Rectal pain

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Rectal pain is uncomfortable and can be upsetting to many patients. Often, the origin of the pain is benign. Carcinoma should be ruled out in older patients. Many times, rectal pain can be easily diagnosed. In some cases, though, the pain may be from the urinary or gynecologic systems. Rectal pain should be distinguished from coccydynia which is buttock pain.

Differential diagnosis of causes of rectal pain

In alphabetical order.

• Anal Fissure
• Anal sex
• Constipation
• Coccygodynia
• Diarrhea
• Fecal impaction
• Idiopathic
• Inflammatory Bowel Disease
• Levator ani syndrome
• Neoplasm
• Perianal abscess
• Proctalgia fugax
• Solitary Rectal Ulcer Syndrome
• Thrombosed hemorrhoid
• Trauma

Treatment

Acute anal fissure

• Increase fiber/water intake
• Sitz bath
• Stool softener
• topical corticosteroids

Coccuodynia

• analgesics
• corticosteroid shot
• Sitz bath

Indications for Surgery

Chronic Anal Fissure

• Sphincterotomy