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What Causes Pain Around The Anus?

Posted on Tue, 9 Sep 2014

Question: Hi. Since Friday I have had severe, constant pain around my anus. I've tried Tylenol, Ibuprofen 400 and Naproxen 500 and tried ice packs and heating pads. I am in serious pain and cannot sit, stand or walk correctly. I wake up in the middle of the night because of the pain. What could be the cause of this? What treament options are there?

Answered by Dr. Deepak Kishore Kaltari (26 minutes later)

Brief Answer:
To rule out Thrombosed pile

Detailed Answer:
Hi
Welcome to healthcare-Magic
Greetings of the day

Dear Ms XXXXXXX

Such severe pain unrelieved with analgesic and persisting for son long could be possibly be due to

1. Thrombosed external pile
2. Anal fissure
3. Peri-anal abscess

Exact diagnosis will depend on clinical examination, providing clinical photograph will be helpful.

I would suggest you the following which will definitely be helpful

1. Hot Seitz bath: To a tub of lukewarm water add 2 spoons of antiseptic like dettol. Sit in it immersing your bottom for 15- 20 minutes each session thrice a day. The warmthness will relieve the pain and reduce anal spasm.

2. Local application of Xylocaine Ointment

3. Continue analgesics

4. Stool softener laxative like Lactulose

These remedies will be helpful in all the above three listed condition. Further specific treatment will depend on knowing exact cause. I would suggest you to consult your Physician for examination. In the meantime you can send me clinical photograph for further assessment.

Awaiting your response

Take Care

Best Regards
Dr Deepak Kishore
MBBS,MS,MCh

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (3 minutes later)

Thank you for your advice. I would send a picture but there is nothing visible. It's very painful and if I feel around, it's kind of hard jelly bean like under the surface of the skin. I've been checking each day and I cannot see anything

Answered by Dr. Deepak Kishore Kaltari (1 hour later)

Brief Answer:
Fissure is small ulcer,requires careful inspection

Detailed Answer:
Hi

Dear Ms

Anal fissure is a small ulceration at anal opening and is visible only on careful inspection. The hard jelly bean like thing is likely to be thromboses pile depending on where the location is.
Are you also suffering from constipation?

Awaiting your response

Regards
Deepak

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (11 minutes later)

I haven't had a bowel movement since Friday afternoon, just before this all started

Answered by Dr. Deepak Kishore Kaltari (46 minutes later)

Brief Answer:
Dulcolax suppository will be helpful

Detailed Answer:
Hi
Dear Ms XXXXXXX

If anal fissure is ruled out, then single suppository of Dulcolax will be sufficient to stimulate bowel movement. Also as previously advised Lactulose will be helpful along with adequate consumption of water.

Take Care

Best Regards
Deepak

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar