anal pain
Introduction
Introduction Anal severe pain, as the name suggests, is severe pain in the anus. This usually happens during defecation, but it can also occur during non-defecation. Mainly related to the following diseases: perianal abscess, internal hemorrhoids incarceration, anal fissure, advanced rectal cancer, and anal foreign body.
Cause
Cause
The causes of acute pain in the anus are mainly the following:
1. Perianal abscess: This disease is more common, which is commonly known as the "pustule" disease. A lump can be rubbed next to the anus, and the tenderness is obvious. If the position is deep, it can be accompanied by a fever. The pain of this disease is more severe, and the activity is aggravated. If the position is shallow, it can be broken and pus out. You can immediately perform a single episode of abscess surgery, and change the dressing twice a day. If you only pus, you may relapse. The pus is not released, and the anti-inflammatory drugs are ineffective by the infusion. The pain is greatly relieved immediately after the incision.
2. Internal hemorrhoids incarceration: common in patients with mixed hemorrhoids, due to dry stools, long sputum, cold, urgency, and many other reasons, resulting in mixed sputum inflammation and edema, internal hemorrhoids, due to anal sphincter spasm, so that the prolapse The blood circulation in the internal hemorrhoids is not smooth, further aggravating the edema, forming a vicious circle, and the more swollen, the more severe the pain. Immediately go to the anorectal hospital under anesthesia, the anal sphincter is relaxed, and the prolapsed part is returned to the anus. After the anti-inflammatory and local dressing changes, the inflammation subsides, and then radically cured by surgery.
3. Anal fissure: General pain can be tolerated, but in some cases, severe pain can occur, often occurring after defecation, and the pain time ranges from tens of minutes to several hours. Chronic anal fissure can cause a variety of anorectal diseases, the most common is perianal abscess and anal fistula. This level often requires surgery.
4. Late anorectal cancer: severe pain. There is no other way to stop the pain of the drug.
5. Anal foreign body: the pain is more severe, sometimes it can be complicated by anal abscess. Usually due to accidental swallowing of fishbone, jujube nucleus, ribs, etc., when the bowel movement is stuck in the anus, piercing the tissue of the anus and causing local infection.
Examine
an examination
Related inspection
Anal examination of anus
The symptoms of anal fissure have clear characteristics. As long as the course of medical history is detailed, as well as the characteristics of pain and bleeding, the diagnosis is not difficult. However, in the diagnosis, in order to improve the accuracy of diagnosis and prevent mistakes, it should be differentiated according to the aspects of consultation, palpation, visual diagnosis and biopsy.
1, visual inspection: acute anal fissure visible secretions in the anus, retracting the buttocks can be seen at the lower end of the anal fissure, such as using the probe to touch the lower end of the rupture, can cause pain, chronic anal fissure often has connective tissue external hemorrhoids.
2, finger diagnosis: due to sphincter spasm anus tightening, such as excessive force, often cause severe pain, sometimes under local anesthesia. The crack touched in the anus, the edge of the acute one is soft, the bottom is shallow, elastic, and sensitive to touch; the chronic side has a hard protrusion, deep bottom, and no elasticity.
3, speculum examination: visible oval ulcer, or see a small gap. The edge of the acute anal fissure is neat and the bottom is light red; the edge of the cleft of the chronic anal fissure is not neat, the bottom is dark grayish white, and some people with severe anal fissure can also see sphincter fibers.
Diagnosis
Differential diagnosis
The difference between acne and anal fissure:
1, most of the anal fissure with sentinel sputum, especially in patients with long-term neglect of anal fissure, after the development of old anal fissure, often accompanied by external hemorrhoids, internal hemorrhoids, then the two are basically the same outside the anus. Therefore, understanding the difference between anal fissure and hemorrhoids, and raising the awareness of anorectal abnormalities can be of great benefit to treatment.
2, anal fissure is an anal canal skin rupture, anal canal ulcer, difficult to heal as the main performance. Hemorrhoids are formed by the formation of varicose veins, venous vascular masses, and the mucosa of the lower rectum.
3, anal fissure is mainly pain, blood in the stool. Hemorrhoids are mainly bleeding, and only when the external hemorrhoids are inflamed and swollen, hemorrhoids will be severely painful.
4, anal fissure can be seen in the anal canal skin cracking, while hemorrhoids are not. In the anal examination, you can be sure, but the anal fissure is not feasible for anal examination, or speculum examination.
5, anal fissure is associated with anal papillary hypertrophy, anal papilloma, and hemorrhoids are not associated with anal papillary hypertrophy or papilloma.
6, anal fissure, the appearance of the anus can be seen narrow, and patients with hemorrhoids are often seen in the internal hemorrhoids, eversion.
