Pain in the anus in men and women

Contents

Physiology of men and women
Causes of pain in the anus
Treatment of pain in the anus
- Diagnostics
- Modern treatments
Prevention of pain in the anus at home
Popular questions and answers

Pain in the anus can cause serious concern and indicate a variety of diseases. We deal with experts, because of what pain in the anus can occur, how to treat it and when to see a doctor.

Pain in the anus or proctalgia causes severe discomfort and can be very intense due to the large number of nerve endings in this area. The pain can be dull, aching, sharp and paroxysmal, give to the coccyx, perineum and lower abdomen. The nature of the pain will tell an experienced doctor a possible diagnosis, but tests and examinations will be needed for the final verdict.

Together with our experts, we figured out what causes pain in the anus in men and women, when to see a doctor, and what methods of diagnosis and treatment are used for such symptoms.

Physiology of men and women

The anus (anal canal or anus) is the final section of the rectum and the entire gastrointestinal tract. In men, the rectum is in contact with the prostate gland, and in women – with the uterus and fallopian tubes, so diseases of these organs can cause proctalgia. Pain in the anus in men often appears with prostatitis and prostate adenoma, and in women with adnexitis (inflammation of the ovaries and fallopian tubes). Pain in the anus in women can also talk about an ectopic pregnancy.

Causes of pain in the anus

The most common causes of pain in the anus are associated with pathologies of the rectum and anorectal region. Pain syndrome occurs with inflammation, purulent processes, injuries and diseases of the hemorrhoidal veins. Sometimes pain is caused by pathologies of the spine and pelvic organs. The causes of proctalgia (pain in the anus) can be very different – from relatively safe osteochondrosis to an oncological process. Consider the most common diseases and conditions that cause pain in the anus.

Hemorrhoids

Hemorrhoids are the most common cause of pain in the anus and a reason to visit a coloproctologist. According to statistics, 13-14% of adults suffer from this disease.¹. Pathology with the same frequency occurs in men and women¹. With hemorrhoids, the veins of the lower rectum expand and form hemorrhoids – “blisters” or “sacs” with blood, which can be located inside and outside the anal canal. Painful sensations usually occur when a hemorrhoid is prolapsed and damaged. In addition to pain in the anus, patients with hemorrhoids complain of itching and burning in the anus, bleeding from the rectum, a feeling of incomplete emptying during defecation¹.

Thrombosis of hemorrhoids

This is a complication of hemorrhoids that occurs when the hemorrhoid is damaged.³. Inflammation develops at the site of injury and a blood clot is formed – a thrombus. A blood clot can disrupt the blood supply to the hemorrhoid and cause its necrosis – cell death with the development of a purulent-inflammatory process and bleeding³. With thrombosis, pain in the anus is accompanied by itching, discomfort, swelling and sensation of a foreign object in the anal area³. Often there is mucous discharge from the rectum³.

anal fissure

This term refers to long-term non-healing wounds on the mucous membrane of the anal canal.⁴. A characteristic symptom of the disease is pain during defecation and some time after it.⁴. Sometimes there is a small amount of blood. If the disease progresses, the pain increases and may last for several hours.⁴. Over time, “bumps” of connective tissue form around the anal fissure – this means that the disease has become chronic.

Acute paraproctitis

This is inflammation of the tissues around the rectum caused by fungi or bacteria. According to statistics, acute paraproctitis is the most common cause of emergency surgical intervention in proctology.⁵. The disease is accompanied by chills, fever up to 38˚C and above, increasing pain and swelling in the rectum and perineum⁵. At the site of inflammation, pus accumulates, which can come out with the formation of a fistula in the perineum, on the abdominal wall, in the abdominal cavity.

Chronic paraproctitis (fistula of the anus or rectum)

Approximately 30–50% of patients with acute paraproctitis subsequently develop a rectal fistula, an abnormal canal with a hole in the skin near the anus⁵. Through this channel, purulent discharge comes out of the focus of inflammation.⁵. In chronic paraproctitis, pain occurs if the outflow of pus is difficult. In this case, symptoms of acute paraproctitis appear – increased pain in the anus, fever and chills.

Chronic prostatitis

Chronic prostatitis is diagnosed in every second man who turned to a urologist⁵. Chronic inflammatory process in the prostate gland is usually accompanied by frequent urination, pain in the perineum and lower abdomen, which can radiate to the anus⁵.

Adnexitis

Inflammation of the fallopian tubes and ovaries is one of the most common diseases of the female reproductive system. In acute adnexitis, there are sharp intense pains in the lower abdomen with irradiation to the anus. The temperature often rises, there is a feeling of weakness, purulent-mucous discharge from the genital tract appears.

Malignant tumors of the anal canal

The oncological process may be accompanied by symptoms such as pain during bowel movements, itching and burning in the anal area, bloody discharge from the rectum, and stool disorders. If the process develops, the pain in the anus becomes constant, it can radiate to the lower abdomen, the thighs and genitals.

Treatment of pain in the anus

It is better to start treatment of pain in the anus with a visit to a coloproctologist. Due to the delicacy of the problem, many put off a visit to a specialist and lose valuable time. Meanwhile, most proctological diseases respond well to treatment at an early stage. Women with complaints of pain in the anus should be examined by a gynecologist to identify or rule out ectopic pregnancy and diseases of the reproductive organs.

Diagnostics

Primary diagnostic methods are history taking and digital examination of the rectum and anal canal. During the examination, a coloproctologist can detect hemorrhoids, anal fistulas, tumors and anal fissures. After a digital examination, anoscopy is usually performed. A narrow tube is inserted into the patient’s anus through which the doctor can examine the rectal mucosa. Palpation and anoscopy are often sufficient to make an accurate diagnosis.

As additional diagnostic methods can be used:

sigmoidoscopy – endoscopic examination of the rectum and lower sigmoid colon;
colonoscopy – endoscopic examination of the large intestine;
Ultrasound of the prostate;
MRI of the rectum with contrast;
general urine analysis;
general and biochemical blood test.

If an oncological process is suspected, a biopsy is usually prescribed. During the procedure, a tissue sample is taken from the pathological site for histological examination. With this analysis, abnormal cells can be detected and cancer can be diagnosed with high accuracy.

Modern treatments

For the treatment of patients with complaints of pain in the anus, conservative and surgical methods are used. In some conditions, for example, acute paraproctitis, only surgery is indicated. Therapeutic tactics are selected taking into account the cause and severity of the disease:

for the conservative treatment of hemorrhoids, systemic and local agents are prescribed that suppress inflammation, eliminate pain and itching, strengthen blood vessels, and prevent the formation of blood clots⁶;
surgical treatment of hemorrhoids includes the removal of internal and external hemorrhoids using methods such as classical hemorrhoidectomy, sclerotherapy, laser hemorrhoidoplasty and HAL-RAR – desarterization of nodes with mucopexy;
for the treatment of chronic prostatitis, antibiotics, alpha-blockers and non-steroidal anti-inflammatory drugs are used;
anal fissures are treated with anti-inflammatory drugs, anesthetics, botulinum toxin injections, or surgical methods⁶;
with thrombosis of hemorrhoids, rectal suppositories and ointments with analgesic, anti-inflammatory and venotonic effects are usually used, and for bleeding and other indications, surgery is performed⁶;
in oncological processes, chemotherapy, radiation therapy, and surgery are indicated.

Prevention of pain in the anus at home

There are no universal methods for the prevention of pain in the anus. But still, some diseases can be prevented if you change your lifestyle: do not ignore reasonable physical activity, eat regularly, include foods rich in protein and fiber in your diet. With hemorrhoids, it is recommended to regularly wash the anus with cool water to improve vascular tone, reduce swelling and bleeding.