Why am I having pain and swelling in my anal area?

Question

Hello doctor,

I have been experiencing severe pain and swelling in the anal area since yesterday morning. I already have an anal fissure that was diagnosed a few months ago, but it had been well-controlled with sitz baths and prescribed medicines until now.

Since yesterday, the pain has become much worse and is persistent throughout the day, even while resting. I have been taking sitz baths regularly and applying Sitcom cream, but the relief has been minimal. The swelling and continuous pain are making it very uncomfortable to sit, walk, or carry out normal daily activities. Please tell me,

What could be causing this sudden worsening of symptoms?
Does it indicate a complication such as infection, thrombosed piles, or worsening of the fissure?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I am sorry you are going through this, because severe, constant anal pain and swelling can become very distressing, especially when a fissure was previously under control.

A fissure can suddenly flare again, but marked swelling and continuous pain can also suggest a thrombosed hemorrhoid or even an infection or abscess, particularly if the pain is intense all the time rather than only during bowel movements.

Continue warm sitz baths several times daily for 15 to 20 minutes; avoid straining; drink plenty of water; and keep stools soft with fiber or a stool softener, such as lactulose or polyethylene glycol, if constipation is present.

For pain relief, medicines such as Paracetamol or Acetaminophen can help. If you can take them safely, Ibuprofen may also reduce inflammation unless you have kidney disease, stomach ulcers, bleeding problems, or have been advised not to use NSAIDs (non sterodal anti inflammatory drug).

Many fissure patients also benefit from prescription creams like topical Nitroglycerin or Diltiazem to help relax the anal sphincter. However, these should ideally be prescribed after a medical examination, as the current swelling may not be solely due to a fissure flare.

I hope this information helps you.

Feel free to ask further queries.

Thank you.