Anal and perianal pain

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The perception of pain during and / or after defecation is a symptom common to various morbid conditions, generally benign, involving the anorectal area. If persistent or particularly intense, the associated evacuation of stool proctologic pain is worth a visit.


The basic characteristics of the pain, in fact, are not sufficient to self-diagnose, however, always advisable for therapeutic purposes; analyzing them in detail and assessing the possible related symptoms may be possible to formulate some hypotheses about the origins of the pain associated with defecation:
– Constipation: the emission of very hard stools can damage the anal mucosa, causing pain during and after defecation;
– Diarrhea: frequent emission of liquid stools can irritate the anal mucosa causing pain; in the presence of intestinal infections or food intolerances (such as lactose), the acid pH of the stool helps produce anal lesions causing pain while passing stool;
– Anal fissures: these small cuts of the anal mucosa are typically associated with burning-and constricting pain (as if a small piece of glass crossed the anus) DURING defecation; characteristics even small hemorrhages highlighted by the typical streaks of bright red blood in the toilet paper. The pain usually occurs after the evacuation and lasts for a period ranging from a few seconds to several hours in the case of gravity;
– Hemorrhoids: These expansions submucosal veins of the same name, situated at the level of anus and rectum final stretch, are associated with major bleeding compared to those caused by fissures, leaving real stains on toilet paper or drops of blood in the toilet . Pain during defecation is usually absent (in case of non-prolapsed internal hemorrhoids), though less violent than the one associated with the fissures; in the case of gravity (for example in case of prolapsed internal hemorrhoids and choked) pain can be quite violent and occur also during the day;
– Intake of large quantities of food or irritating spices such as black pepper or chili;
– Injuries due to scratching: scratching, either idiopathic or following local infections, specific dermatologic conditions (psoriasis, eczema, lichen simplex …) or contact dermatitis, causes skin damage perianal that favors the proliferation of infectious processes and causes burning pain during defecation, erythema (redness) of the perianal skin. Children are easily infected with various types of worms such as pinworms (Enterobius vermicularis) that cause severe itching;
– Causing injury to anal sex nature: there is generally a basic pain that may worsen with eventuallmente defecation;
– Injuries caused by sexually transmitted diseases such as gonorrhea, herpes and chlamydia: there is generally a basic pain worsening over time that can eventually worsen with defecation; you may notice mucus anal leakage, blood or pus;
– Fistula and anal abscess: the formation of a pathological canaliculus which connects the anal canal with the skin around the anus (fistulas), and the subsequent infection of that gap (abscess) causes an acute anal pain, ongoing and progressing disease associated to swelling and purulent losses;
– Rectal cancer: it can cause symptoms such as issuance of ribbon-like stools and a burning sensation in the anal canal to the sphincter spasm accompanied by urgency of defecation and a sense of incomplete emptying during defecation; if so anal pain is dull and persists throughout the day.


Coccydynia (s. Of the elevators), fleeting proctalgia, chronic idiopathic anal pain, idiopathic stenosis of the internal sphincter. While you know enough about the causes of the first two groups, which then can be treated appropriately, it is difficult to rare causes of therapy, probably because of the still not completely clarified etiology and pathogenesis.

Coccydynia: Also known as “Syndrome spasm of elevators”, affects equally men and women. Caused by a muscle spasm levator. Patients report pain and restlessness when you are sitting. Among the causes were reported trauma of coccyx region and the prolonged sitting position obbligatamente (microtrauma of the coccyx). The pathogenesis would be referred to the local muscle inflammation, because of the major pain.
SYMPTOMS: Pain localized to the anus and rectum, but can be irradiated variably to the genitals, the coccyx and sometimes the buttocks.
DIAGNOSIS: It is important to perform a sacrococcygeal segment radiography.
Treatment with anti-inflammatory and analgesic Useful association of local treatments such as massage of the elevator muscles and electrical stimulation (good results).

Proctalgia BOW TO: Typical of women in middle-young age, is a rare symptom (~ 4-5 times a year or every 15 days or 1 time per month), usually brief and unexpected, very intense without notice and night appearance. Usually the patient identifies the rectum-anus as the site of the pain. The visit is practically impossible to find the site and cause of symptoms.
SYMPTOMS: The pain is localized to the anorectal region, but can be irradiated variably to the genitals, the coccyx and sometimes the buttocks.
DIAGNOSIS: Intussusception rectosigmoid fissures coccydynia et al.
THERAPY: Each person finds his own way to relieve pain (position, walking, rectal self-exploration, defecation voluntary or otherwise). Useful analgesics and minor tranquilizers.

CHRONIC PAIN idiopathic ANAL: Often there is no clinical examination which in many cases is normal (in rare cases, there is very vague and superficial pain). It detects a notable anxiety component in the patient. Sometimes you have radiation of pain to the thighs or buttocks. They can be various causal agents such as a previous anal surgery or a difficult defecation.
TREATMENT: Riosservare many times the patient. Reassure the patient after performing all the examinations. personalized treatment.

STENOSIS IDIOPATHIC SPHINCTER ANAL INSIDE: The only data characteristic is hypertrophy without ipertono sphincter.
TREATMENT: The treatment is surgical and involves the internal anal sphincterotomy (good results almost always).


Consult your doctor to determine the cause of pain, and correct it. They can also be useful general advice, such as:
– Wear cotton underwear, avoiding the non-breathable synthetic
– Carry out careful hygiene of the anal area with detergent appropriate after each defecation, while avoiding over hygiene or manic that may cause irritation eczema
– Regulate body weight
– Use soft toilet paper, uncolored and unscented: coloring agents and perfumes can aggravate anal itching or promote its development
– Thoroughly wash the anal area after sport: even sweat can accentuate or trigger an annoying itching and anal pain, which is accentuated with defecation
– Always thoroughly dry the genital and anal area with a hair dryer with a soft cotton cloth
– Regulate the diet in cases of constipation or diarrhea foodborne
– Wash the anal area with fresh water but not cold: the cold exerts a mild analgesic effect, but can cause constriction of any hemorrhoidal nodules and accentuate the spasm of the anal sphincter.[/vc_column_text][/vc_column][/vc_row]