Do I need a colonoscopy for tailbone and anal pain to rule out cancer?

Doctor's Answers 3

Photo of Dr Wai Leong Quan
Dr Wai Leong Quan

Gastroenterologist

Hello,

There is a clinical entity known as coccydynia which matches your description to some extent.

This condition is believed to be a result of tailbone (aka coccyx) inflammation presenting with local pain or dull ache and sometimes with a tender point at the upper portion of the buttock cleft some distance away from the anus; which explain your discomfort when rocking backwards.

Coccydynia can develop spontaneously without any significant trauma to the tailbone although previous trauma to the surrounding area predisposes you to coccydynia. In this case, avoiding pressure at the tailbone by leaning forward while sitting may help.

Depending on individual, the discomfort should go away within a few months with or without pain killers.

As to the transient throbbing anal pain which you felt more on the right, local cause such as a small anal fissure with spasm could be the reason although anal fissure pain usually last more than 5min.

May I suggest you watch the discomfort and your bowel movement. If there is now a constant urge to open your bowel with the discomfort worsening or a significant change in your stool consistency or stool caliber, seek medical help early.

- Dr Quan

Photo of Dr Jason Lim
Dr Jason Lim

Colorectal Surgeon

Hi,

The description of your symptoms appear to be proctalgia ani. While it literally translate to "pain in your anus", the persistence of your symptoms warrants a physical examination by a doctor.

The causes can range anywhere from an anal fissure (tear in your anus), to deep anal infections, to referred pain from somewhere else e.g. coccydynia / pelvic floor strain (from your weight lifting), and stress.

Statistically, this is unlikely to be cancer despite your family history but it is worthwhile getting your risk assessed accurately with a detailed history taking so that you can be counselled on when you should commence cancer screening. Take care.

From the sounds of it, you're most worried about cancer (which I can understand, given your father' s colorectal cancer) so let's address that first.

Dull pain near tailbone -> anal pain - could it be cancer?

Although doctors can very rarely say it's not X or Y with 100% certainty (much less online, without seeing you in person), the answer to your question is that it's less likely, given that:

  • You are 20 - anal cancer is usually diagnosed in the 60s
  • It's a very rare cancer in itself
  • It's common among men who receive anal intercourse, and / or have HPV (human papilloma virus)

In other words, cancer will be pretty low down on a list of people with your story, although a doctor will need to ask you some further questions about you in person.

What's more common in your age group is haemorrhoids, which can be brought on by weight lifting if you are too much, without the correct breathing technique.

They are very common, and can cause a dull aching sensation around the anal area, just as you 've described.

I began to get a brief dull pain near the tailbone occasionally when I got up from a chair and when I rock back while seated. I could not tell if it was muscle related, bone related, or anything deeper. I do not know if the two cases are related but I have not experienced either before.

It's hard for a doctor to tell if these 2 are linked, without examining you. With your history of weight lifting, it's very likely that this could just be a musculoskeletal type injury too, which should recover over time with proper rest.

If this pain is prolonged, do see a doctor (or you can just highlight this issue to the GP, whom I recommend you see anyway to have your anal pain checked out)

What should I do? Is this what I need to wait for it out?

You should see a doctor just to have a look around your anal region. Your GP / polyclinic would be a good place to start.

Let him advise you on what you need next.

He MAY perform proctoscopy just to look at your rectal and anal region. If necessary, he will be the best person to decide if you also require a colonoscopy (which is to look at ALL of your bowels). You can read more about colonscopies in Singapore at this link.

Cheers

Similar Questions

How useful is a colonoscopy, and are colonoscopies really necessary?

Hi Cai Shum, A colonoscopy is one of the investigative tools we have to examine the colon, rectum and in some cases the terminal ileum. The alternatives are a computed tomography scan of the colon (also known as a CT Colonography) and a barium enema. The key benefit of performing a colonoscopy is the ability to directly visualize the colonic lumen through a high definition lens and biopsy the lesion if necessary. This cannot be done with the other imaging options.

Photo of Dr Jason Lim

Answered By

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How can I best prepare for a successful colonoscopy?

If you have booked an advanced date for your colonoscopy, it would be ideal to keep to a low fibre diet 3 to 5 days prior to the date of your colonoscopy. This reduces the fibrous debris in the colon and allows a better clean during the bowel preparation. Furthermore, the remnant stools, if any, would often be liquid, which can be sucked out by the colonoscope itself. It is important also to be compliant to the prescribed timing and the volume of the bowel preparation to take.

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Answered By

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