Unexplained Anal Pain: Causes and Solutions for Discomfort

It doesn't seem like an anal fissure, hemorrhoids, or an anal fistula, but it hurts a lot?

Hello Doctor, recently I've been experiencing a sharp pain near my anus while walking for more than half an hour.
It feels like a friction burn, and there have been two or three instances where I've noticed a little blood, but it stopped quickly.
Bowel movements are smooth and painless, and I don't feel discomfort when sitting or lying down; it only hurts after walking for a while.
I've checked while showering and found no lumps or pus, just flat skin.
This symptom has persisted for almost a week.

After taking some pictures, I noticed a light red mark about 3 cm long and 0.5 cm wide, located slightly above the anus and close to the vaginal opening (two marks on each side), approximately 2-3 cm away from both the anus and the vaginal opening.
I suspect this is the source of the pain.
I would like to ask the doctor if this is just a regular friction burn.
I haven't engaged in any activities or sexual intercourse; I simply increased my activity level after a month of prolonged sitting.
I don't understand why this suddenly occurred, and it doesn't seem like an anal fissure, hemorrhoids, or an anal fistula.

1.
If I leave it untreated, will it heal on its own? (I have applied some antiseptic ointment a couple of times.)
2.
How long might it take to heal?
3.
Will continuing to walk worsen the injury due to friction? I also have pubic hair in that area, so I feel like it might irritate the wound.
4.
Is this injury likely caused by prolonged sitting for a month followed by a sudden increase in activity, or could it be due to stress or tension?
Thank you, Doctor, for your answers!

Gao bu dong wei shen me hui you shang., 20~29 year old female. Ask Date: 2023/02/23

Dr. Li Zhonghuai reply Surgery

Hello! It is recommended to wear loose-fitting pants and pure cotton underwear, and to change them frequently.
Generally speaking, the blood circulation in the perineal area is good, and small wounds heal quickly, usually just requiring the application of antibiotic ointment.
If the issue persists, it is advisable to consult a gynecologist to check for any problems in the vagina or uterus that may be causing excessive discharge.
Prolonged sitting in a warm and humid environment can lead to friction and skin irritation.
Another possibility is that the anal sphincter is not tight, leading to leakage of fecal matter, which can also cause moisture and friction-related skin irritation, although this is more common in the elderly and less likely in your case.
Take care! Changhua Hospital is concerned about you!

Reply Date: 2023/02/23

More Info

Unexplained anal pain can be a distressing experience, and it's important to understand the potential causes and appropriate solutions for discomfort. Based on your description, it seems that you are experiencing pain and irritation in the anal area, particularly when walking for extended periods. You also mentioned the presence of a faint red mark near the anal region, which could indicate some form of irritation or minor injury.

Possible Causes of Your Symptoms
1. Skin Irritation or Chafing: Given that you have recently increased your activity level after a period of prolonged sitting, it is possible that the skin around the anal area is experiencing friction, leading to irritation or chafing. This is especially common in individuals who may not be accustomed to increased physical activity.

2. Anal Fissures: While you mentioned that your bowel movements are smooth and painless, it's still worth considering that minor fissures can occur without significant pain during defecation. These can sometimes bleed slightly and may be exacerbated by friction.

3. Hemorrhoids: Although you ruled out hemorrhoids, they can sometimes present with mild discomfort and bleeding, especially if there is increased pressure in the area due to prolonged sitting or straining.

4. Infection or Inflammation: Conditions such as folliculitis (inflammation of hair follicles) or other skin infections could also cause localized pain and redness.

Recommendations
1. Self-Care: If the irritation is mild and you have not noticed any significant changes (like swelling or pus), it may resolve on its own. Continue to keep the area clean and dry. Using a barrier cream or ointment may help protect the skin from further irritation.

2. Avoiding Irritation: To prevent further irritation, consider wearing loose-fitting clothing and avoiding activities that may exacerbate the friction, such as prolonged walking or sitting on hard surfaces. If you find that hair is irritating the area, trimming or grooming may help.

3. Monitoring Symptoms: Keep an eye on the symptoms. If the redness or pain worsens, or if you notice any signs of infection (such as increased swelling, warmth, or discharge), it would be advisable to seek medical attention.

4. Consulting a Healthcare Provider: If the symptoms persist beyond a week or worsen, it is important to consult a healthcare provider. They can perform a physical examination and possibly recommend treatments such as topical medications or further investigations to rule out other conditions.

Answers to Your Specific Questions
1. Will it heal on its own?: Many minor skin irritations can resolve on their own with proper care. However, if the symptoms persist or worsen, medical evaluation is recommended.

2. How long will it take to heal?: Healing time can vary depending on the severity of the irritation. Minor skin irritations may improve within a few days to a week with appropriate care.

3. Will continued walking worsen the injury?: Yes, continued friction from walking could potentially exacerbate the irritation. It may be wise to limit activities that cause discomfort until the area has healed.

4. Is this due to increased activity after prolonged sitting?: It is quite possible that the sudden increase in activity after a period of inactivity has contributed to the irritation. The skin may not have been accustomed to the friction, leading to discomfort.

In conclusion, while your symptoms may be related to skin irritation due to increased activity, it is essential to monitor the situation closely. If there are any changes or if the discomfort persists, seeking medical advice is the best course of action to ensure proper diagnosis and treatment.

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