Differential Diagnosis for Anal Pain
- Single most likely diagnosis
- Hemorrhoids: This is often the most common cause of anal pain, especially if the pain is associated with bowel movements, bleeding, or a palpable mass.
- Other Likely diagnoses
- Anal fissure: A tear in the lining of the anus can cause severe pain during and after bowel movements, often accompanied by bleeding.
- Proctalgia fugax: A condition characterized by sudden, severe anal pain that lasts for a few seconds to minutes, often at night.
- Levator ani syndrome: A condition where the muscles around the anus become spasmodic, leading to chronic pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Anal cancer: Although rare, anal cancer can present with anal pain, bleeding, or a palpable mass, and early detection is crucial for treatment.
- Rectal abscess: A collection of pus in the rectum can cause severe anal pain, fever, and swelling, and requires prompt drainage to prevent complications.
- Ischiorectal abscess: Similar to a rectal abscess, but located in the ischiorectal fossa, it can cause severe pain and requires drainage.
- Rare diagnoses
- Coccydynia: Pain in the coccyx (tailbone) can radiate to the anus and be mistaken for anal pain.
- Pudendal neuralgia: A condition where the pudendal nerve becomes irritated or damaged, leading to chronic pain in the anal and genital areas.
- Anal Crohn's disease: A complication of Crohn's disease that can cause anal pain, fistulas, and abscesses.