|Other names||Anal pain, anorectal pain, proctalgia, pain in the bottom|
|Causes||Common: Anal fissures, hemorrhoids, anal fistulas, anal abscess|
Less common: Prostatitis, anal cancer, sexually transmitted infections, imflammatory bowel disease, tailbone pain, levator ani syndrome
Common causes include anal fissures, thrombosed hemorrhoids, anal fistulas, and anal abscesses. Less common causes include prostatitis, anal cancer, sexually transmitted infections, imflammatory bowel disease, tailbone pain, and levator ani syndrome.
One of the most common causes of rectal pain is an anal fissure. It involves a tear in the anal canal probably due to trauma from defecation and are usually treated effectively with sitz baths, stool softeners, and analgesics.
After structural diseases have been ruled out a functional disorder may be considered. Two causes of functional anorectal pain are levator ani syndrome (LAS) and proctalgia fugax. Both of these conditions are thought to be caused by muscle spasms of the either the levator ani muscle or the anal sphincter muscle respectively, and may overlap symptomatically with a third less-common condition called coccygodynia which is the result of previous trauma to the coccyx bone. Stress, prolonged sitting, and constipation all seem to be associated with LAS. The majority (90%) of those reporting chronic episodes of such pain are women. Some researchers group these conditions under the medical category of "tension myalgia of the pelvic floor". Less than a third of those experiencing these conditions seek medical treatment for them. Treatment can involve the use of antispasmodic medications as well as the down-training (conscious involvement and relaxation of previously unconscious muscle movements) so that spasms occur less frequently or not at all.
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