It is common to see patients who come to the clinic with complaints of anal cramping. Some patients not only feel a cramping sensation in the anal area, but even sometimes experience a cramping sensation in the perineum and small abdomen. Some people may have a sensation of anal cramping when standing or sitting, and the symptoms disappear when lying down. Some patients even suffer from insomnia, anxiety, and restlessness due to the sensation of anal drop, which seriously affects their work life.
Why do I have the sensation of a drop? Do I need to seek medical treatment? And what treatments are available to eliminate this annoying symptom? Today, we’ll take a look at what anal cramping is all about.
Internal hemorrhoids
When the internal hemorrhoid is heavy, it can cause a sensation of anal drop due to local inflammation and edema of the mucous membrane, or when the prolapsed internal hemorrhoid cannot be retracted, a sudden and strong drop can occur.
The symptoms of anal cramping caused by internal hemorrhoids are often mild and correspond to the timing of the hemorrhoid attack. In this case, after medication or surgery for hemorrhoids, the sensation of anal cramping disappears immediately.
Prolapse of the rectal mucosa
The rectal mucosa becomes loose and accumulates in the rectal canal, causing a feeling of anal swelling or incomplete defecation, commonly in the elderly and in people with chronic constipation. In severe cases, prolapse of the entire rectum, or “prolapse”, may occur. The diagnosis of prolapse can be made after anoscopic examination and imaging.
Proctitis
Rectal mucosa congestion and edema, or even erosion, can irritate the local area and lead to symptoms such as a sensation of anal cramping and increased frequency of bowel movements. The duration of the disease is usually long, recurrent, and the degree of lesions varies.
Colonoscopy can reveal congested intestinal mucosa, unclear vascular texture, and significant inflammation in the lesioned area. It can be treated with suppositories or drug enemas, and after the local inflammation is controlled, the feeling of falling will be significantly reduced or disappeared.
Rectal cancer
Rectal cancer is more hidden and it is difficult to be detected in time at the early stage. Due to the gradual enlargement of tumor, patients in the late stage of cancer may experience anal cramping, increased frequency of bowel movement, incomplete bowel movement and thin stool shape. Patients should be vigilant and have timely examination.
Anal sinusitis
The anal sinus is a pouch-like fossa with an upward opening between the anal flap and the lower part of the two adjacent rectal columns, where feces often accumulates. The sensation of anal swelling caused by anal sinusitis is usually accompanied by pain at the anal opening, itching or increased secretions in the anus, and requires prompt medical attention and symptomatic treatment.
Retention of feces
When fecal retention occurs, green fishy fecal water may be discharged from the patient’s anal opening. In this case, an enema or a bowel movement should be performed to prevent the occurrence of intestinal obstruction and critical symptoms.
Anorectal neurosis
This condition is the most difficult to cure and the most painful to treat. Neurosis is a condition in which no significant organic lesion is seen on examination, or the lesion is mild and does not match the patient’s description. Patients are usually self-aware of the disease, have significant pain, and have a strong desire to seek treatment. Patients with a longer course of the disease may become depressed or experience increased anxiety as a result of the shadowing sensation, which may lead to increased attention to the “site” of the disease, thus creating a vicious cycle.
There is no definitive clinical solution for this functional disorder, but usually a combination of warm water baths, local nerve stimulation, and functional exercises are needed to treat the patient’s accompanying symptoms. Commonly used treatments mostly focus on helping to restore coordinated movements of the pelvic floor muscle groups, along with antidepressant medications and psychological guidance to relieve or reduce patients’ anxiety.
It should be noted that the influence of mental factors on the body is often beyond our perception. Patients should first have a positive attitude toward treatment, do not take the bull by the horns, relax, understand that this disease is difficult to treat but not terrible, and do not give themselves too heavy a burden of thought in order to achieve twice the result with half the effort in the process of treatment.