Pain

Pain after bleeding is the most common cause to visit a doctor. The character of pain is of different quality and often already suggests the diagnosis. A fierce, sharp pain during defecation indicates a tear in the anus (anal fissure). The pain sometimes occurs only a short time after defecation (interval pain) and diminishes slowly again. A slow onset and then a continuously increasing pain is often associated with a hardening and indicates an anal abscess. If a pain to some extent comes out of the blue, often after pressing, and one feels a knot in the anal area, it is usually an anal thrombosis, rarely a pinched, prolapsed haemorrhoid knot. Very violent, spasmodic paroxysmal pain lasting from a few minutes up to half an hour is the result of a proctalgia fugax. There can be day and night attacks. At night, the patients are torn from sleep by pain. These symptoms are very troubling but not dangerous