Rectal pain
Pain in the rectal area with 68 documented causes.
Rectal pain refers to discomfort felt in the rectal area. Medical literature has recorded 68 distinct causes for this symptom.
**Differential diagnosis**
**Anal fissures** A very frequent cause of rectal pain is an anal fissure, which is a tear in the anal canal, likely resulting from trauma during bowel movements. Standard treatment involves sitz baths, stool softeners, and pain relievers.
**Levator ani syndrome and proctalgia fugax** Two other common sources of functional anorectal pain are levator ani syndrome (LAS) and proctalgia fugax. Both conditions are believed to stem from muscle spasms—of the levator ani muscle or the anal sphincter, respectively. Their symptoms can overlap with a rarer condition called coccygodynia, which arises from prior injury to the coccyx bone. Stress, prolonged sitting, and constipation are associated with LAS. About 90% of people reporting chronic episodes of this type of pain are women. Some researchers classify these conditions as "tension myalgia of the pelvic floor." Fewer than one-third of those affected seek medical care. Treatment may include antispasmodic medications and down-training, a technique that involves consciously relaxing previously unconscious muscle movements to reduce or prevent spasms.
**Anorectal abscess** An anorectal abscess is an infection that creates a pus-filled pocket in the tissues around the anus. It is managed surgically through incision and drainage.
**Infections** Bacterial, viral, and protozoal infections can occur in the area surrounding the rectum, sometimes as a result of a sexually transmitted infection.
**Other** Additional causes include hemorrhoids or a rectal foreign body.
Quick Facts
- Field
- General surgery
Facts from the source article.
Lore & Background
Rectal pain is a symptom with a broad differential diagnosis. One of the most common causes is an anal fissure, a tear in the anal canal likely due to trauma from defecation, typically treated with sitz baths, stool softeners, and analgesics. Two other highly common causes are levator ani syndrome (LAS) and proctalgia fugax, both thought to result from muscle spasms of the levator ani muscle or anal sphincter muscle, respectively. These may overlap symptomatically with coccygodynia, a less common condition from previous trauma to the coccyx bone. Stress, prolonged sitting, and constipation are associated with LAS.
Reader's Guide
Rectal pain is a common symptom with a wide range of underlying causes, from benign conditions like anal fissures to infections requiring surgical intervention. The documented existence of 68 different causes underscores the complexity of diagnosis. Functional anorectal pain conditions such as levator ani syndrome and proctalgia fugax are notable for their high prevalence among women (90% of chronic cases) and the fact that less than a third of sufferers seek medical treatment. Treatment approaches vary from conservative measures (sitz baths, stool softeners) to surgical drainage for abscesses, and for muscle spasm conditions, antispasmodic medications and conscious muscle relaxation techniques. The grouping of these conditions under 'tension myalgia of the pelvic floor' reflects an evolving understanding of their shared pathophysiology.
Did You Know?
- A total of 68 different causes of rectal pain have been documented.
- 90% of those reporting chronic episodes of functional anorectal pain are women.
- Less than a third of individuals with levator ani syndrome or proctalgia fugax seek medical treatment.
- An anorectal abscess is treated surgically by incision and drainage.
More in Symptoms and signs: Digestive system and abdomen 1-24
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