Short-term paroxysmal dull pain in the anus

Introduction The anus often has short-term paroxysmal dull pain, or pain lasts for several hours, which is a common manifestation of clinical symptoms of anal sinusitis. Anal sinusitis, also known as anal cryptitis, is often the origin of infectious diseases of the anorectal and rectal parts. Because the symptoms are not heavy, it is easy to be ignored. The anal sinus is in the lower part of the sinus, the opening is upward, and it is in the shape of a bag. The drainage is poor. It is easy to store the feces and cause infection and injury. The edge of the anal sinus has a free half-moon anal flap, which is also vulnerable to scratching of dry feces. Teared when defeated.

Cause

Causes:

Infection and injury

The anal sinus is in the lower part of the sinus, the opening is upward, and it is in the shape of a bag. The drainage is poor. It is easy to store the feces and cause infection and injury. The edge of the anal sinus has a free half-moon anal flap, which is also vulnerable to scratching of dry feces. Teared when defeated. Increased frequency of bowel movements or intestinal inflammation, dysentery, diarrhea, constipation, etc., frequently stimulate the anal sinus and anal flap. Physical and local resistance is reduced, or there are chronic wasting diseases, feces and foreign bodies accumulate in the anal sinus, the sinus is blocked, the anal fluid secreted by the anal gland is not drained, and the feces are decomposed, the bacteria multiply, and the anal sinus is Inflamed and swollen. Common pathogens include Escherichia coli, Staphylococcus, Proteus, Aerobacter, Streptococcus, Mycobacterium tuberculosis, Pseudomonas aeruginosa, etc., of which Escherichia coli accounts for 60% to 70%.

2. The effects of sex hormones

Gao Yuejin et al (1985) pointed out that, like sebaceous glands, the development and function of anal glands are mainly regulated by human sex hormones. The level of sex hormones directly affects the proliferation and atrophy of anal glands. Therefore, the level of sex hormones and the occurrence of anal sinusitis close relationship. And sex hormones have the greatest effect on androgens. In a person's life, the mother's body brings more androgen than the mother, so the perianal infection is more, once developed into a long-term, with the level of androgen decreased, and the perianal infection can be self-healing. Men and young adults have higher levels of androgen, so anal gland infections increase, and perianal abscesses often occur in young adults. The level of senile sex hormones decreased significantly, and the anal glands atrophied. Therefore, anal sinusitis and perianal infection rarely occur in the elderly.

3. The impact of embryonic development

It is believed that in the 7th week of embryonic development, the cloaca and anal membrane rupture and fuse with the hindgut. At this time, the dorsal part of the cloaca is derived from the anal canal, the dentate line and the lower part of the anal column. If for some reason, the anus is caused. Abnormal fusion between the membrane and the hindgut, can not form normal dentate lines and crypts, and form irregular dentate lines and deep crypts, susceptible to bacterial infection and injury after birth, forming anal sinusitis, perianal abscess And anal fistula. Clinical observation confirmed that the anal crypts of patients with perianal abscess and anal fistula are often abnormally deepened, which can be as deep as 3 to 10 mm, and the number can be increased to 3 to 13. The theory that embryonic development affects the anal sinus has been widely recognized by experts.

an examination

Related inspection

Anal finger examination anus visual anus reflex rectal-anal motor function measurement

1. Anal burning during defecation: Anal fissure can cause periodic pain due to feces, which is the main symptom of anal fissure. When defecation, the fecal block stimulates the nerve endings of the ulcer surface, and immediately feels the burning pain of the anus, but the pain is relieved a few minutes later. This period is called the intermittent period of pain.

2, rectal pain: anorectal pain is the most common symptom of anorectal disease, due to anatomy and physiology, anal bowel disease pain mostly occurs in the lower abdomen, perineum, anal margin and lower rectum.

3, anal area redness and painful lumps: swelling in the anal area is the main symptom of abscess around the anorectal rectum. At the time of examination, local anal swelling, tenderness and painful lumps were observed.

4, anal short-term paroxysmal dull pain: the anus often has short-term paroxysmal dull pain, or pain lasts for several hours, is a common manifestation of clinical symptoms of anal sinusitis. Anal sinusitis, also known as anal cryptitis, is often the origin of infectious diseases of the anorectal and rectal parts. Because the symptoms are not heavy, it is easy to be ignored.

5, anal pain: anal pain as the name suggests is severe pain at the anus. This usually happens during defecation, but it can also occur during non-defecation. Mainly related to the following diseases: perianal abscess, internal hemorrhoids incarceration, anal fissure, advanced anorectal cancer and anal foreign body.

Differential diagnosis

Differential diagnosis of paroxysmal dull pain in short anus:

1, anal fissure: anal fissure with anal periodic pain, constipation, stool with blood as the main symptom. The pain is heavier than the anal crypt and the pain is longer.

2, perianal abscess: is the result of further development of anal cryptitis, mainly manifested as perianal pain, gradually aggravated, chicken pain when pus, with aversion to cold fever embolism, blood routine examination of white blood cells increased significantly, in the middle The granulocytes are also elevated.

3, anal pain: anal pain is a clinical manifestation of a variety of anorectal diseases. Pain of different nature reflects different disease characteristics.

4, thrombosis external hemorrhoids: external hemorrhiod (external hemorrhiod) thrombosis external hemorrhoids is a clinically frequently-occurring disease, often due to overeating spicy food, stools to the toilet, the perianal subcutaneous vein rupture, blood stasis under the skin. Clinically, the patient is conscious of anal swelling, pain and foreign body sensation as the main symptom. It can be seen that there are grape-like dark purple tumors under the perianal or anal canal, sometimes with mild erosion on the surface.

5, anal canal inflammation: anal canal inflammation is caused by long-term fecal stimulation and poor bowel habits, the main symptoms are persistent beating pain, anal itching, abnormal bowel movements. Persistent beating pain: Many patients suffer from persistent pain when they are defecation due to stool stimulation of the anal canal, making the patient inconvenient and uneasy.

6, anal sinusitis: no obvious symptoms in the chronic phase, but often there is a slight pain in the anus, swelling or discomfort, or anal gland secretion reduction, anal canal dryness, poor bowel movements and so on. In the acute attack period, there is pain in bowel movements, more secretions, accidental pus and blood in the toilet paper, burning discomfort, anal bulge and so on. If the anal sphincter is inflammatory, it can cause mild or moderate spastic contraction of the sphincter, often with short-term paroxysmal dull pain, or pain lasting for several hours. In severe cases, the pain can pass through the pudendal nerve, the radial nerve, and the perineal nerve. Radioactive pain.

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