What Causes Severe Pain Around Anus Associated With Sensation Of Incomplete Evacuation?

Posted on Wed, 23 Jul 2014

Question: I always have burning severe pain around my anal opening when I wash it with soap (area around anal hair root/growth). However, the doctor said I have no hemmerhoids (possibly one internally) after doing a rectal exam and seeing no blood on the feces. There is a lot of pain and difficulty in pooping sometimes and even pissing. There are always things that looks like bits of transparent green spinach or sometimes even tomato skin looking particles in my feces. My feces is sometimes unusually tinted orange and almost always liquid and sometimes there are dark dry brown bits of poop along with the rest of my poop. I always feel like I have liquid feces in my stomach when I am walking around and I can never get it all out in one sitting because of how cohesive it is sometimes and I feel like it often just stays in my stomach. I feel like I could sit in the toilet all day just trying to squeeze and slowly ooze feces out because I always feel more liquid poop often constantly daily. By the way, the last time I went to the doctor for a regular checkup it was found out that my AST liver enzyme levels were doubled normal levels (from blood test, and this was the only irregularity) but apparantly that could have been due to anything like too much exercise according to my doctor, so I have to do a followup checkup soon.

Answered by Dr. T Shobha Deepak (1 hour later)

Brief Answer:
Possibility of colitis

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

Severe pain around and anus associated with sensation of incomplete evacuation(Tenesmus) is likely to be due to pelvic muscle spasm (Proctalgia Fugax). I assume anal fissure or painful anal condition has been ruled out.
Persistent liquid stools along with features of Tenesmus possibility of Colitis needs to be considered.
Was stool examination carried out anytime?

I would suggest you the following
1. Get Stool examination done to rule out any infection as cause of your symptoms
2. Urine examination
3. Antibiotics: Empirical treatment with Cirprofloxacin and Tinidazole for 10 days will be effective
4. Hot seitz bath: To a tub of lukewarm water add handful of common table salt. Sit in it immersing your bottom for 15 to 20 minutes. It will relax pelvic muscle

5. High fiber diet
6. Probiotics

do get back to me if you need any further assistance, will be glad to assist you.

Take care
Best regards
Dr T Shobha Deepak
MBBS, MD

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Prasad