Causes and Symptoms
The perception of pain during and / or after defecation is a symptom that unites several morbid conditions, generally benign, affecting the anorectal area.
If persistent or particularly intense, the pain associated with the evacuation of stool is worthy of a proctological examination. The simple characteristics of the pain, in fact, are not sufficient to carry out a self-diagnosis, which is however always inadvisable for therapeutic purposes; By analyzing them in detail and evaluating any related symptoms, it is still possible to formulate some hypotheses on the origins of pain associated with defecation:
- constipation: the emission of particularly hard stools can damage the anal mucosa, causing pain during and after defecation;
- diarrhea: frequent passing of liquid stool can irritate the anal mucosa causing pain; in the presence of intestinal infections or food intolerances (such as those to lactose), the acid pH of the stool contributes to producing anal lesions causing pain when passing stool;
- anal fissures: these small cuts in the anal mucosa are typically associated with burning and constricting pains (as if a small piece of glass passed through the anus) DURING defecation; also the small hemorrhages highlighted by the typical streaks of bright red blood in the toilet paper are characteristic The pain usually arises after evacuation and lasts for a period ranging from a few seconds to several hours in case of severity;
- hemorrhoids: these dilations of the submucosal veins of the same name, located at the level of the anus and the terminal tract of the rectum, are associated with more important hemorrhages than those caused by fissures, leaving real stains on toilet paper or drops of blood in the toilet. Pain during defecation is generally absent (in the case of non-prolapsed internal hemorrhoids), however less violent than that associated with fissures; in case of severity (for example in the case of prolapsed and strangled internal hemorrhoids) the pain can be quite violent and manifest even during the day
- large amounts of irritating foods or spices, such as black pepper or chilli
- scratching lesions: scratching, whether idiopathic or resulting from local infections, particular dermatological conditions (psoriasis, eczema, lichen simplex ...) or contact dermatitis, causes perianal skin damage that favors the proliferation of infectious processes and causes pain burning during defecation, with erythema (redness) of the perianal skin. Children are easily infected with various types of worms, such as pinworms (Enterobius vermicularis) that cause severe itching
- injuries resulting from sexual intercourse of an anal nature: there is generally a basic pain that can possibly accentuate with defecation
- lesions caused by sexually transmitted diseases, such as gonorrhea, herpes and chlamydia: there is generally a basic pain that worsens over time which may eventually accentuate with defecation; anal discharge of mucus, blood or pus may be noted
- fistula and anal abscess: the formation of a pathological canaliculus that connects the anal canal with the skin surrounding the anus (fistula) and the subsequent infection of this gap (abscess) causes acute, continuous and worsening anal pain associated with swelling and purulent discharge
- rectal cancer: can cause symptoms such as the emission of ribbon-like stools and a burning sensation in the anal canal accompanied by spasm of the sphincter with urgency of defecation and a sense of incomplete emptying during defecation; in this case the anal pain is dull and persists throughout the day.
What to do
- Contact your doctor to determine the causes of the pain and remedy it. General advice may also be useful, such as:
- wear cotton underwear, avoiding non-breathable synthetic underwear
- carry out a thorough hygiene of the anal area with appropriate detergents after each defecation, while avoiding excessive or manic hygiene that could cause irritative eczema
- regulate body weight
- use soft, uncolored and unscented toilet paper: coloring substances and perfumes can aggravate anal itching or promote its development
- wash the anal area carefully after sports: even sweat can accentuate or trigger an annoying itch and anal pain, which is accentuated with defecation
- always dry the genital and anal area carefully with a hairdryer or a soft cotton cloth
- Regularize your diet in case of food-borne constipation or diarrhea
- wash the anal area with fresh but not freezing water: the cold has a mild analgesic effect but can cause the constriction of any haemorrhoidal nodules and accentuate the spasm of the anal sphincter
