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Pain in my lower stomach and on anal part but internal what can be diagnosis

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Based on the medical textbooks, here is a comprehensive overview of the possible diagnoses for your symptoms — lower stomach (lower abdominal/pelvic) pain combined with internal anal/rectal pain.

Possible Diagnoses

Your combination of lower abdominal pain + internal anorectal pain points to several conditions. Here are the most common and important ones:

1. Hemorrhoids (Internal)

Internal hemorrhoids sit above the dentate line inside the anal canal, so the pain is felt internally. Symptoms include:
  • Dull, gnawing internal pain (especially with thrombosed hemorrhoids)
  • Bright red rectal bleeding (blood drips into toilet or streaks stool)
  • Sensation of fullness or pressure in the rectum
  • May worsen with straining or sitting for long periods
Very common cause of internal anal pain. — Rosen's Emergency Medicine, p. 1344

2. Anal Fissure

A small tear in the lining of the anal canal. Symptoms include:
  • Sharp, sudden pain during or after bowel movements
  • Bright red blood on toilet paper
  • The pain is typically felt inside the anal area

3. Perirectal / Anorectal Abscess

A collection of pus near the rectum or anal canal. This is a significant cause of both lower abdominal and internal anal pain. Features:
  • Constant, throbbing pain internally in the anorectal area
  • May feel like deep pressure or swelling
  • Can cause fever
  • Pain may precede any visible swelling (making early diagnosis difficult)
— Rosen's Emergency Medicine, p. 1345

4. Anal Fistula

An abnormal tunnel between the inside of the anal canal and the skin outside. Often follows a perirectal abscess. Symptoms:
  • Persistent internal anorectal discomfort
  • Discharge or moisture around the anal area

5. Proctalgia Fugax / Levator Ani Syndrome

Spasm of the muscles around the rectum. Features:
  • Severe, episodic internal rectal/anal pain with no bleeding or swelling
  • Pain can radiate into the lower abdomen and pelvis
  • Often no visible physical abnormality on exam
— Rosen's Emergency Medicine, p. 1344; Schwartz's Principles of Surgery, p. 1144

6. Proctitis (Rectal Inflammation)

Inflammation of the rectal lining — causes include inflammatory bowel disease (IBD), infection, or radiation. Symptoms:
  • Internal rectal pain and urgency
  • Bloody mucus discharge
  • Tenesmus (feeling of needing to pass stool but unable to)
  • Lower abdominal cramping

7. Inflammatory Bowel Disease (IBD) — Crohn's Disease or Ulcerative Colitis

Chronic inflammatory conditions of the bowel. Both can cause:
  • Recurrent lower abdominal pain
  • Internal rectal pain, urgency, tenesmus
  • Diarrhea, sometimes with blood or mucus

8. Pelvic Inflammatory Disease (PID) (in females)

Infection of the reproductive organs. Causes:
  • Lower abdominal/pelvic pain
  • May cause referred anorectal discomfort
  • Associated with fever, vaginal discharge

9. Endometriosis (in females)

Uterine tissue growing outside the uterus, sometimes on the rectum. Features:
  • Cyclical pain that worsens with menstruation
  • Internal rectal pain, especially during periods
  • Lower abdominal pain

10. Colorectal Cancer

Less common but important to rule out, especially with:
  • Persistent pain not resolving over weeks
  • Change in bowel habits
  • Rectal bleeding
  • Unexplained weight loss

When to See a Doctor Urgently

Seek medical care promptly if you have:
  • Fever with the pain (may indicate abscess/infection)
  • Heavy rectal bleeding
  • Inability to pass stool or gas
  • Severe, worsening pain
  • Unintentional weight loss
Important: This information is for educational purposes only and is not a substitute for a proper medical evaluation. A doctor will need to perform a physical and digital rectal examination, and possibly anoscopy, colonoscopy, or imaging (ultrasound/MRI), to reach an accurate diagnosis. Please consult a healthcare provider — especially a gastroenterologist or colorectal surgeon — for proper assessment and treatment.
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