It’s a condition that affects approximately 15% of the population of the United States, across all ages and demographics (though the numbers are even higher for people 45 years of age and older). It can be tremendously debilitating, making basic functioning, including bowel movements and even just sitting down, a very painful experience. And perhaps worst of all, because it affects a sensitive, personal area of the anatomy, it can be quite difficult for some people to talk about, meaning many suffer in silence.
Rectal pain – that is to say intermittent, severe pain that does not only occur during bowel movements – has a number of medical names. Proctalgia furax is the main name, though that’s often shortened to simply proctalgia or the plain English term ‘fleeting rectal pain.’ No matter what you call it, it’s a diagnosis that comes as a ‘diagnosis of exclusion,’ meaning that it’s diagnosed by eliminating all possible alternatives. Rectal pain can be a symptom of a large number of conditions of the bowels, rectum, and prostate, and so in order to secure a proctalgia diagnosis, doctors must first eliminate the possibility of anal fissures, abscesses, hemorrhoids, inflammation, and malignancies. In men, all forms of prostatitis must also be eliminated, including bacterial and non-bacterial, and chronic and acute forms. Once all other alternatives are eliminated, proctalgia furax is all that remains.
What Causes Rectal Pain?
Because there are so many potential causes for rectal pain, and so many potential diagnoses, it can be difficult to pinpoint the exact cause of a specific case of the condition. For instance, rectal pain is one of the most common side effects of hemorrhoids, which is the swelling of veins inside your rectum. Anal fissures, which are tiny rips or tears along the surface of the anus, can cause tremendous rectal pain. Rectal pain can be a side effect of constipation, the difficulty defecating due to excessively hard, dry stools – and constipation itself can have any number of causes, from viral infections to dietary issues to dehydration. And on the flipside, rectal pain can also be caused by diarrhea, the opposite conditions, where stools have an excess of liquid due to your intestines collecting too much liquid, which again has many causes.
Proctalgia, which is an inflammation of the prostate gland (in men only) can result in pains in the entire region surrounding the crotch, including the penis, testicles, anus, and rectum. Lower back pain can even be present. The pain is normally less acute than some of the above-described conditions, more of a dull ache or feeling of excessive pressure, rather than a sharp pain. As with hemorrhoids, it may be made worse by sitting down for a long period.
This barely scratches the surface of what can cause rectal pain. It can also be a result of a variety of infections, inflammatory diseases like Crohn’s, rectal prolapse, foreign bodies in the rectum, and even cancer. It can also be caused by injuries or weaknesses in the ligaments, specifically the iliolumbar ligament and the sacrococcygeal junction.
The good news is that many of these conditions are simple to diagnose and treat with courses of antibiotics and medications. However, because there are so many possible causes, finding the specific cause of the pain can be the most challenging part of the whole endeavor.
What Are the Symptoms of Rectal Pain?
Rectal pain normally presents as a sharp, intermittent pain in the rectal region, generally lasting from several seconds to several minutes. It can also take other forms, including a dull ache, muscle spasms, and generalized tenderness in the area. Pain from anal fissures can be particularly intense, with a knife-like feeling.
Sufferers often report a feeling of tight pressure, especially when sitting, normally lasting about 20 minutes, and returning at regular intervals. Many report that this feeling goes away more quickly after standing up and/or walking around.
Certain conditions causing rectal pain, such as hemorrhoids and anal fissures, also involve rectal bleeding.
How Is Rectal Pain Treated?
There are a variety of treatment regimens for rectal pain, depending on the cause of the condition. However, if left untreated, many of these conditions can become quite serious. For this reason, if you’re experiencing rectal pain, it is strongly recommended that you seek treatment from a doctor as soon as possible.
Before your appointment, carefully consider what type of pain you’re experiencing. The more precisely you can describe the type of pain – sharp versus dull, constant versus intermittent, etc. – and location – inside the rectum, on the surface, in nearby areas – the better equipped your doctor will be to provide an accurate diagnosis.
In addition to conventional methods of treatment, it may be beneficial to look into prolotherapy, a natural treatment which can strengthen your body’s structure, preventing further problems.