Brief Answer: go to a specialist Detailed Answer: hi, i understand your anxiety, as the anal area is a very sensitive area and it is embarrassing for patients to talk about it. keep in mind that a digital rectal examination provides very limited information in terms of causes of anal pain. The most common cause of anal pain is an anal fissure, however this is usually due to trauma to the area. A colorectal surgeon can do an "anoscopy" and have a better look and better view to the anus compared to a standard colonoscopy (a different technique and equipment is used). If there has not been any trauma or manipulation of the rectal area before the pain started, then other considerations are muscle spasms and hypersensitivity to the anal nerves. This can be related to stress; i see that you suffer from anxiety and depression, so it could be related. Traditional treatments include warms baths and even warm water enemas. There are medications available that can be used to relax the anal sphincter muscles and relieve the pressure and pain, however you should see a specialist first, and i suggest you visiting a colorectal surgeon. Hope that helped, let me know if you have any further questions or concerns.

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