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Anal pain is a frequent problem that can be a caused by different factors, most of which are not serious. However, the nerve endings located in the perianal region can make even mild irritations sore and, in severe cases, incapacitating. Pain and bleeding in the anus are commonly from a skin fissure during defecation. It can also be experienced when wiping the anal region, which indicates a skin problem or infection from fungus. A constant and progressive pain is more serious and can be a symptom of cancer.

A high-fiber diet and adequate water intake can relieve short-term anal discomfort associated with skin conditions.

Common Causes of Anal Pain

An anal fissure is a small tear in the skin, usually found at the anal opening, created when large and hard stools stretch the rectum. It may also develop when the muscle controlling the anal opening, called the anal sphincter, cannot relax to let stool pass. Fissures cause a sharp, knife-like pain at the anal opening and may cause bleeding and prolonged soreness from muscle spasms. Intense pain can force bowel movement to get delayed and build up, making the stool harder when it is finally passed.

Hemorrhoids, characterized by swollen veins that cause tissues to protrude from the anal opening, occur in 50% of the population. They usually follow heavy lifting, childbirth, and straining when passing stool. They cause mild discomfort but can escalate to a throbbing or stabbing pain when blood in the protruding tissue clots or thromboses.

Fecal impaction is also a common cause for anal pain and is brought about by masses of hardened stool left behind in the rectum from chronic constipation. On the other hand, an anal abscess is caused by bacterial infections and can be defined by the presence of pus in deep anal tissues. It can cause prolonged, constant pain, as well as fever and night sweats. The stool and abscesses that block the anal tunnel can cause the formation of anal fistula, an abnormal channel between the rectum and anus.

Levator ani syndrome is the spasm of muscles that support the anus. It causes a tight pressure deep inside the rectal passage and is aggravated by sitting. This occurs in regular intervals, with one episode lasting for roughly twenty minutes.

Other causes of anal pain include:

  • trauma

  • diarrhea

  • anal sex

  • anal ulcer

  • anal tumor or cancer

  • skin problems that cause itching or burning

  • rectal STD's like gonorrhea, chlamydia, or herpes

  • coccydynia or coccygodynia, characterized by tailbone pain

  • proctalgia fugax, caused by the spasms of the anal sphincter muscle

  • inflammatory bowel diseases like ulcerative colitis or Crohn's disease

  • perianal hematoma (a collection of blood in the perianal tissue caused by a ruptured vein)

When to See a Doctor

Early detection of anal discomfort is essential in preventing and treating subsequent conditions. Home remedies include over-the-counter medication, stool softeners, and fiber-rich food. Sitting in a hot sitz bath thrice a day and massaging muscles around the anus can also relieve spasms.

Medical advice should be sought for pain that persists after 48 hours of medication, as well as any discomfort that continues for two weeks. Skin irritations and STD's can be treated by ingesting or applying medications, while surgeries can remove blood clots, abscesses, fistulae, hemorrhoids, and fissures. Early removal and chemotherapy can eliminate cancerous tumors.

Immediate treatment must be given in the occurrence of bleeding, which can be indicative of cancer. Pain that spreads outside of the rectum and is accompanied by lightheadedness, fever, and rectal discharge must also be treated by a professional at once.

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