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Rectal Pain (cont.)

Rectal Pain Symptoms

  • Most hemorrhoids only cause a mild discomfort, but the pain can become severe if the hemorrhoids become thrombosed. This occurs when the blood in the hemorrhoid clots. There is an excruciating throbbing or stabbing pain that begins suddenly and can last for several days.
  • An anal fissure causes a tearing or knifelike pain when it first occurs and turns into a dull ache that can last for hours. The tearing of the skin may also cause a small amount of bleeding. Each bowel movement irritates the injured skin producing sharp pain. The pain can be so intense that most people try to delay or not have a bowel movement, which only causes formation of harder stools and more pain when stool is passed.
  • The pain of proctalgia fugax is sudden and intense, usually lasting less than a minute. But in rare cases, the spasm can continue for an hour. The pain is described as a sharp, stabbing, or cramp-like occurring at the anal opening. The pain can awaken the person from a sound sleep. The attacks occur in clusters, appearing daily for a while then disappearing for weeks or months.
  • The pain of levator ani syndrome is a constant or frequently occurring dull pain that is felt higher up inside the rectal passage. The sensation is made worse by sitting and improves with walking or standing. The pain usually lasts approximately 20 minutes and tends to reoccur at regular intervals.

When to Seek Medical Care for Rectal Pain

Contact your doctor if home therapies are not helpful.

  • You should call immediately if you think you may have a thrombosed hemorrhoid because early treatment is the key to pain relief.
  • Also call your doctor if you are having any bleeding. Sometimes rectal bleeding can be a sign of a more serious problem such as colon cancer.

It is unlikely that rectal pain would require a visit to a hospital's emergency department. You may want to contact your doctor first before going to the hospital. A more urgent evaluation in the emergency department might be required if the following conditions develop:

  • Rectal pain becomes more severe, especially if associated with fevers and infectious discharge from the rectum.
  • Pain is no longer confined to the rectum but spreads to the abdomen.
  • You notice an increasing amount of rectal bleeding or a large amount of bleeding in one episode.
  • You think you have a foreign body in your rectum or suspect rectal prolapse as the cause of pain.

Rectal Pain Diagnosis

  • The doctor can make the diagnosis of a thrombosed hemorrhoid by doing a visual exam of the patient's rectum.
  • The diagnosis of anal fissure is usually made by a visual exam.
  • The diagnosis of proctalgia fugax is made by history. The doctor may do a rectal exam on the patient to rule out other causes of the pain.
  • A digital rectal exam is needed to make the diagnosis of levator ani syndrome. During the exam, the doctor can feel the levator ani muscles. The muscles may feel tight, and touching them can reproduce the pain.
Medically Reviewed by a Doctor on 2/19/2015

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