Pain In The Anus In Men : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 01/07/2022

Pain in the anus in men occurs with proctological diseases, some andrological pathologies. It can be short-term, long-term, constant, insignificant, moderate, strong, dull, sharp, burning, pressing, pulling, bursting, cutting, pulsating. Perhaps a combination with itching, burning, tenesmus, constipation, diarrhea, mucous or bloody discharge. To establish the etiology of the pain syndrome, a survey, external examination, ultrasound, sigmoidoscopy, anoscopy, and laboratory tests are performed. Treatment regimens include antibiotics, anti-inflammatory, analgesics, coating preparations, local procedures.

Why there is pain in the anus in men

External causes

Drawing pain in the anus is noted when wearing tight underwear and trousers. Unpleasant sensations sometimes disturb drivers, which is explained by a long stay in a sitting position, constant vibration. Less often, similar complaints occur in men of other "sedentary" specialties. Soreness is aggravated by the overflow of the colon.

Haemorrhoids

An increase in hemorrhoids is one of the most common proctological causes of pain in the anus. Uncomplicated hemorrhoids are manifested by burning, bursting at the time of bowel movement, often supplemented by non-intense dull aching or pulling pain. All symptoms persist for no more than a few hours.

In patients with thrombosis, the symptom intensifies, becomes permanent. The connection with the act of defecation is lost. When inflammation is attached, the pain increases even more, persists at night, becomes pulsating. Inflamed thrombosed nodes increase, feel like a foreign body in the anus. Possible deterioration of the general condition, hyperthermia.

Prolapse of hemorrhoids occurs several years after the manifestation of chronic hemorrhoids, at first it is asymptomatic or with a short-term sensation of interference in the anus, which disappears after self-reduction of the nodes. Pain and itching join when the nodes stop repositioning on their own, begin to fall out outside the act of defecation. The manifestation of the inflammatory process is characterized by sharp pains, subfebrile condition.

anal fissure

Acute anal fissure is manifested by spasm, intense pain that occurs during defecation and persists for a long time after its completion. Because of the pain, men try to delay bowel movements, which leads to constipation and exacerbates the problem. With chronic cracking, the symptom decreases somewhat, but does not disappear, the spasm becomes more persistent. Both forms of the disease are accompanied by itching, the appearance of small smears of blood on toilet paper, or streaks of blood in the stool.

Pain in the anus in children

 

Proctitis

Acute proctitis is characterized by false urges, stool disorders, general hyperthermia, severe pain in the anus, which increases during defecation, radiates to the scrotum, lumbar region. The clinical picture is somewhat different depending on the type of proctitis:

  • catarrhal. Symptoms are mild or moderate.
  • Erosive. It proceeds more severely than catarrhal, there is a release of blood and mucus.
  • Ulcerative. An even more severe form. Accompanied by the release of a large amount of blood.
  • Ray. Develops during or after the completion of radiation therapy. Manifestations are quite variable.

In men suffering from chronic proctitis, the severity of symptoms decreases. The pains are not intense, dull, pulling or aching. Periodically there are relapses with a clinic resembling an acute form of the disease.

Proctalgia

Pain syndrome is caused by spasm of the anus, develops secondarily against the background of other pathologies, or forms independently due to mental and physical overload. Painful sensations are intense, stabbing, cutting, spastic in nature, appear suddenly at any time, regardless of the act of defecation. The duration of an attack of proctalgia does not exceed several hours. Sometimes the symptom disappears after a bowel movement or a warm sitz bath.

Traumatic injuries

The cause of the injury can be sexual intercourse in passive homosexuals, the introduction of various objects for the purpose of masturbation, with mental disorders, improper procedures prescribed by the doctor, an attempt at self-treatment using folk remedies. Microtraumas, superficial burns of the mucosa are more often noted. Sometimes tears and breaks are revealed.

Foreign bodies enter the intestine not only through the anus, but also through the digestive tract. Men sometimes swallow toothpicks, small fish bones, and other sharp objects that dig into the mucous membrane, causing sharp pain, frequent urges. Dull foreign bodies and fecal stones provoke a feeling of heaviness, bursting, pressing pain.

With a mucosal injury, the occurrence of an inflammatory process, all symptoms intensify, fever, weakness, weakness are possible. A sharp excruciating pain indicates a violation of the integrity of the rectal wall and the exit of a foreign object into the pararectal tissue. Unbearable cutting pain, followed by symptoms of an acute abdomen, indicates the penetration of a foreign body into the abdominal cavity.

Neoplasms

Dull pain in the anus can be provoked by large villous tumors, rectal polyps. Sometimes the appearance of a pain syndrome indicates erosion or injury of benign neoplasia. Melanomas of the anorectal zone, rectal cancer are asymptomatic at first, then they are accompanied by rapidly growing pains, false urges, bleeding, mucus separation.

Other proctological pathologies

The list of other diseases of the anus and lower colon with pain includes:

  • acute and chronic paraproctitis;
  • inflamed epithelial coccygeal passage;
  • pararectal dermoid cyst;
  • crypt inflammation.

In addition, pain attacks in men can develop due to infringement of the prolapsed rectum. Sometimes sudden painful sensations at the time of defecation are observed in people with fecal incontinence on the background of chronic diseases, after injuries, proctological operations.

Constipation and diarrhea

The likelihood of pain associated with diarrhea correlates with the duration and severity of the disorder. In the acute form, the symptom is spasmodic in nature or occurs against the background of overstretching of the sphincter. In patients with a chronic form, itching, burning, pain may indicate the formation of secondary perianal dermatitis.

Pressing, bursting painful sensations, combined with a feeling of fullness in the intestines, often bother men with chronic constipation. After defecation, pain syndrome is formed due to damage to the anus by too hard feces.

Men's diseases

Pain in the anus with inflammation of the prostate gland is radiating in nature. It is not a mandatory sign of pathology. Features of pain in the anus in men depend on the form of prostatitis:

  • Spicy. Irradiation to the anus is sometimes determined at the second stage of the disease, some time after the increase in urination, the appearance of pain in the sacrum and perineum.
  • Chronic. Some patients are concerned about a slight soreness during bowel movements.
  • Calculous. Dull aching pain in the scrotum, sacrum, coccyx, anus area prevails. Painful attacks are possible during defecation, long walking, bumpy driving, physical activity, sexual intercourse.
  • stagnant. Painful sensations are constant, localized in the perianal zone, perineum, penis, scrotum. Irradiate to the coccyx, lower back, along the inner surface of the thighs.

With prostate cancer that has arisen against the background of chronic prostatitis, pain is also due to irradiation, combined with pain in the perineum, pelvis, and above the pubis. In patients with colliculitis, discomfort, dull pain, sensation of a foreign object in the anus are mild, slowly progressing. Possible involuntary ejaculation during bowel movements.

Proctological examination

 

Diagnostics

The determination of the etiology of pain in the anus is carried out by a proctologist. Men with prostate pathology are examined by an andrologist. According to the survey and physical examination, the patient is assigned such diagnostic manipulations as:

  • Proctological examination. Includes assessment of the condition of the anus, examination in rectal mirrors, digital examination, and other techniques. It makes it possible to detect cracks, fistulas, signs of hemorrhoids, foreign objects, neoplasia, inflammatory infiltrates.
  • Rectal examination of the prostate. Indicated for suspected prostatitis, prostate cancer. During the procedure, the doctor determines the shape, size and structure of the prostate, reveals signs of inflammation, volumetric formations.
  • Ultrasonic Methods . Patients are referred for transrectal ultrasound of the rectum to diagnose cancer, polyps, hemorrhoids, cysts, fistulas, and injuries. Ultrasound of the prostate can be performed transrectally or transabdominally, confirms inflammatory changes, areas of calcification, changes in the echostructure characteristic of a cancerous tumor.
  • Endoscopic techniques . Sigmoidoscopy and anoscopy are highly informative for erosions, ulcers, inflammatory processes, polyps, malignant tumors, fistulas, internal hemorrhoids. It is possible to take material for subsequent morphological examination.
  • Anal manometry. The technique is recommended for proctalgia, fecal incontinence, and other conditions accompanied by a decrease or increase in the tone of the anal sphincter.
  • Laboratory tests . A general scatological examination is prescribed to detect signs of inflammation and bleeding, and to detect parasites. According to the results of sowing, the etiology of the inflammatory process is determined. According to the cytological or histological examination, the nature of the tumors is established.
  • Other Methods . In diseases of the colon, an overview radiography of the OB, colonoscopy, and a biochemical analysis of feces are performed. In some cases, diagnostic laparoscopy is required. Men with suspected prostate cancer should have a PSA test.

Treatment

Help before diagnosis

To prevent pain arising from the action of external stimuli, you should choose comfortable underwear, take regular breaks during sedentary work, adjust your diet, and move enough to prevent constipation. You can reduce the likelihood of accidental injury by avoiding non-traditional sexual practices and self-medication.

Drug therapy is not indicated until the cause of the pain is determined. With general hyperthermia, intense pain, profuse bleeding, it is urgent to contact a proctologist. If the pain in the anus is supplemented by urination disorders, you need to make an appointment with an andrologist-urologist.

Conservative therapy

To create conditions conducive to the treatment of proctological diseases, a man is prescribed a special diet. It is necessary to exclude fatty, fried, salty. With a tendency to constipation, it is necessary to increase the amount of plant fibers, to ensure the possibility of a comfortable bowel movement at a certain time of the day.

With frequent diarrhea, it is recommended to abandon products that stimulate motility, increase fermentation and gas formation. Preference should be given to steamed dishes. The following medications are included in the drug therapy regimen for pain in the anus:

  • Rectal suppositories . Candles with analgesic, anti-inflammatory and softening effects reduce the severity of symptoms. Enveloping components protect the mucosa from injury during the passage of feces.
  • Antibacterial agents . They are prescribed for acute inflammatory diseases, exacerbation of chronic inflammatory pathologies. Medications are selected taking into account the sensitivity of the pathogen.
  • Hormonal preparations. To quickly eliminate edema and inflammation, men with severe proctitis, complications of hemorrhoids, are prescribed drugs from the group of corticosteroids.
  • Phleboprotectors . Used for chronic hemorrhoids. Strengthen the walls of blood vessels, slow down the progression of the disease, reduce the likelihood of thrombosis and bleeding.
  • local procedures . In the acute phase, to increase the effectiveness of treatment, microclysters are performed with painkillers, anti-inflammatory and emollient solutions. After the elimination of acute phenomena, baths with potassium permanganate, a perineal shower are used.
  • Physiotherapy . To eliminate burning and pain syndrome, men are given a referral for laser therapy, diadynamic therapy, and ultrasound.

Drug treatment of prostatitis involves long-term antibiotic therapy. Among non-drug remedies, prostate massage, ultrasound, laser exposure, microclysters are prescribed. For prostate cancer, radiotherapy, chemotherapy, hormone therapy are possible.

Surgery

Men with diseases of the anus and rectum perform the following surgical interventions:

  • Hemorrhoids . At the initial stages, minimally invasive techniques are used: electrocoagulation, sclerotherapy, laser coagulation, infrared coagulation. With the progression of the disease, ligation with latex rings and open surgery are recommended.
  • Anal fissure . In chronic cracks with signs of scarring, but without pronounced muscle spasm, infrared, laser or radiofrequency coagulation is performed. Deep cracks with widespread cicatricial changes, significant spasm are subject to surgical excision.
  • Foreign bodies, neoplasms . Foreign objects, coprolites, polyps, villous tumors are removed by an open method or using endoscopic techniques.
  • Malignant tumors . Extensive surgical interventions are shown - partial or complete removal of the rectum with bringing down or imposing a stoma.
  • Prolapse of the rectum . Repositioning is carried out on an emergency basis. To eliminate the pathology, the intestine is fixed by rectopexy, Zerenin-Kummel, Altmeyer, Delorme operations.
  • Diseases of the pararectal region . In acute paraproctitis, an abscess is opened. Fistulas are excised using various techniques (depending on the type of fistulous tract). Dermoid cysts are removed.

For men suffering from andrological diseases, operations such as:

  • Prostate cancer : radical prostatectomy, testicular enucleation to eliminate hormonal induction of tumor growth.
  • Prostatitis : installation of a cystostomy in case of acute urinary retention, transurethral or transrectal opening of the abscess during the formation of an abscess.
  • Colliculitis : transurethral resection of the seminal tubercle with frequent relapses, obstruction of the seminal ducts.

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