Gut is likely the cause. constipation and other bowel pathologies should be considered first.

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Brief Answer:
Intestinal infection or inflammation; clinical evaluation, investigations.

Detailed Answer:
Hi.
Thanks for your query, albeit short and specific.
To recapitulate: Male/41 - pain in lower abdomen - during day and night - 2 months - pain radiates to the anus - causing colics or itching - whats to know what is gut in response to the XXXXXXX query and wants recommendations...

Let me clear you first the meaning of gut, in literal meaning this is the word used for stomach and bowels, meaning gastrointestinal system.

Your history is suggestive of the following problems:
- Inflammation and/or infection of the small and large intestines.This gives the symptoms that you have mentioned.
- Problems related to prostate also have to be considered.

I would advise you the following in such a situation since you are having problems for a long time (2 months):
- Tests of stool for 3 consecutive days.
- Tests of blood: CBC, liver and thyroid functions, sugar and as needed as per clinical findings.
- Tests of urine:
- Ultrasonography to start with and to continue with CT scan if needed.
- Colonoscopy.
- A course of an antibiotic and metronidazole as needed if the tests show intestinal infection (needs a valid prescription).
- Clinical evaluation, examination by your Doctor, preferably by a General Surgeon as per-rectal examination for prostate, peri-anal area, anal canal and rectum by finger tests as well as ano-proctoscopy is necessary. This is very informative and quite diagnostic in some cases, colonoscopy helping further to see the whole large intestine (colon).
- Further tests as per the clinical evaluation, examination and reports of the routine tests will help to get a proper diagnosis and get a proper plan of treatment.
I hope this answer helps you to get an early and proper diagnosis, treatment and cure.

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