What is rectal or anal pain?

The rectum is the lower section of the large intestine, and it ends at the anus. Rectal pain has a vast array of causes, from minor to severe. Because pain around the anus has so many potential sources, it's essential to have a proper diagnosis. Inflammation, injury, or infections that impact the anus and rectum can lead to rectal pain. Several signs can help a healthcare professional narrow down and determine the cause of rectal pain. For example, determining when the pain occurs - such as when sitting or through a bowel movement -- and discovering any additional symptoms might help reveal the cause. Other common symptoms include stinging, bleeding,  itching, and stomach cramps. 

 frequent causes of the symptom of rectal pain, pressure, or discomfort are fleeting anal spasms (Proctalgia fugax), hemorrhoids, anal fissures, persistent muscle spasm (Levator ani syndrome). Many other rare causes of rectal pain are cancers or prostate problems.

Rectal pain generally varies based on its underlying cause; as an instance, hemorrhoids usually cause mild or moderate distress, while anal fissures can cause a tearing or knife-like sharp pain. Should you experience rectal pain without bleeding, contact your healthcare professional, however, go to an Emergency Department if you're bleeding from the anus, have increasing severity of pain, or the pain is spreading.

For most people, identifying the reason behind rectal bleeding is done by a physician that includes a rectal examination.

See: Ayurvedic Treatment For Hemorrhoids or Piles

What causes rectal or anal pain?

Causes of rectal anal pain include the following:

- Anal fissures

An anal fissure is a tiny cut or tears in the skin that lines the rectal opening. They generally grow because of stretching or straining the tissue at the opening of the anus. Like hemorrhoids, anal fissures happen because of bearing down through or passing a hard stool or childbirth. Other symptoms of an anal fissure include blood in the feces, burning, or increased rectal pain during bowel movements.

Hemorrhoids

Potential causes of rectal pain include muscle spasms, hemorrhoids, and fecal impaction. Hemorrhoids are swollen veins in the anus. They may develop on the inner or outer side of the rectum. Hemorrhoids are a relatively common cause of rectal pain, particularly if they're on the inside. The NIDDKD (National Institute of Diabetes and Digestive and Kidney Diseases) estimates that roughly 50 percent of adults over the age of 50 may develop hemorrhoids. The anus' veins can swell more frequently when someone has difficulty having a bowel movement and pushes. Pushing during childbirth also increases an individual's risk of developing hemorrhoids. Together with rectal pain, hemorrhoids may cause additional symptoms, such as itching, burning, or swelling around the rectal opening.

- Muscle spasms

Like all muscles, those around the anus may spasm, and this can result in pain. Rectal spasms might only last a few seconds or a few minutes. Brief rectal spasms are known as proctalgia fugax. Specific actions may trigger a spasm, such as sexual activity, bowel movement, or constipation. Spasms may also happen for no known reason. Some research indicates that proctalgia is not uncommon and may occur in approximately 18 percent of the populace. Proctalgia most frequently develops in adults ages 30--60, and it's more prevalent in women. Other signs and symptoms of rectal spasms include pain that worsens when sitting or sudden rectal pain.

- Fecal impaction

Fecal impaction is a hard stool that's stuck in the anus. Chronic constipation is the main cause of fecal impaction. Other symptoms of fecal impaction may include stomach pain, nausea, bloating

- Bowel conditions

A gut condition can lead to stomach cramps, diarrhea, and a diminished appetite. Certain bowel conditions can lead to inflammation from the intestines, including the rectum. Other symptoms of the bowel conditions include stomach cramps, diarrhea, diminished appetite, or blood in the feces.

- Sexually transmitted infections

Though not as common as other causes, sexually transmitted diseases (STIs) can spread to the anus in the genitals and cause pain. Various kinds of STIs can spread, such as human papillomavirus, herpes, and chlamydia. Other symptoms of STIs impacting the anus could include burning, infection, itching, or rectal discharge.

- Rectal prolapse

Rectal prolapse occurs when a section or the entire rectum slides out through the rectal opening.

The condition isn't common, and the cause isn't clear. However, around 67 percent of individuals who undergo a rectal prolapse have long term constipation. Additionally, it is much more common in women over age 50. Other symptoms of rectal prolapse include leaking stool, pain during bowel movements, or a bulge outside the anus

- Anal intercourse

The skin around the anus is quite sensitive. Friction from sexual activity between the anus can cause tiny tears, swelling, irritation, or bleeding as the anus doesn't produce its lubrication. Anal sex is mostly safe. If someone experiences pain during or following anal intercourse, they could try using foreplay and many lubricants to avoid pain in the future.

- Inflammation of the rectal lining

Infection of the lining of the anus develops most frequently from bowel disease. Along with rectal distress, other inflammation symptoms around the rectal lining might contain diarrhea, rectal bleeding, and a pressure feeling in the anus.

- Cancer

Rectal or rectal cancer may also cause rectal distress. But most cases of rectal pain aren't because of cancer.

See: Ayurvedic treatment for anal fissure

Natural home remedies for rectal pain

Home remedies for rectal pain relief

The treatment choices for rectal pain usually depend on the cause. For instance, treatment for fecal impaction may include a medical procedure to remove the impacted stool. Treatment for STIs often involves drugs.

To ease general rectal pain, people can try at home some remedies:

sitting in warm water for 20 minutes

applying a topical numbing ointment

taking over-the-counter hemorrhoid creams comprising hydrocortisone

avoid constipation 

avoid straining during a bowel movement

eating a diet high in fiber 

drinking a lot of water 

using a stool softener and additional fiber to reduce pain with bowel movements

sitting on a pillow, which might reduce the pressure on the anus

using antibiotics for bacterial infections

Individuals should speak with their health care provider if rectal pain lasts longer than a couple of days. Rectal pain goes away quickly without having to find a healthcare provider. However, there are cases when it's essential to see a physician. Consider visiting a doctor or health care provider if the pain becomes intense or spreads into other parts of the body or there's continuing rectal bleeding.

See: Acupuncture for Hemorrhoids Treatment

Rectal pain prevention

The best way to stop rectal pain is to consume a high-fiber diet and drink lots of water. This will create soft stools that are easy to pass and cause fewer traumas to the anal passage. Rectal pain might occur temporarily and usually doesn't indicate a serious illness, mainly when it only happens sometimes. However, there are instances when it's a symptom of something more serious, such as inflammatory bowel disease or an STI. Although many cases of rectal pain are treatable with home remedies, it could be necessary to find a doctor in some cases, like if rectal pain worsens or doesn't go away.

See: Fistula Ayurvedic Treatment Kshar Sutra has Positive Results for a 30 Year Old Male

References


1. Anal pain. (n.d.) https://www.fascrs.org/patients/disease-condition/anal-pain

2. Definition & facts of hemorrhoids. (2016) https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/definition-facts

3. Jeyarajah, S., & Purkayastha, S. (2013). Proctalgia fugax. http://www.cmaj.ca/content/185/5/417.short

4. Levator syndrome. (2011). https://rarediseases.info.nih.gov/diseases/6899/levator-syndrome

5. Rectal prolapse. (n.d.) https://www.fascrs.org/patients/disease-condition/rectal-prolapse-0

6. What is inflammatory bowel disease (IBD)? (2018). https://www.cdc.gov/ibd/what-is-IBD.htm

7. Sugerman DT. Anal fissure. JAMA. 2014;311(11):1171. doi:10.1001/jama.2014.214

8. Gardner IH, Siddharthan RV, Tsikitis VL. Benign anorectal disease: hemorrhoids, fissures, and fistulas. Ann Gastroenterol. 2020;33:9-18. doi:10.20524/aog.2019.0438

9. Mapel DW, Schum M, Von Worley A. The epidemiology and treatment of anal fissures in a population-based cohort. BMC Gastroenterol. 2014;14:129. doi:10.1186/1471-230X-14-129

10. Lang DS, Tho PC, Ang EN. Effectiveness of the Sitz bath in managing adult patients with anorectal disorders. Jpn J Nurs Sci. 2011;8(2):115-28. doi:10.1111/j.1742-7924.2011.00175.x

11. American Heart Association. Whole grains, refined grains, and dietary fiber. Updated September 20, 2016. 

12. Cleveland Clinic. Anal fissures: Management and treatment. Updated February 22, 2019.

13. American Society of Colon & Rectal Surgeons. Anal fissure expanded information.

14. Cleveland Clinic. Anal fissures: Prevention. Updated February 22, 2019.

15. Additional Reading

16. 9. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015.

See: Ayurvedic herbs for constipation relief

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