Anal pain is a clinical manifestation of a variety of anorectal diseases. Pain of different nature reflects different disease characteristics. If the pain occurs after surgery, it is caused by stimulation of the nerve endings of the wound, or by external stimuli such as feces, secretions, and drug stimulation. Anesthesia before surgery is not good, too much tightness in the dressing after the operation, anal edema, thrombosis, or anal sphincter pain caused by foreign body stimulation in the wound. After anal surgery, the wound heals to form a scar, and compression of the nerve causes pain.
Patients with anal pain are not uncommon in clinical practice. Most patients can find a clear cause, but a small number of patients have unclear causes. In general, the causes of anal pain are as follows:
1, mental factors: mostly caused by mental stress, such as anal rectal neurosis, pudendal nerve syndrome, sciatica and caudal nerve pain reflected to the anus and cause anal pain;
2, foreign body and bad diet stimulation: such as trauma, foreign body in the rectum, spicy food and alcohol can stimulate the anus, causing pain;
3, anorectal infection around the anus: that is, anorectal abscess, anal sinusitis, anal papillitis, etc., these diseases can also cause anal pain;
4, anal diseases: such as hemorrhoids incarceration, inflammatory external hemorrhoids, thrombosis, anal fissure, anal fistula, etc., can cause anal pain;
5, intestinal infection or diarrhea, constipation: intestinal infection, can cause inflammation to stimulate the anus, diarrhea and constipation can make the feces through the anus, mechanical stimulation of the anus, resulting in anal pain;
6, anorectal tumor: whether benign tumors, or malignant tumors, its surface mucosal infection or direct compression of the anus, can lead to anal pain. Late anorectal cancer invades the nerves and can cause severe pain.
Anal finger examination anal inspection
1, the time of pain: pain and defecation at the same time, pain relief after defecation. More common in anal fissure, anal stenosis, anal sinusitis, mixed sputum inflammation and edema. The rectum and anus are not operated correctly, and the feces pass through the stool to cause pain.
2, persistent pain: more common in the perianal abscess, thrombotic external hemorrhoids, anal canal cancer, anorectal surgery followed by suppurative infection, anal trauma with foreign bodies embedded in the anus.
3, pain: more common in the anus embedded in foreign bodies can not be discharged, rectal submucosal abscess.
4, paroxysmal pain: seen in rectal inflammation, neurosis, pudendal syndrome.
5, laboratory examination: must be based on the medical history and physical examination of the objective materials to be summarized and analyzed, from which to propose several diagnostic possibilities, and then further consider those physical examinations to confirm the diagnosis. Such as: rectal examination, colonoscopy and so on.
Differential diagnosis of anal pain:
Acne is a soft vein group formed by the expansion and flexion of the submucosal and subcutaneous venous plexus of the human rectum. It can be divided into internal hemorrhoids, external hemorrhoids, mixed hemorrhoids with the tooth line as the boundary, and sometimes symptoms of fecal pain.
Pain: Simple internal hemorrhoids have no pain, and a few have a feeling of falling. When the internal hemorrhoids or mixed hemorrhoids are incarcerated, and there is edema, infection, and necrosis, there are different degrees of pain.
Second, anal fissure
The anal fissure is a small ulcer formed after the laceration of the anal canal layer below the dentate line. It is clinically common in the stool, such as severe pain, blood in the stool, constipation, itching and other symptoms.
Defecation pain is the main symptom of anal fissure, which is characterized by periodic bowel movement pain. When there is a willingness, the anus relaxes and the pain begins. When the bowel movements, the feces rush out of the crack, and immediately feel the burning pain in the anus or the pain of the knife cut, called pain; after a few minutes or 10 minutes after defecation, the pain stops or is relieved. Called the intermittent period, then, due to the contraction of the anal sphincter, the patient feels the pain of severe cracking.
The degree of anal fissure pain is light and heavy with the size and depth of the anal fissure. The pain during this period, which usually lasts for half an hour to several hours, makes the patient restless and very painful. When the sphincter is tired and tired, the pain gradually stops. This is a cycle of pain, a pain from the bowel movement, a pain relief process. Later, due to defecation or sneezing, coughing, urination, etc. can cause periodic pain episodes. When the anal fissure is combined with an infection, the pain is more pronounced.
Third, anal canal inflammation
Anal canal inflammation is caused by long-term fecal stimulation and poor bowel habits. The main symptoms are persistent beating pain, anal itching, and abnormal bowel movements.
Persistent beating pain: Many patients suffer from persistent pain when they are defecation due to stool stimulation of the anal canal, making the patient inconvenient and uneasy.
Fourth, perianal abscess
Anal abscess refers to an acute or chronic suppurative infection that occurs in or around the soft tissue around the anorectum and forms an abscess. The main symptoms are pain, hard lump, and fever.