Pain in the anus and rectum: what can be and what to do

Anal pain, or pain in the anus or rectum, can have several causes, such as fissures, hemorrhoids or fistulas, so it is important to check in what situations the pain appears and whether it is accompanied by other symptoms, such as blood in the stool or itching, for example.

However, anal pain can also be caused by sexually transmitted diseases, such as chlamydia, gonorrhea or herpes, as well as other infections, inflammation of the intestine, abscesses or cancer. That is why it is important to consult a proctologist, as it may be necessary to take antibiotics or need surgery, depending on the cause of anal pain. Learn more about anal cancer.

Some common causes of anal pain are:

1. Hemorrhoids

The presence of hemorrhoids can result in itchy anal pain and arise mainly due to chronic constipation, intimate anal contact or pregnancy. Hemorrhoids can be noticed by swelling in the anal area that causes discomfort, itchy anus, blood in stools or toilet paper, in addition to anal pain when walking or sitting, for example.

What to do: In order to treat hemorrhoids, sitz baths or the application of ointments for hemorrhoids, such as Proctosan, Proctyl or Traumeel, for example, may be indicated. If the hemorrhoids do not disappear and the discomfort becomes more and more, it is recommended to seek the advice of a gastroenterologist or proctologist so that the hemorrhoids are evaluated and, thus, the best treatment can be done, which may involve a surgical procedure in the hemorrhoids. Learn more about hemorrhoid treatment.

2. Anal fissure

The anal fissure is a small wound that appears in the anus and that can cause anal pain when evacuating and the presence of blood in the stool. In addition, the anal fissure can be noticed through the appearance of other symptoms such as burning when evacuating or urinating and itching in the anus, for example.

What to do: most of the time, the anal fissure passes by itself without needing any type of treatment. However, the use of anesthetic ointments, such as Lidocaine, for example, in addition to a sitz bath with warm water, may be recommended. Learn more about the treatment for anal fissure.

3. Intestinal endometriosis

Intestinal endometriosis is a disease in which the endometrium, which is the tissue that lines the uterus internally, develops around the walls of the intestine, which can result in anal pain during menstruation. In addition to anal pain, there may be abdominal pain, nausea and vomiting, blood in the stool and difficulty with bowel movements or persistent diarrhea. Learn more about intestinal endometriosis.

What to do: the most recommended is to consult the gynecologist as soon as possible to make the diagnosis and treatment, which is usually done through surgery.

4. Infection

Most common infections that cause anal pain are sexually transmitted microorganisms, such as HPV, Herpes, Chlamydia, Gonorrhea and HIV, for example, but also due to inadequate intimate hygiene, such as fungus infections. Thus, it is important to go to the doctor to identify the microorganism that causes the infection and, thus, the best treatment.

What to do: it is recommended to use antimicrobials, in addition to avoid using toilet paper in an exaggerated way, giving preference to the hygienic shower.

5. Perianal abscess

The abscess is an infection of the skin or the result of another anorectal disease, such as inflammatory bowel disease, rectal cancer or surgery, which causes swelling, redness and a lot of pain. There is also formation of pus and high fever. Learn more about how to identify and treat the abscess.

What to do: seek medical attention to drain the pus and take antibiotics. If an abscess is formed that is very large or deep, the doctor may indicate a hospital stay for the person to take painkillers and antibiotics in the vein, perform tests, such as a tomography, and have surgery with general anesthesia to remove the entire abscess, thus preventing a new infection or formation of a fistula.

6. Anal cancer

Cancer of the anus may show symptoms with bleeding, pain, or a palpable lump. It can start as a wound or a mole and then turn into a lump. There are some studies that correlate the appearance of this type of cancer with HPV infections and that is why it is very important to be up to date with the Pap test, popularly known as the Gynecological Prevention Exam.

What to do: if you have any symptoms, the patient should see a doctor so that tests can be carried out and the suspicion of anal cancer is confirmed and thus indicate the best treatment.

When to go to the doctor

It is important to consult a proctologist or go to the emergency room when anal pain takes more than 48 hours to pass after using anal ointments or analgesic or anti-inflammatory drugs, such as Paracetamol or Ibuprofen.

It is important for the doctor to identify the cause of the pain in the anus that recurs or that gets worse over time, as it can be a sign of serious problems, such as anal fistula or cancer, which may need treatment with surgery.