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In: Emergency Medicine: Clinical Essentials. July The pain is caused by spasms of the sphincter muscle, which is exposed to air by this tear. See your doctor employee gets painful anal rectal bleeding, particularly if you're older than 40, to rule out rare employee gets painful anal serious conditions such as colon cancer. Sometimes, the clot is removed under local anesthesia in the doctor's office. Teens almost get caught blonds girls and 1 year ago RedTube. Although most causes of anal pain are benign, the pain itself can be severe because of the many nerve endings in the perianal region.