When it comes to subjects for polite conversation, anal pain ranks pretty low. In fact — other than the scatological jokes you told as a kid — you don’t talk about, or hear about, anuses much at all.
So when you start experiencing anal pain, you worry. Is this something normal that everyone’s too embarrassed to talk about? Or is anal pain a sign that something’s seriously wrong?
The expert team of surgeons at Colon and Rectal Surgeons of Greater Hartford diagnose and treat anal pain at their offices in in Bloomfield, South Windsor, and Plainville, Connecticut. If you have anal pain, the following are a few of the factors that might be “behind” it.
Approximately one out of every three adults in the United States has evidence of thrombosed hemorrhoids on colonoscopy. Hemorrhoids themselves are actually normal structures, but when they become inflamed or thrombosed (i.e., develop a blood clot) they cause unpleasant symptoms, including pain.
Hemorrhoids are composed of veins, smooth muscle, and connective tissue. When you’re healthy, the hemorrhoids act as cushions to help keep stool in your anus until you’re ready to defecate.
You have two sets of hemorrhoids. The internal hemorrhoids are far up your anal canal and rarely cause pain. The external hemorrhoids reside near your anus and may become inflamed or thrombosed, which can cause excruciating pain. They may resolve on their own with lifestyle changes, or your doctor may need to remove the clot.
An anal fissure is a small cut in your anal tissue that can nevertheless be extremely painful. If your fissure is small, it may heal with minimal treatment.
A fistula is an infected tunnel of flesh that runs from an abscess caused by blocked anal glands to the exterior of your skin. Fistulas must be cleaned and repaired to prevent the infection from spreading.
Sexually transmitted diseases (STDs) take many forms. Some anal pain could be caused by anal warts, a type of STD. You might also have another type of viral or bacterial infection.
During your workup, we take blood tests to check for STDs and other infections. Most bacterial infections are cured with a course of antibiotics.
When you have a skin condition, such as eczema or psoriasis, it could affect the skin in and around your anus, too. Another skin condition, called lichen sclerosus, is usually limited to the genital area. Lichen sclerosus causes your skin to thin, become weaker, discolored, and painful.
Anal sex and sex play — even if it’s consensual — may damage your anus if the activity is too rough or forceful. If you’ve been anally raped, your anus and anal canal may be injured.
Even the strain from trying to evacuate your bowels when you’re constipated could traumatize your anal tissues. Paradoxically, the loose stools of diarrhea can also irritate your anal tissues, as can overly vigorous wiping to try to clean up after diarrhea.
Inflammatory bowel diseases (IBDs) such as ulcerative colitis and Crohn’s disease can cause you to alternate between constipation and diarrhea, both of which may irritate your colon and anus. In addition, the diseases themselves tend to cause pain along the digestive tract, including the anus.
You may also have weak pelvic floor muscles that don’t fully support your anus. Weak muscles may make it difficult — and therefore painful — to defecate.
Levator ani syndrome can be another source of anal pain. In this condition, the muscles around your anus have painful spasms.
Your first thought when you experience anal pain may be worries about anal cancer. Anal cancer is far less common that the other conditions that cause anal pain. However, you should never ignore anal pain, especially when it’s accompanied by other symptoms, such as anal bleeding or pus.
Don’t ignore anal pain. Get the diagnosis and treatment you need by calling us at 860-242-8591. You can also book online at the office nearest you.
