From the Guidelines
Lower abdominal pain referred to the rectum is most likely caused by inflammatory or infectious disorders of the anorectum, such as proctitis or anorectal abscesses.
Possible Causes
- Proctitis: an inflammation of the rectum, which can be caused by sexually transmitted pathogens such as N. gonorrhoeae, C. trachomatis, T. pallidum, and HSV 1.
- Anorectal abscesses: a collection of pus in the tissues around the anus, which can cause pain, swelling, and tenderness 1.
Clinical Presentation
Patients with these conditions may present with symptoms such as pain, tenesmus, rectal discharge, and bleeding 1. The diagnosis is usually based on the patient's history and physical examination, and imaging modalities may be used for further evaluation 1.
Key Considerations
It is essential to differentiate anorectal abscesses from other causes of anal pain, such as anal fissure, thrombosed hemorrhoids, levator spasm, and cancer 1. A thorough evaluation and diagnosis are crucial to provide appropriate management and treatment.
From the Research
Causes of Lower Abdominal Pain Referred to the Rectum
The causes of lower abdominal pain referred to the rectum can be attributed to various factors, including:
- Visceral pathology, such as inflammation, ischemia, or acidosis, which can stimulate visceral nociceptors and induce pain 2
- Central sensitization and alteration of endogenous pain modulation, which can lead to an increased excitability of the central nervous system and an amplification of pain perception 2
- Mechanical distension or stretch of the colon and rectum, which can elicit visceral pain through mechanotransduction 3
Specific Conditions Associated with Lower Abdominal Pain
Some specific conditions that can cause lower abdominal pain referred to the rectum include:
- Appendicitis, which is the most common cause of lower abdominal pain 4, 5, 6
- Diverticulitis, which can cause colic and intense pain 4, 5, 6
- Colon cancer, which can cause colic and intense pain 4
- Crohn's disease, which can cause colic and intense pain 4
- Ovarian and tubal pathology, which can cause lower abdominal pain 5
- Ureteral stones, which can cause lower abdominal pain 5
- Hernias, which can cause lower abdominal pain 5
Diagnosis and Management
Diagnosis of the underlying cause of lower abdominal pain referred to the rectum is crucial for effective management. Imaging modalities such as CT or ultrasound can be used to diagnose conditions such as appendicitis and diverticulitis 4, 5, 6. A thorough understanding of the individual pathophysiology of the patient's condition can help guide treatment and management strategies 2.