Intro

• The doctor should discuss both the animal's risk for having rabies and the risk of the exposure for transmission of the virus.
• The doctor also should know if you have previously received vaccination against rabies, either because you're in a high-risk profession (for example, a veterinarian or zoo worker) or you have been exposed to a potentially rabid animal before. If you have been vaccinated previously, it will change the treatment that will follow after a new potential exposure.
• Because rabies is such a rare disease, the doctor may be unfamiliar with the need for treatment or may not have the vaccine in the office for prompt administration. The local public health department is a good source of information in these cases, and a hospital's emergency department is a good place to seek medical care.

Any serious animal bite should be cared for as soon as possible in a hospital's emergency department.

In addition to the potential for transmission of rabies, other medical  issues need to be checked:

• Transmission of regular bacterial germs from the mouth of the biting animal
• Need for an injection to maintain protection, or immunity, against tetanus   (another type of infection that can be transmitted by bites or to open wounds)
• Issues of wound repair

Even the most trivial bite can transmit rabies. Any bite or scratch by a rabid animal warrants the administration of rabies shots. Whether or not that animal is at risk for rabies depends somewhat on the region of the country and on the species of the animal. Any exposure to a bat where a bite cannot be ruled out is a significant exposure.

Self-Care at Home

Proctalgia fugax: Because the pain lasts so briefly, there is no treatment that will stop an attack of proctalgia fugax.

Levator ani syndrome: You can help stop an attack of levator ani syndrome with the following techniques.

• Sit in a tub of hot water.
• Massage the levator ani muscles to relieve the muscle spasm.
• Take over-the-counter, anti-inflammatory medications such as ibuprofen or naproxen.

Hemorrhoids: The following treatments can help lessen the discomfort of a painful hemorrhoid.

• Sit in a tub of hot water for 20 minutes several times a day.
• Apply over-the-counter hemorrhoid creams, especially those containing hydrocortisone.
• Take stool softeners and extra fiber to lessen pain with bowel movements.

Anal fissures: These home treatments will promote healing   of anal fissures.

• Sit in a tub of hot water for 20 minutes, 3 times a day, to reduce pain and help healing.
• Eat a high-fiber diet and use stool softeners to make bowel movements less painful.
• Apply hydrocortisone creams to decrease pain.

Prevention

The best way to prevent rectal pain is to eat a high-fiber diet and drink plenty of water. This will produce soft stools that are easy to pass and cause less trauma to the anal passage.

Outlook

Thrombosed hemorrhoids are treated with a simple procedure, and 90% of anal fissures heal in 3 weeks. Two-thirds of people suffering with levator ani syndrome will get some relief with treatment. Proctalgia fugax remains the most difficult to treat, but new therapies are being tested.