experiencing. Based on your description, it seems you may be dealing with a condition that could be related to hemorrhoids, an anal fissure, or possibly an abscess. Let’s address your questions one by one.

Q1: What could the painful round protrusion near my anus be?
The round protrusion you described, especially if it is hard and painful upon touch, could likely be a hemorrhoid or an anal abscess. Hemorrhoids are swollen veins in the lower rectum and anus that can cause discomfort, especially when sitting. An anal fissure, which is a small tear in the lining of the anus, can also cause sharp pain and may be accompanied by a hard lump if there is swelling. An abscess, which is a collection of pus, can occur due to infection and may present as a painful lump as well. Given the symptoms of pain and the presence of a lump, it is advisable to seek medical evaluation to determine the exact cause.

Q2: Is my current treatment of warm water rinses and topical ointment appropriate?
Using warm water rinses can be soothing and may help alleviate some discomfort associated with hemorrhoids or fissures. Topical treatments like the one you mentioned (喜癒痔) can also provide relief. However, while these methods may help manage symptoms, they do not address the underlying issue. If the protrusion is indeed an abscess, it may require drainage and antibiotics. If symptoms persist or worsen, it is crucial to consult a healthcare provider for a thorough examination.

Q3: How long will it take to heal, and will there be any long-term effects?
The healing time for conditions like hemorrhoids or anal fissures can vary. If it is a minor issue, you may start to feel relief within a few days to a week with proper care. However, if it is more severe or if there is an underlying infection, healing may take longer. As for long-term effects, if treated appropriately, most patients do not experience lasting issues. However, untreated conditions can lead to complications, such as chronic pain or recurrent hemorrhoids.

Q4: Should I proceed with my health check-up given my current condition?
It is generally advisable to wait until your rectal issue has resolved before undergoing a health check-up. The inflammation and discomfort may affect your ability to undergo certain tests comfortably, and it could potentially skew results if there is an ongoing inflammatory process. Once you have addressed the rectal pain and any associated symptoms, you can proceed with your health check-up with more confidence.

In conclusion, while home care measures can provide temporary relief, it is important to have a healthcare professional evaluate your condition to ensure proper diagnosis and treatment. If you notice any worsening of symptoms, such as increased pain, fever, or changes in bowel habits, please seek immediate medical attention.

Take care, and I wish you a speedy recovery.

Best regards,
Dr. Zhang

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