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Anal pain

MedGen UID:
66776
Concept ID:
C0238637
Sign or Symptom
Synonyms: Anal Pain; Anorectal pain; Proctalgia; Rectal pain
SNOMED CT: Anal pain (68653001)
 
HPO: HP:0500005

Definition

Pain in and around the anus or rectum (perianal region). [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVAnal pain

Conditions with this feature

Paroxysmal extreme pain disorder
MedGen UID:
331565
Concept ID:
C1833661
Disease or Syndrome
SCN9A neuropathic pain syndromes (SCN9A-NPS) comprise SCN9A erythromelalgia (EM), SCN9A paroxysmal extreme pain disorder (PEPD), and SCN9A small fiber neuropathy (SFN). SCN9A-EM is characterized by recurrent episodes of bilateral intense, burning pain, and redness, warmth, and occasionally swelling. While the feet are more commonly affected than the hands, in severely affected individuals the legs, arms, face, and/or ears may be involved. SCN9A-PEPD is characterized by neonatal or infantile onset of autonomic manifestations that can include skin flushing, harlequin (patchy or asymmetric) color change, tonic non-epileptic attacks (stiffening), and syncope with bradycardia. Later manifestations are episodes of excruciating deep burning rectal, ocular, or submandibular pain accompanied by flushing (erythematous skin changes). SCN9A-SFN is characterized by adult-onset neuropathic pain in a stocking and glove distribution, often with a burning quality; autonomic manifestations such as dry eyes, mouth, orthostatic dizziness, palpitations, bowel or bladder disturbances; and preservation of large nerve fiber functions (normal strength, tendon reflexes, and vibration sense).

Professional guidelines

PubMed

Knowles CH, Cohen RC
Cleve Clin J Med 2022 Jun 1;89(6):336-343. doi: 10.3949/ccjm.89a.21102. PMID: 35649568
Godeberge P, Sheikh P, Lohsiriwat V, Jalife A, Shelygin Y
J Comp Eff Res 2021 Jul;10(10):801-813. Epub 2021 Apr 30 doi: 10.2217/cer-2021-0038. PMID: 33928786
Carrington EV, Popa SL, Chiarioni G
Curr Gastroenterol Rep 2020 Jun 9;22(7):35. doi: 10.1007/s11894-020-00768-0. PMID: 32519087

Recent clinical studies

Etiology

Zhao S, Zhang L, Gao F, Wu M, Zheng J, Bai L, Li F, Liu B, Pan Z, Liu J, Du K, Zhou X, Li C, Zhang A, Pu Z, Li Y, Feng B, Tong W
JAMA Surg 2021 Dec 1;156(12):1151-1158. doi: 10.1001/jamasurg.2021.4568. PMID: 34613330Free PMC Article
Grabski B, Kasparek K
J Sex Med 2020 Apr;17(4):716-730. Epub 2020 Feb 28 doi: 10.1016/j.jsxm.2020.01.020. PMID: 32122772
Morlino A, La Torre G, Vitagliano G, Cammarota A
Ann Ital Chir 2015 Mar 26;86(ePub) PMID: 25818193
Nelson RL
BMJ Clin Evid 2014 Nov 12;2014 PMID: 25391392Free PMC Article
Nelson R
BMJ Clin Evid 2010 Mar 24;2010 PMID: 21718564Free PMC Article

Diagnosis

Knowles CH, Cohen RC
Cleve Clin J Med 2022 Jun 1;89(6):336-343. doi: 10.3949/ccjm.89a.21102. PMID: 35649568
Carrington EV, Popa SL, Chiarioni G
Curr Gastroenterol Rep 2020 Jun 9;22(7):35. doi: 10.1007/s11894-020-00768-0. PMID: 32519087
Lohsiriwat V
World J Gastroenterol 2016 Jul 14;22(26):5867-78. doi: 10.3748/wjg.v22.i26.5867. PMID: 27468181Free PMC Article
Shawki S, Costedio M
Gastroenterol Clin North Am 2013 Dec;42(4):729-58. Epub 2013 Nov 7 doi: 10.1016/j.gtc.2013.09.007. PMID: 24280397
Parks AG, Thomson JP
Br Med J 1973 Jun 2;2(5865):537-9. doi: 10.1136/bmj.2.5865.537. PMID: 4714472Free PMC Article

Therapy

Wan XY, Fu YJ, Li GM, Xiao GZ, Guo ZW, Ren DL, Cao B, Lin HC
BMC Surg 2022 Aug 1;22(1):298. doi: 10.1186/s12893-022-01744-3. PMID: 35915446Free PMC Article
Zhao S, Zhang L, Gao F, Wu M, Zheng J, Bai L, Li F, Liu B, Pan Z, Liu J, Du K, Zhou X, Li C, Zhang A, Pu Z, Li Y, Feng B, Tong W
JAMA Surg 2021 Dec 1;156(12):1151-1158. doi: 10.1001/jamasurg.2021.4568. PMID: 34613330Free PMC Article
Carrington EV, Popa SL, Chiarioni G
Curr Gastroenterol Rep 2020 Jun 9;22(7):35. doi: 10.1007/s11894-020-00768-0. PMID: 32519087
Shawki S, Costedio M
Gastroenterol Clin North Am 2013 Dec;42(4):729-58. Epub 2013 Nov 7 doi: 10.1016/j.gtc.2013.09.007. PMID: 24280397
Nelson R
BMJ Clin Evid 2010 Mar 24;2010 PMID: 21718564Free PMC Article

Prognosis

Grabski B, Kasparek K
J Sex Med 2020 Apr;17(4):716-730. Epub 2020 Feb 28 doi: 10.1016/j.jsxm.2020.01.020. PMID: 32122772
Molendijk I, Peeters KC, Baeten CI, Veenendaal RA, van der Meulen-de Jong AE
Best Pract Res Clin Gastroenterol 2014 Jun;28(3):505-18. Epub 2014 May 5 doi: 10.1016/j.bpg.2014.04.011. PMID: 24913389
Koyama S, Hirota M, Kobayashi M, Tanaka Y, Kubota S, Nakamura R, Isobe M, Shiki Y
J Obstet Gynaecol Res 2014 Feb;40(2):595-8. Epub 2013 Oct 10 doi: 10.1111/jog.12184. PMID: 24118245
Slesser AA, Bhangu A, Bower M, Goldin R, Tekkis PP
Surg Oncol 2013 Dec;22(4):230-7. Epub 2013 Aug 26 doi: 10.1016/j.suronc.2013.08.002. PMID: 24050823
Dudding TC
Colorectal Dis 2011 Mar;13 Suppl 2:23-8. doi: 10.1111/j.1463-1318.2010.02522.x. PMID: 21284799

Clinical prediction guides

Grabski B, Kasparek K
J Sex Med 2020 Apr;17(4):716-730. Epub 2020 Feb 28 doi: 10.1016/j.jsxm.2020.01.020. PMID: 32122772
Bondi J, Avdagic J, Karlbom U, Hallböök O, Kalman D, Šaltytė Benth J, Naimy N, Øresland T
Br J Surg 2017 Aug;104(9):1160-1166. Epub 2017 May 10 doi: 10.1002/bjs.10549. PMID: 28489253
Gaj F, Candeloro L, Biviano I
Clin Ter 2016 Mar-Apr;167(2):e32-7. doi: 10.7417/CT.2016.1922. PMID: 27212575
Nelson R
BMJ Clin Evid 2010 Mar 24;2010 PMID: 21718564Free PMC Article
Kuehn HG, Gebbensleben O, Hilger Y, Rohde H
Int J Med Sci 2009;6(2):77-84. Epub 2009 Mar 6 doi: 10.7150/ijms.6.77. PMID: 19277253Free PMC Article

Recent systematic reviews

Zhang H, Lin M, Nan Z, Zhang Y, Liu S, Li A, Li G
Int J Colorectal Dis 2023 Sep 14;38(1):228. doi: 10.1007/s00384-023-04519-1. PMID: 37707561
Nelson RL
BMJ Clin Evid 2014 Nov 12;2014 PMID: 25391392Free PMC Article
Slesser AA, Bhangu A, Bower M, Goldin R, Tekkis PP
Surg Oncol 2013 Dec;22(4):230-7. Epub 2013 Aug 26 doi: 10.1016/j.suronc.2013.08.002. PMID: 24050823
Nelson R
BMJ Clin Evid 2010 Mar 24;2010 PMID: 21718564Free PMC Article
Steele SR, Madoff RD
Aliment Pharmacol Ther 2006 Jul 15;24(2):247-57. doi: 10.1111/j.1365-2036.2006.02990.x. PMID: 16842451

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