Pain in the anorectal area

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  • 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.
  • Colorectal pain may be a sign of colorectal cancer
  • Rectal pain, pressure or throbbing pain may occur with other primary problems like prostate problems, infections or other diseases.

A 60-year-old gentleman presents with a 3-day history of constant perianal pain and bright red blood seen in the toilet bowl. This morning, he noticed a small swollen mass at his anus when washing in the shower. He experienced a similar episode of pain and bleeding several months ago, which he attributed to hemorrhoids, but his symptoms today are far more severe.

Update July 9, 2016

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