Same-day & next-day appointments sometimes available for urgent concerns — Call (551) 321-1388
Anal or Rectal Pain — Find the Source, Treat the Cause
Anal and rectal pain has a long list of possible causes — from common and easily treated conditions to ones that require more complex evaluation. Dr. Karmina Choi identifies the specific source of pain accurately and offers targeted treatment at your first visit whenever possible.
ANORECTAL CONDITION
Many
distinct causes — accurate diagnosis at the first visit prevents months of mismanagement
Same
visit examination and diagnosis — treatment often begins immediately
Most
causes are benign and highly treatable with targeted in-office or medical treatment
Why anal and rectal pain needs specialist evaluation?
Anal and rectal pain is one of the most symptomatically diverse conditions in colorectal medicine. The same symptom — pain in or around the anus or rectum — can stem from a surface tear, an infected gland, a muscle spasm, a nerve disorder, an inflammatory condition, or, rarely, a malignancy. Each of these requires a completely different treatment approach.
Self-treating anal pain as hemorrhoids — the most common assumption — frequently delays the correct diagnosis by months or years. A brief in-office examination by a specialist identifies the source accurately, rules out serious causes, and allows treatment to begin at the same visit in most cases.
Common causes of anal and rectal pain
Anal fissure
A tear in the anal lining causing sharp, burning pain during and after bowel movements — often with bright red bleeding. The most common cause of severe acute anal pain.
Anal fissure treatment ->
Proctitis
Inflammation of the rectal lining causing rectal pain, urgency, and discharge — from IBD, infection, or radiation. Requires investigation and targeted treatment.
Anal cancer
Persistent anal pain with a palpable mass, non-healing ulcer, or bleeding — particularly in patients with HPV history. Requires biopsy and prompt specialist evaluation.
Anal cancer ->
Seek evaluation promptly if your anal pain includes any of these
Fever or chills with anal pain · Rapidly worsening swelling · Pain with a palpable mass that is not clearly a hemorrhoid · Persistent pain that has not improved in two weeks · Pain with unexplained weight loss or change in bowel habits. These features require same-week specialist evaluation to exclude abscess, fistula, and malignancy.
Anal fistula
Chronic pain and drainage from a tunnel between the anal canal and perianal skin — often recurring after abscess episodes. Requires surgical repair.
Fistula treatment ->
Anal abscess
Rapid-onset, constant throbbing pain with swelling — caused by infection of an anal gland. Cannot resolve without drainage. Seen and drained in the office.
Abscess and fistula ->
Thrombosed external hemorrhoid
Sudden intense pain with a tender lump at the anal opening — a blood clot in an external hemorrhoid. Dramatically relieved by in-office excision within 48–72 hours of onset.
Hemorrhoid treatment ->
Levator ani syndrome
A dull aching or pressure deep in the rectum — worse with sitting, better with walking. Caused by spasm of the levator ani muscles. Treated with pelvic floor therapy and muscle relaxation techniques.
Proctalgia fugax
Brief, severe episodes of rectal pain lasting seconds to minutes — often at night, waking the patient from sleep. Caused by spontaneous internal anal sphincter spasm. Frightening but benign.
Pilonidal disease
Infection at the top of the buttock crease — throbbing pain and swelling near the tailbone, separate from the anus. Drained in the office.
Pilonidal cyst ->
How Dr. Choi evaluate anal and rectal pain?
Detailed history. Character of the pain (sharp, burning, aching, cramping), timing (constant, with bowel movements, episodic), triggers, duration, associated symptoms — all provide strong diagnostic clues before examination begins.
Careful in-office examination. Visual inspection of the perianal area, digital rectal exam, and anoscopy — identifying fissures, abscess, fistula openings, hemorrhoids, masses, and sphincter tone changes at the same visit. Most anal pain causes are identifiable on examination alone.
Anorectal manometry when functional pain is suspected. Objectively identifies elevated resting pressures (levator spasm, hypertonic internal sphincter) and abnormal relaxation patterns that confirm functional anorectal pain syndromes.
MRI or endoanal ultrasound when indicated. For suspected deep abscess, fistula anatomy mapping, or to exclude a mass not palpable on digital exam.
Biopsy when appropriate. Any suspicious anal lesion — ulcer, mass, or unusual tissue — is biopsied for pathological examination to exclude dysplasia or malignancy.
Why choose Dr. Karmina Choi?
Same-visit diagnosis
Most causes of anal and rectal pain are identified at the first office visit — no waiting for a separate procedure appointment.
Urgent abscess drainage
Anal abscesses are drained in the office under local anesthesia — avoiding an ER visit and providing immediate relief.
Biopsy when needed
Suspicious lesions are biopsied on the spot — no referral required, no delay in excluding serious diagnoses.
Functional pain expertise
Levator ani syndrome and proctalgia fugax are frequently missed or dismissed. Dr. Choi recognizes and treats these conditions specifically.
Prompt appointments
Anal pain is distressing. We prioritize seeing patients with new or acutely worsening symptoms as quickly as possible.
Female physician option
A sensitive, comfortable environment for an intimate and often embarrassing area of concern.
Common Questions
I've been told it's hemorrhoids but the pain hasn't improved. What else could it be?
Internal hemorrhoids are almost always painless — pain is not a primary hemorrhoid symptom unless a thrombosis has occurred. If you've been self-treating painful anal symptoms as hemorrhoids without improvement, the much more likely diagnoses are an anal fissure (sharp pain with bowel movements), a developing abscess (constant throbbing), or a functional pain syndrome (levator ani syndrome, proctalgia fugax). A specialist examination quickly clarifies which is present and allows the right treatment to begin.
I wake up at night with severe rectal pain that lasts a few minutes and then disappears. What is this?
This is the classic presentation of proctalgia fugax — sudden, intense, brief episodes of rectal pain caused by involuntary internal sphincter spasm. It is entirely benign, though alarming. Episodes typically resolve spontaneously within minutes. Warm baths, relaxation of the sphincter, and in some cases low-dose muscle relaxants can reduce frequency and severity. Dr. Choi confirms this diagnosis by exclusion — ruling out other structural causes first.
What is levator ani syndrome?
Levator ani syndrome is a functional anorectal pain condition caused by spasm or excessive tension of the levator ani muscles — the pelvic floor muscles that cradle the rectum. It produces a persistent dull ache or pressure sensation deep in the rectum, typically worse with sitting and relieved by walking or standing. It is diagnosed by identifying tenderness of the levator muscles on examination and normal findings on structural investigations. Treatment is pelvic floor physical therapy, and most patients respond well with consistent participation.
Anal pain that isn't improving deserves a real answer.
Dr. Choi can identify the cause at your first visit and begin targeted treatment the same day in most cases.
1625 Anderson Avenue, Suite 203, Fort Lee, New Jersey 07024
This page is for informational purposes only and does not constitute medical advice. Individual results vary. Please consult Dr. Choi for a personalized evaluation and treatment plan.
© 2026 Colorectal Care of New Jersey. All rights reserved.
Colorectal Care of New Jersey
Expert, compassionate colorectal care — from office procedures to complex surgery — with a natural-first approach and a commitment to your long-term quality of life.
1625 Anderson Ave, Ste 203
Fort Lee, New Jersey 07024
ANORECTAL CONDITIONS
DIGESTIVE & GI CONDITIONS
PROCEDURES
(551) 321-1388
Monday - Friday & some Saturdays by appointment
SERVING
Fort Lee · Edgewater · Englewood · Teaneck · Hackensack · Palisades Park · Ridgefield · Manhattan (via GWB)
ABOUT
GI motility disorder
Crohn's disease
Ulcerative colitis
SIBO
Pelvic floor dysfunction
Visceral hypersensitivity
Patient reviews
APPOINTMENTS
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