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What Causes Rectal Pain Post Anal Unprotected Intercourse?

Posted on Mon, 6 Jun 2016

Question: Hello doctor. I had Anal unprotected penetration with 2 ppl. Who forced me. Now I have pain and boils inside my rectum. I have severe fever. Body ache. Shiverng and bad tummy.

Doctor I visited says I might have case of fistula. And need operation. I.did not mention the forced sex to him

Answered by Dr. T Chandrakant (8 hours later)

Brief Answer:
Rush to ER- get hospitalized tell the truth to the Doctors, family members

Detailed Answer:
Hi.
Thanks for your query.
To recapitulate: Age and gender(not mentioned) - history of forceful anal unprotected penetration with 2 people - have pain and boils inside rectum - severe fever - body ache - shivering and bad tummy - visited a Doctor - thinks of fistula - says needs operation - you did not mention about the forceful penetration ...

Sorry to know what has had happened, your not telling the truth to the Doctor and the Doctor unable to understand what exactly happened as if he has not examined carefully.

My advise to you would be as follows:
- First of all visit ER immediately and get admitted.
- Inform the facts to your Doctor and insist that you be clinically evaluated, examined by a General Surgeon or a Proctologist - tell them the facts. Tell the facts to your family members too. Ask for notification to the Police or whichever way the system works in your country that your Doctors will guide you fully through.
You will be started on proper intravenous antibiotics and further management as per the results of examination.

I hope this answer helps you to get a proper early diagnosis, any assistance as may be needed as per the legal status and most important to get the best possible treatment.

Please feel free to ask for further relevant queries if you feel that there is a gap of communication.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. T Chandrakant (2 days later)

Dear doctor

Attached are

1 file with all blood reports.
1 file with prescription of 4 doctors.
2 photo pixs of current situation. Its with cream applied on one pic.

Doctor A I visited 5 days back. General physician. Advised me to see a surgeon. Gave me cefoprox CV 325.

Doctor B I visited 4 days back. Is a general surgeon. Advised I have fistula and must operated.

Doctor C I visited 3 days back. Is a very XXXXXXX surgeon. Advised I have submucus fistula and said I need a minor surgery.

Doctor D I visited. 2 days back. Is a very XXXXXXX reputed gastroenterologist. He feels I have boils. Which has not yet developed into fistula. Advised me to eat stronger anti biotics and avoid operation. Gave me moxclav 625.

Currently am going by doctor D's prescribed medicine.

Please help me decide further course.

Answered by Dr. T Chandrakant (2 hours later)

Brief Answer:
Insist for MRI of the area / exploration under anesthesia can help.

Detailed Answer:
Thanks for your detailed history, clear pictures, prescriptions and reports.

Since there is no single opinion even on consultation the specialists, it is better to insist for MRI of the area as it gives the best idea about the situation.

I hope you have given those Doctors the real history also.

Since you have the symptoms and the picture shows the red mass like structures at 12 o'clock and 6 o'clack position, these are more suggestive of the anal fissures which on infection can cause an abscess or so. The abscesses in this area can really spread fast and in upward direction to appear as a ischiorectal fossa abscess or fistula in ano.

Hence MRI or exploration under anesthesia can tell us a better diagnosis.

Regards

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Above answer was peer-reviewed by : Dr. Arnab Banerjee