Anorectal Pain

CLINICAL DIAGNOSTIC MANUAL

Anorectal pain is a painful sensation located in the anal and rectal regions, ranging from mild discomfort to severe, debilitating pain. This type of pain can be associated with various conditions affecting the anorectal area, each with specific clinical characteristics.

Evaluating anorectal pain requires a detailed medical history and careful physical examination to identify the underlying cause and determine appropriate treatment.

Condition	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmatory Diagnosis
Anal fissure	Intense, sharp pain during and after defecation, bright red bleeding	Medical history and physical examination	Anoscopy, detailed physical examination
Haemorrhoids	Pain and itching in the anal area, bright red bleeding during defecation, lumps	Medical history and physical examination	Anoscopy, sigmoidoscopy
Perianal abscess	Severe, constant pain, swelling, redness, fever, purulent discharge	Medical history, physical examination	Endoanal ultrasound, MRI
Proctalgia fugax	Brief episodes of intense rectal pain, no inflammatory signs	Medical history	Clinical diagnosis, exclusion of other causes
Coccygodynia	Pain in the coccyx, worsened by sitting or rising	Medical history and physical examination	X-ray of the coccyx, MRI
Proctitis	Rectal pain, bleeding, mucous discharge, diarrhoea, sensation of rectal pressure	Medical history, physical examination	Sigmoidoscopy, biopsy
Prostatitis	Perineal or anorectal pain, urinary symptoms, fever, general malaise	Medical history, physical examination	Urinalysis, urine culture, prostate ultrasound
Other causes	Vary depending on aetiology, including inflammatory diseases, infections, tumours	Medical history, physical examination, specific tests based on suspicion	Specific tests based on suspected cause (e.g., colonoscopy, biopsy)