The reason why I wake up in the middle of the night with pain in my anus

The feeling of heaviness and pain in the anus in the middle of the night is mainly caused by some anorectal diseases. For example, prolapsed anal diseases often cause such symptoms. Of course, we must also be vigilant. The symptoms of colitis and proctitis may cause this phenomenon. Therefore, we must pay attention to it and go to the hospital for examination in time to determine the cause and treat it symptomatically.

The reason why I wake up in the middle of the night with pain in my anus

1. Prolapsed anal disease

(1) Prolapsed internal hemorrhoids, prolapsed rectal mucosa, and polyps can all stimulate the dentate line area (a highly specialized sensory nerve terminal tissue band that is the inducing area for defecation movements), causing a feeling of heaviness and distension in the anus and thus a feeling of defecation. (2) Uterine prolapse and vaginal prolapse often cause a feeling of falling. In patients with internal rectal prolapse, the mucosa sinks into the anal canal, stimulating the nerve endings in the dentate line and producing a feeling of heaviness.

2. Inflammatory diseases

(1) Colitis, proctitis, anal cryptitis, and anal papillitis can all cause anal swelling due to inflammation irritating the dentate area. (2) Submucosal rectal abscesses and pelvic rectal space abscesses are caused by inflammation that stimulates the pelvic nerves and often result in swelling in the anus and rectum. (3) Acute bacterial prostatitis may cause swelling in the perineum. (4) Foreign bodies in the anorectal canal can cause bleeding and ulceration of the rectal mucosa, difficult defecation, and anal swelling.

3. Compressive diseases

(1) The contents of pelvic floor hernia compress the rectum and anal canal, which may cause anal swelling. The innervation of the rectum and surrounding organs mainly comes from the pelvic plexus. Once the sacral nerves, which are components of the pelvic plexus, are compressed by lumbar disc herniation, the patient may experience discomfort and heaviness in the anus. (2) Retroverted uterus can cause anal swelling. If blood accumulates in the rectouterine pouch, anal swelling may occur. (3) In the late stage of cervical cancer, compression of the rectum may also cause anal swelling.

4. Surgical stimulation

The anal swelling that occurs after anorectal surgery may be related to the stimulation of the defecation receptors by the surgery and inflammation. For example, if swelling and heaviness occur 1 to 2 days after internal hemorrhoid injection, it is because the injection of the drug causes the hemorrhoids to temporarily become larger; in mixed hemorrhoid external stripping and internal ligation, when the internal hemorrhoid ligature has not yet fallen off, it can stimulate the anal canal to produce a urge to defecate, causing swelling and heaviness in the anal canal; in high anal fistula incision and hanging thread surgery, in the early stage of the rubber band falling off, the anus often falls down because part of the anal muscles are strangled. After receiving negative pressure suction ligation treatment for hemorrhoids, all patients felt unbearable swelling and heaviness in the anus. After surgery for complex anal fistula, large scars may cause anal swelling and discomfort. The main reason for the feeling of anal distension after stapled hemorrhoidectomy (PPH) is that the operating plane is too low, and it may also be related to anastomotic inflammation and rectal traction reflex.

5. Autonomic dysfunction

Anal prolapse caused by autonomic nervous system dysfunction is also called anal prolapse syndrome. It is an anal neurosis. The condition is real, but there are no positive physical signs, and it is often related to emotional changes. About 70% of patients with this disease are women, and it is related to suspiciousness, sensitivity and fear of cancer.