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Anorectal pain



  • Anorectal pain can be an incredibly uncomfortable symptom that may be caused by a wide range of conditions affecting the anus and rectum.


    • Causes of Anorectal Pain

    • Thrombosed haemorrhoid
    • Anal fissure
    • Proctitis - IBD (Crohn’s / ulcerative colitis), infectious proctitis, radiation proctitis
    • Perianal abscess
    • Prostatitis
    • Proctalgia fugax
    • Anal SCC
    • Trauma

History of Presenting Complaint

    • Site

    • Where the pain is - in the anus or rectum.
    • Onset

    • Whether the pain began suddenly or gradually, and under what circumstances.
    • Character

      The type of pain - sharp, dull or burning.
    • Sharp pain while passing stoolsSuggestive of anal fissure
    • Aching pain after opening bowelsSuggestive of internal haemorrhoids
    • Radiation

    • Whether the pain radiates anywhere else, such as the abdomen.
    • Associated Symptoms

      Whether the pain is associated with any other symptoms.
    • Perianal massSuggestive of thombosed haemorrhoid, perianal abscess or anal SCC
    • Blood stained stoolsSuggestive of proctitis
    • Blood on toilet paperSuggestive of haemorrhoids or anal fissure
    • Tenesmus - urge to defaecate despite passing stoolSuggestive of space-occupying lesion or proctitis
    • Timing

      How long the pain has been going on for, and whether it is constant or comes and goes.
    • Intermittent spasms of severe painSuggestive of proctalgia fugax
    • Worse at nightSuggestive of proctalgia fugax
    • Exacerbating Factors

      Whether the patient has noticed anything that makes the pain worse.
    • Opening bowelsSuggestive of anal fissure
    • Alleviating Factors

    • Whether there is anything that relieves the pain.
    • Severity

    • How bad the pain is on a scale of 1-10, with 10 being the worse pain.
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