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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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