Differential Diagnosis for Anal Pain and Perianal Itching
- Single most likely diagnosis
- Hemorrhoids: This is often the most common cause of anal pain and perianal itching, especially if the pain is exacerbated by bowel movements or straining. Hemorrhoids can cause itching due to the leakage of mucus and minor bleeding.
- Other Likely diagnoses
- Anal fissure: A tear in the lining of the anus can cause severe pain during and after bowel movements, and may also lead to itching due to the discharge of blood and mucus.
- Pruritus ani: A condition characterized by intense itching around the anus, often without a clear cause, but can be related to hygiene, diet, or skin conditions.
- Proctitis: Inflammation of the rectum can cause pain, itching, and discharge, often due to infections or inflammatory bowel disease.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Anal cancer: Although rare, anal cancer can present with pain, itching, and bleeding. Early detection is crucial for effective treatment.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause anal pain, itching, and other systemic symptoms, and require prompt diagnosis and treatment to prevent complications.
- Infectious diseases (e.g., herpes simplex, syphilis): Certain infections can cause anal pain and itching, and may have serious consequences if left untreated.
- Rare diagnoses
- Levator ani syndrome: A condition characterized by chronic pain and discomfort in the anal region, often related to muscle spasms.
- Coccygodynia: Pain in the tailbone area can sometimes be referred to the anal region, causing discomfort and itching.
- Eczema or psoriasis: Skin conditions that can affect the perianal area, causing itching and discomfort.