[Anal acute pain]

Anal acute pain. Anal pain is a symptom commonly reported during consultation for ano-rectal disease. It is a nonspecific symptom, associated with both emergency and chronic pathologies, and with both benign and serious conditions. Aetiological diagnosis is not always easily established during initial visit. In a patient without significant past medical history, when no sign of severe problem is present, and when clinical examination is normal, a second visit can help establishing diagnosis. When an abscess is suspected, antibiotherapy will not cure the patient, and may expose to occurrence of septic complications. When immediate intervention for an abscess is not possible, incision will control pain and infection for a few days. Haemorrhoidal thrombosis is another frequent aetiology of acute pain. Diagnosis is not difficult, and when appropriate medical treatment does not alleviate pain, incision under local anaesthesia is indicated. Pain associated with anal fissure is typicaly ryhthmed by stool passage. For non healing fissures, surgery may be proposed. Fecaloma, trauma, herpes virus infection and foreign body are less frequent, and clinical context is often suggestive.