Anorectal pain

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]


Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic Eczema, pruritus ani
Drug Side Effect Cholestyramine resin, dextranomer and hyaluronic acid, hydrocortisone (topical), mesalamine, norfloxacin, orlistat, phenylephrine (topical)
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes

Anal abscess, anal cancer, anal fissure, anal fistula, anal prolapse, anal thrombosis, anorectal abscess, anorectal fistula, anorectal tuberculosis, appendicitis, cauda equine tumor, chlamydia trachomatis infection, coccygodynia, colitis, colon cancer, colon polyp, constipation , Crohn's disease, cryptitis, diarrhea, diverticulitis, fecal impaction, hemorrhoids, inflammation of the sacral nerves, intergluteal pilonidal disease, intersphincteric abscess, levator ani syndrome, papillitis, perianal abscess, perianal hematoma, perianal thrombosis, presacral cyst, proctalgia fugax, proctitis, pruritus ani, radiation proctitis, rectal abscess, rectal bleeding, rectal cancer, rectal prolapse, solitary rectal ulcer syndrome, ulcerative colitis

Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic Radiation proctitis
Infectious Disease Anorectal tuberculosis, chlamydia trachomatis infection, lymphogranuloma venereum, neisseria gonorrhea infection, proctitis, prostatitis
Musculoskeletal/Orthopedic Compression of the sacral nerves, inflammation of the sacral nerves
Neurologic Cauda equine tumor, compression of the sacral nerves
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic Chlamydia trachomatis infection, endometriosis, ovarian cyst, pelvic inflammatory disease, uterine fibroid
Oncologic Anal cancer, colon cancer, mucosal melanoma, perianal hematoma, prostate cancer, rectal cancer
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma Trauma
Urologic Cauda equine tumor, compression of the sacral nerves, inflammation of the sacral nerves, prostate cancer, prostatitis
Miscellaneous Anal sex, rectal foreign bodies

Causes in Alphabetical Order

[1] [2]


  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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