Anal Pain: Causes, Symptoms, and When to Seek Help

Anal issues

Hello Doctor,
1.
I would like to ask about the feeling I had the day before yesterday morning, where I constantly felt the urge to have a bowel movement.
I sat in the bathroom for a long time but couldn't pass anything.
By the afternoon, I finally had some signs of a bowel movement, but the stool was very hard and only a small amount came out, with the rest stuck at the anal opening.
Additionally, the anal area was extremely painful.
Because of the pain, I couldn't push hard, but I could feel a foreign object stuck in the anus and had a persistent urge to go.
Later that evening, I managed to have another bowel movement, but it was very painful, and there were some traces of blood on the toilet paper.
In the following days, when I wiped, there was a faint trace of stool on the paper, and I still had the urge to go.
Whenever I tried to push, it was very painful.
2.
Will the issue of having stool on the toilet paper resolve on its own?
3.
I haven't seen a doctor yet because I'm feeling a bit anxious and scared.
I would like to know if this could be hemorrhoids or an anal fissure.

Gaga Miss, 20~29 year old female. Ask Date: 2023/07/20

Dr. Zhang Shuhao reply Surgery

1.
Pain during bowel movements that feels like cutting, accompanied by bleeding, is a typical symptom of anal fissures.
It is advisable to take warm sitz baths, avoid irritating the anal wound, and increase fluid intake to prevent constipation.
If the pain is severe, it is recommended to seek medical attention for medication, which can lead to improvement in about a week.
2.
Anal wiping with fecal matter is often due to a wound that makes one hesitant to wipe too hard, combined with mild hemorrhoidal prolapse.
Treatment can lead to recovery.
3.
If constipation is frequent, hemorrhoids and anal fissures often coexist.
If there are concerns, it is advisable to seek medical evaluation.

Reply Date: 2023/07/20

More Info

Anal pain can be a distressing and uncomfortable experience, often accompanied by a range of symptoms that can indicate various underlying conditions. Based on your description, it seems you are experiencing significant discomfort, particularly during bowel movements, along with the presence of blood on toilet paper and a sensation of an obstruction at the anal opening. Let’s break down the potential causes, symptoms, and when to seek medical help.

Causes of Anal Pain
1. Hemorrhoids: These are swollen veins in the lower rectum or anus that can cause pain, itching, and bleeding. They can be internal (inside the rectum) or external (under the skin around the anus). Straining during bowel movements, especially with hard stools, can exacerbate hemorrhoids.

2. Anal Fissures: These are small tears in the lining of the anus, often resulting from passing hard or large stools. They can cause sharp pain during and after bowel movements, and may also lead to bleeding.

3. Constipation: Hard, dry stools can lead to straining, which may cause or worsen hemorrhoids and fissures. The sensation of having a blockage can be due to the stool being too large or hard to pass comfortably.

4. Infections or Abscesses: Infections in the anal area can lead to pain and swelling. An abscess is a collection of pus that can form due to infection, causing significant discomfort.

5. Other Conditions: Conditions such as inflammatory bowel disease (IBD), anal warts, or even certain sexually transmitted infections can cause anal pain and discomfort.

Symptoms to Watch For
- Pain during bowel movements: This is a common symptom associated with both hemorrhoids and anal fissures.

- Bleeding: The presence of blood on toilet paper or in the stool can indicate a fissure or hemorrhoids. It’s important to note the color of the blood; bright red usually indicates a problem in the lower gastrointestinal tract.

- Persistent urge to defecate: This can occur with both constipation and rectal issues.

- Discomfort or pain when sitting: This can be a sign of an anal fissure or hemorrhoids.

When to Seek Help
Given your symptoms, it is advisable to seek medical attention, especially if:
- The pain is severe and persistent.

- You notice significant bleeding or blood clots.

- You experience changes in bowel habits, such as prolonged constipation or diarrhea.

- You have fever, chills, or other systemic symptoms that may indicate an infection.

Self-Care and Management
While waiting for your appointment, there are some self-care measures you can take:
1. Increase Fiber Intake: Eating a diet rich in fiber can help soften stools and promote regular bowel movements. Consider fruits, vegetables, whole grains, and legumes.

2. Stay Hydrated: Drinking plenty of fluids can help prevent constipation.

3. Warm Baths: Soaking in a warm bath can help relieve pain and discomfort.

4. Over-the-Counter Remedies: You may consider using over-the-counter creams or ointments designed for hemorrhoids or anal fissures, which can provide temporary relief.

5. Avoid Straining: Try to relax during bowel movements and avoid straining, which can worsen pain and lead to further complications.

Conclusion
Your symptoms suggest that you may be dealing with hemorrhoids or an anal fissure, but only a healthcare professional can provide a definitive diagnosis. It’s understandable to feel anxious about seeking help, but addressing these symptoms early can prevent complications and improve your quality of life. Don’t hesitate to reach out to a healthcare provider for a thorough evaluation and appropriate treatment.

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