Anal Pain
WHEN TO SEE YOUR DOCTOR
* You are bleeding from the rectum.
* Your anus feels swollen.
* The pain persists for more than two to three days.
* You have a fever.
* You have changes in bowel habits, such as chronic diarrhea or constipation.
What Your Symptom Is Telling You
Somewhere between watching a rerun of "Gilligan's Island" and being branded with a hot poker is a torment called anal pain.
Pain in your bottomside can mean that you simply have a bruise from a nasty fall or that a hemorrhoid has become clotted with blood. Fissures (cracks in the skin surrounding the anus) are another common cause of pain. "Fissures are like cold sores, only they're more painful," explains Robert Gilsdorf, M.D., a general surgeon in Phoenix.
In addition, some people have occasional muscle spasms in their rectums. These spasms, called proctalgia fugax, usually occur at night. Common among teenagers, the painful spasms tend to subside as a person ages, says James Harig, M.D., associate professor of medicine in the Department of Digestive and Liver Diseases at the University of Illinois College of Medicine in Chicago.
On the more serious side, anal pain could be a sign that you have an abscess or a sexually transmitted disease or that your rectum is slipping out of its normal position—a condition that frequently affects older women who have had several children.
Symptom Relief
Fortunately, there are a number of easy ways to get fast relief from anal pain.
Submerge your tush. Sitting in a sitz bath—three to four inches of 110° to 115°F water—for 15 minutes two or three times a day may relieve much of your pain. (The water should be very warm, but not painfully hot to your hand.) Covering the area with towels soaked in warm water is an effective alternative.
Numb it. Applying over-the-counter medications containing benzocaine or dibucaine to the tender spot may take some of the sting out of your pain, says Dr. Harig.
Don't forget the water. Drinking six to eight glasses of water a day is a must if you want to prevent constipation and anal pain. "If you don't put enough water into your system, your stool can get hard like a sponge left out on the kitchen counter," says Bruce Orkin, M.D., an assistant professor specializing in colon and rectal surgery at the George Washington University School of Medicine and Health Sciences in Washington, D.C. A hard stool takes more effort to expel from your body, and that extra strain increases your chances of developing a painful fissure or hemorrhoid.
Eat high-fiber foods. Doctors recommend adding more raw fruits, leafy vegetables, whole-grain breads and cereals to increase the amount of fiber in your diet. Fiber increases the bulk and softness of your stool and reduces pressure on blood vessels during bowel movements.
Try laxatives. When you have problems with regularity, doctors recommend bulk-forming laxatives containing psyllium seeds to soften stools and make them easier to expel from your body. Easy evacuation lessens your chance of developing painful symptoms.
K is for Kegel. Usually used to control certain types of incontinence, Kegel exercises also can help strengthen anal muscles and prevent painful hemorrhoids, Dr. Gilsdorf says. Kegels work on the slinglike group of muscles that stretch from the pubic bone in the front to the anus and tailbone in the rear. Squeezing those muscles not only can cut off urinary flow but also can keep the rectal muscles in tone. Although it may vary according to your condition, a typical Kegel regimen might include 20 contractions of these muscles for ten seconds each, four times a day. Ask your doctor if Kegels may be right for you.
Swim like a dolphin. Exercise is an important way to help keep your bowel movements regular. When you experience anal pain, however, you should avoid exercises such as weight lifting that put a strain on anal muscles. "Swimming is good because it's a non-weight-bearing exercise. Tennis and racquetball are okay, too," Dr. Harig says. "But you want to avoid doing squats or anything that increases pressure in the anal area."
