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A localized area of tenderness could signal pain in the anal canal abscess. Anorectal disorders. Anal abscess - An anal abscess sometimes drains on its own, although it is always safer for a doctor to evaluate the problem. You may be able to prevent anal fissures by preventing constipation. This causes severe stabbing pain like a knife sticking into the rectum. Other unproven associations are food allergies, especially to artificial sweeteners or caffeine. The first office visit includes a physical exam, exam of the anal canal with a small, lighted scope anoscopy to visualize any abnormal areas, and biopsy of the mass.