Diagnosis is largely clinical, and one of exclusion
Digital rectal examination should be performed, with special attention and care noted to assess the external areas for contributing sources of pain
This includes a prostate examination in men
Women should also have pelvic examination to assess for pelvic etiology masking as rectal complaint
Laboratory evaluation, including ESR and CRP, may be obtained though are frequently normal
If febrile or leukocytosis present, consider advanced imaging to assess for deeper infections or process not easily evaluated by physical examination
This includes a prostate examination in men
Women should also have pelvic examination to assess for pelvic etiology masking as rectal complaint
Rome IV Criteria
The Rome IV criteria are meant to differentiate and assist in the diagnosis of functional gastrointestinal disorders (FGID)
For the diagnosis of<unk> , the following should be present
Proctalgia fugax
Levator ani
Amaurosis fugax
External hemorrhoid
Facial paralysis
Anal fissure
Catatonia
Rectal prolapse