Rectal Venous Plexus Pain

The internal rectal venous plexus refers to a network of veins located in the rectum, responsible for draining blood from the rectal tissues. When these veins become swollen or irritated, it can cause discomfort or pain. This condition is commonly associated with hemorrhoids but may arise from other issues. Understanding the anatomy, causes, symptoms, diagnosis, treatments, and prevention methods can help manage this condition effectively.

---

Anatomy of the Internal Rectal Venous Plexus

1. Structure:
The internal rectal venous plexus is a collection of veins situated in the rectal submucosa, which is the layer of tissue beneath the mucous membrane of the rectum. These veins connect with the external rectal venous plexus and are part of the larger hemorrhoidal venous system.

2. Blood Supply:
The blood supply to the internal rectal venous plexus comes primarily from the superior rectal artery, which is a branch of the inferior mesenteric artery. Blood is drained from this venous plexus via the superior, middle, and inferior rectal veins. These veins eventually drain into the portal venous system, which leads to the liver.

3. Nerve Supply:
The rectum receives its nerve supply from both the autonomic and somatic nervous systems. The parasympathetic fibers come from the pelvic splanchnic nerves (S2-S4), while the sympathetic fibers come from the lumbar splanchnic nerves. Sensory nerves are primarily responsible for pain perception in this region.

---

Types of Rectal Venous Plexus Pain

1. Hemorrhoidal Pain:
   This is the most common type of pain associated with the internal rectal venous plexus. It occurs when the veins in the rectal area become swollen, resulting in hemorrhoids.
2. Thrombosed Hemorrhoid Pain:
   This type of pain occurs when a blood clot forms in a hemorrhoid, leading to severe pain and inflammation.
3. Proctalgia Fugax:
   This refers to sudden, sharp pain in the rectum that may last for a few seconds to a few minutes. It is related to spasms of the rectal muscles.
4. Rectal Varices:
   Similar to varicose veins, these occur when the veins in the rectum become abnormally enlarged, causing discomfort and pain.

---

Causes of Internal Rectal Venous Plexus Pain

1. Chronic constipation
2. Chronic diarrhea
3. Straining during bowel movements
4. Sitting for prolonged periods
5. Pregnancy
6. Obesity
7. Anal intercourse
8. Liver cirrhosis
9. Portal hypertension
10. Aging
11. Rectal trauma or injury
12. Rectal cancer
13. Pelvic floor dysfunction
14. Dehydration
15. Poor fiber intake
16. Chronic coughing
17. Lifting heavy objects
18. Excessive alcohol consumption
19. Sedentary lifestyle
20. Genetic predisposition

---

Symptoms of Internal Rectal Venous Plexus Pain

1. Rectal pain
2. Bleeding during bowel movements
3. Itching around the anus
4. Swelling around the anus
5. Mucus discharge
6. Feeling of incomplete evacuation
7. Rectal pressure
8. Difficulty sitting comfortably
9. Burning sensation in the rectum
10. Visible protrusion of hemorrhoids
11. Pain during bowel movements
12. Throbbing pain after bowel movements
13. Soreness around the anus
14. Bright red blood on toilet paper
15. Pain that worsens with sitting
16. Pain during physical activity
17. Rectal lump
18. Tenderness around the rectum
19. Frequent urge to have a bowel movement
20. Difficulty passing stool

---

Diagnostic Tests for Internal Rectal Venous Plexus Pain

1. Physical examination
2. Digital rectal exam (DRE)
3. Anoscopy
4. Proctoscopy
5. Sigmoidoscopy
6. Colonoscopy
7. Fecal occult blood test
8. Stool analysis
9. CT scan of the pelvis
10. MRI of the pelvis
11. Ultrasound (transrectal)
12. Endorectal ultrasound
13. Doppler ultrasound
14. Barium enema
15. Defecography
16. Pelvic floor dysfunction test
17. Liver function tests
18. Blood tests for anemia
19. Rectal biopsy
20. Hemorrhoid grading

---

Non-Pharmacological Treatments for Internal Rectal Venous Plexus Pain

1. Warm sitz baths
2. Increasing fiber intake
3. Hydration (drinking more water)
4. Cold compresses
5. Avoiding straining during bowel movements
6. Regular exercise
7. Using a donut cushion for sitting
8. Improving bathroom habits (avoiding long sitting on the toilet)
9. Topical application of aloe vera
10. Topical witch hazel pads
11. Biofeedback therapy for pelvic floor dysfunction
12. Pelvic floor exercises (Kegel exercises)
13. High-fiber supplements (psyllium)
14. Maintaining good anal hygiene
15. Avoiding heavy lifting
16. Switching to softer toilet paper or using wet wipes
17. Eating smaller, more frequent meals to avoid constipation
18. Avoiding prolonged sitting or standing
19. Managing stress (meditation, relaxation techniques)
20. Changing sleeping position (avoiding pressure on the rectum)
21. Yoga for gentle movement
22. Maintaining a healthy weight
23. Avoiding alcohol and caffeine
24. Use of a squatting position during bowel movements
25. Herbal remedies (butcher’s broom, horse chestnut)
26. Topical application of coconut oil
27. Avoiding processed foods
28. Acupuncture
29. Regular movement to avoid sitting for too long
30. Improving diet (whole grains, fruits, vegetables)

---

Drugs for Internal Rectal Venous Plexus Pain

1. Hydrocortisone suppositories
2. Topical lidocaine
3. Topical nitroglycerin ointment
4. Stool softeners (docusate sodium)
5. Topical corticosteroids
6. Oral pain relievers (acetaminophen, ibuprofen)
7. Topical anesthetics (pramoxine)
8. Flavonoids (diosmin, hesperidin)
9. Topical astringents (witch hazel)
10. Laxatives (polyethylene glycol)
11. Topical zinc oxide
12. Topical phenylephrine (Preparation H)
13. Topical ephedrine
14. Oral fiber supplements
15. Topical hydrocortisone foam
16. Oral calcium channel blockers (nifedipine)
17. Oral venotonic drugs (diosmin)
18. Topical sucralfate ointment
19. Topical vasoconstrictors
20. Antibiotics (if infection is present)

---

Surgeries for Internal Rectal Venous Plexus Pain

1. Hemorrhoidectomy
2. Stapled hemorrhoidopexy
3. Sclerotherapy
4. Rubber band ligation
5. Infrared coagulation
6. Laser hemorrhoid surgery
7. Doppler-guided hemorrhoidal artery ligation
8. Cryotherapy
9. Excision of thrombosed hemorrhoid
10. Rectal varices surgery

---

Prevention of Internal Rectal Venous Plexus Pain

1. Eat a high-fiber diet
2. Drink plenty of fluids
3. Avoid straining during bowel movements
4. Exercise regularly
5. Maintain a healthy weight
6. Avoid prolonged sitting
7. Take bathroom breaks regularly
8. Use a proper posture during bowel movements
9. Avoid heavy lifting
10. Practice good anal hygiene
11. Treat constipation early
12. Use stool softeners when needed
13. Reduce alcohol intake
14. Quit smoking
15. Use soft, unscented toilet paper

---

When to See a Doctor

• If rectal pain lasts more than a few days
• If there is rectal bleeding
• If you experience severe pain during bowel movements
• If you feel a lump near your anus
• If you notice changes in your bowel habits
• If home remedies and over-the-counter treatments do not relieve symptoms
• If you experience symptoms of anemia (fatigue, weakness)
• If there is discharge from the rectum
• If pain worsens over time
• If there is a fever along with rectal pain

---

Frequently Asked Questions (FAQs)

1. What is the internal rectal venous plexus?
   • It’s a network of veins in the rectum that drains blood from the rectal tissues.
2. What causes pain in the internal rectal venous plexus?
   • Swelling or irritation of the veins, often due to hemorrhoids, constipation, or straining.
3. Can hemorrhoids cause rectal venous plexus pain?
   • Yes, hemorrhoids are a common cause of pain in the internal rectal venous plexus.
4. How is rectal venous plexus pain diagnosed?
   • Through physical exams, anoscopy, and imaging tests like colonoscopy or ultrasound.
5. Is surgery always necessary for internal rectal venous plexus pain?
   • No, many cases can be treated with non-surgical methods like diet changes or medication.
6. What is a thrombosed hemorrhoid?
   • It’s a hemorrhoid with a blood clot inside, causing severe pain.
7. Can internal rectal venous plexus pain be prevented?
   • Yes, by maintaining a healthy diet, staying hydrated, and avoiding straining.
8. Are over-the-counter treatments effective for this condition?
   • Yes, topical treatments like hydrocortisone creams and witch hazel pads can help.
9. What are the symptoms of rectal venous plexus pain?
   • Pain during bowel movements, rectal bleeding, itching, and swelling.
10. What foods can help prevent this pain?
    • High-fiber foods like fruits, vegetables, and whole grains.
11. Can sitting for long periods cause rectal pain?
    • Yes, prolonged sitting can increase pressure on the rectal veins.
12. What lifestyle changes can reduce rectal pain?
    • Regular exercise, avoiding heavy lifting, and staying hydrated.
13. Are there any home remedies for rectal pain?
    • Warm sitz baths, cold compresses, and fiber supplements can help.
14. Can stress cause rectal pain?
    • Yes, stress can worsen symptoms, especially in conditions like irritable bowel syndrome (IBS).
15. When should I see a doctor for rectal pain?
    • If the pain is severe, lasts more than a few days, or if you have rectal bleeding.

---

This detailed overview is designed to provide a comprehensive understanding of the internal rectal venous plexus, its pain, and the treatments available

 

Authors Information

 

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

 

References