Chronic Idiopathic Anorectal Pain Disorders

Perineal, anal, and anorectal pain is a common clinical manifestation, affecting 6.6% of the population. An organic cause that might explain this kind of pain is found in 30% of examined patients. Hence, in two thirds of the cases, anorectal pain can be termed idiopathic. Pain is defined as chronic when the symptoms have lasted for at least 6 months. The somatic-visceral duality of perineal innervation complicates the diagnosis and results in a limited effectiveness of specific treatments. Chronic idiopathic anorectal pain disorders are a challenge for physicians, and their complexity requires a multidisciplinary approach for both diagnosis and treatment. A better understanding of how visceral innervation works, along with a prospective randomized assessment of known treatments, will greatly contribute to improving chronic idiopathic anorectal pain management.