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Ache after bowel movement: Why Does It Hurt When I Poop? 8 Causes of Painful Bowel Movements


Why Does It Hurt When I Poop? 8 Causes of Painful Bowel Movements

Pain when you poop isn’t something you “just have to live with.” It’s a symptom of another health issue, and you can treat most of them easily.

If you have trouble on the toilet, it helps to learn the causes so you and your doctor can figure out the best way to take care of the problem.


If food doesn’t move through your digestive tract fast enough, your colon absorbs too much water. This leaves your stool hard and dry, so it hurts to push it out. Many things can make you constipated, including some medicines, too little fluid or fiber in your diet, lack of exercise, and big changes in your habits or lifestyle, such as travel or pregnancy.

Besides pain when you poop, constipation can make you feel sluggish and bloated and cause belly pain.Most of the time, eating a healthy diet, drinking more water, and exercising more can help.

Call your doctor if fiber, exercise, and more water don’t help. If you think a drug is making you constipated, ask your doctor if you can switch to a different one that doesn’t have this side effect.


Nearly 3 out of 4 people get these swollen veins around their anus. They can happen if you sit too long on the toilet or strain too much during a bowel movement. Pregnancy and obesity can raise your chances of getting them, too.

If your hemorrhoid forms a blood clot, you can have pain when you poop, sit, or walk.

If a hemorrhoid is causing your painful bowel movements, you might also have:

  • Bleeding during bowel movements or small amounts of bright red blood on your toilet tissue or in the toilet
  • Itching or irritation around your anus
  • Pain or discomfort
  • Swelling around your anus
  • A lump near your anus, which may be sensitive or painful

Warm baths, stool softener, and an over-the-counter hemorrhoid cream can help.

Call your doctor if your pain doesn’t clear up within a few days. The clot may need to be removed. This is a quick procedure that some doctors do in their office.

Anal Fissures

It’s common to get small tears inside or around your anus, the opening where your poop comes out. These anal fissures are often caused by a large or very hard stool. They cause the muscles around your anus to spasm, so bowel movements hurt.

If these tears are the source of your pain, you can try to drink more fluids and add extra fiber to your diet. This will make your stools softer, so they don’t hurt as much.

Anal fissures often heal within a few weeks. If not, your doctor could prescribe a drug that helps stop the spasms and allows the area to heal faster. In rare cases, people may have surgery for anal fissures.

Inflammatory Bowel Disease

Ulcerative colitis is a type of inflammatory bowel disease (IBD) that causes swelling, soreness, and ulcers in your large intestine (colon) and rectum, which make pooping painful.

Another type of IBD, called Crohn’s disease, has similar symptoms to ulcerative colitis.

You may also have stomach cramping or diarrhea that’s bloody or contains pus. Some people with ulcerative colitis have an urgent need to poop or feel like not all their poop comes out.

Although ulcerative colitis is a lifelong condition, many different drugs can help. Some calm down an overactive immune system — your body’s defense against germs — which doctors believe may be a cause. Others manage your symptoms. While surgery can get rid of your ulcerative colitis for good, that often means taking out your colon and rectum.

Skin Conditions

Long-term skin problems like eczema, psoriasis, and warts can affect the area around your anus. Besides pain before, after, and while you poop, you could notice itching and bleeding around the area where your bowel movement comes out.

If you think one of these might be causing your painful poops, you should see a doctor sooner rather than later. Your doctor may need to take a small sample from your skin down there to send to a lab. This will confirm the cause of your discomfort and how to best treat it.


Some infections can cause anal pain before, during, or after bowel movements. These include:

  • Anal abscess (a pocket of pus near your anus or rectum), which may also come with pain, redness, or swelling around the anus
  • Sexually transmitted infections (STIs) like chlamydia, gonorrhea, herpes, and syphilis, which may come with anal pain, bleeding, discharge, or itching
  • Fungal infections, which can include mild to severe rectal pain

You should see a doctor if you think you have an infection. You’ll likely get medicine in the form of a cream or a pill. In some cases, if you have a deep abscess, you might also need surgery. Once your infection clears up, your bowel movements shouldn’t hurt anymore.


Although the reasons why aren’t clear, the type of tissue that grows inside a woman’s uterus sometimes spreads to other organs in the pelvis. It then builds up and bleeds just like the lining of your uterus during a monthly period. Known as endometriosis, this condition causes swelling, inflammation, and chronic pain. It can also cause you to feel a shooting pain when you poop.

Your doctor can look for signs of endometriosis with imaging tests. Hormone therapy can offer some relief. In severe cases, surgery to remove the misplaced tissue will also help.

You should see your doctor about endometriosis if any of these things happen to you:

  • Pain for several days during your menstrual cycle
  • Menstrual pain that causes you to miss work
  • Pain that causes you to avoid sexual intercourse
  • You change your lifestyle because of pain

Anal Cancer

While not as likely as other reasons, anal cancer can cause painful pooping. Besides soreness and pressure when you have a bowel movement, bleeding is often an early sign. You could also have anal itching, discharge, or notice that your stool looks more narrow than normal.

If your pain or bleeding doesn’t go away, or if it gets worse after a few days, see your doctor. They’ll do a physical exam to check for signs of cancer. If you do have an anal tumor, doctors will treat it with surgery, chemotherapy, or radiation.

Understanding and Managing Pain in Irritable Bowel Syndrome (IBS)


Pain, by definition, is the dominant symptom experienced by patients with irritable bowel syndrome (IBS). Three out of 4 people with IBS report continuous or frequent abdominal pain, with pain the primary factor that makes their IBS severe. Importantly, and unlike chronic pain in general, IBS pain is often associated with alterations in bowel movements (diarrhea, constipation, or both).

The standard general definition for pain is an unpleasant sensory and emotional experience that’s associated with actual or perceived damage to the body. Pain that is short-lived is termed acute, while pain that lasts 6 months or longer is termed chronic. Chronic pain may be constant or recurring frequently for extended periods of time.

The chronic pain in IBS can be felt anywhere in the abdomen (belly), though is most often reported in the lower abdomen. It may be worsened soon after eating, and relieved or at times worsened after a bowel movement. It is not always predictable and may change over time. People with IBS use different descriptors to explain how the pain feels; some examples include cramping, stabbing, aching, sharp, or throbbing.

IBS is a long-term condition that is challenging both to patients and healthcare providers. It affects 10–15% of adults. Less than half of those see a healthcare provider for their symptoms. Yet patients with IBS consume more overall health care than those without IBS. The primary reason people with IBS see a clinician is for relief of abdominal pain.

Understanding pain in IBS

Chronic abdominal pain in irritable bowel syndrome (IBS) is not associated with structural damage, like ulcers, but the pain is just as real. The sensation starts in the gut and then travels to the brain, which interprets the sensation as pain. The pain is not related to obvious damage in the body, like a broken bone.

Brain imaging shows that people with IBS feel more pain for a certain level of stress than other people. Those with IBS are hypersensitive; they have an increased response that makes a stimulus feel more painful. They may experience pain from sensations that other people don’t think are painful (called allodynia) or have more severe pain than others (called hyperalgesia).

How is the pain experienced?

In IBS, some signals in the gut are experienced in some brain regions as pain. After the brain receives pain signals, it can modify the signals to increase or reduce the feeling of pain.

The brain’s ability to modify sensations is called the gate control theory of pain. Signals that travel from the body to the brain pass through the spinal cord, which can serve as a kind of “gate”. The brain can open and close this gate, like a volume switch on a stereo. Opening the gate increases the signals that reach the brain and increases the feeling of pain. Closing the gate decreases signals and blocks pain.

This explains how a person can sprain an ankle while running a race and not feel pain until the race is over. Or, how during a bad day at work, a minor discomfort can feel really painful – all because the spinal cord acts as a gate to modify how much pain in the brain feels. 

Managing the Pain

All treatment for IBS begins with education to understand the nature of the condition, including why and how symptoms arise. IBS is a brain-gut disorder. For people with IBS that is mild, the treatment is at the level of the gut. But, when more severe chronic pain is present, the treatment also needs to be at the level of the brain. 

Learn more about Cognitive Behavioral Therapy to help with the brain-gut interaction

Can the chronic pain state be reversed?

With proper treatment, chronic pain can be reduced or stopped. Different approaches include medication, psychological approaches, and self-management. Using more than one therapy may work better than using just one method alone. For example, combining psychological approaches with medication is often effective. When treating chronic pain, it is important to be patient. Treatments often take time before they start wo

Treatment approaches for IBS

When pain is chronic it takes time for it to go away. Because pain is an emotional experience, taking steps to improve emotions can lead to reduction of the harmful effects of the pain even when it is still present.

Maintaining an active role in life, engaging in physical activity, and addressing emotional and social health are important to help promote a sense of well-being, which counters negative expectations.

  • Medications
    • Anticholinergic agents taken before a meal can provide short-term relief. These gut-targeted medications work on several IBS symptoms, including pain, diarrhea, and constipation.
    • Central acting agents, or central neuromodulators, can block signals from the brain. This type of drug can help decrease intestinal and central hypersensitivity, help the brain control the pain, and improve gut motility. Central acting agents use two approaches to help reduce pain. In the first approach, the medication helps the brain to limit nerve signals by closing the gate to pain. In four to six weeks, the pain is generally 30%–50% better. The second approach involves helping to regrow the damaged nerves. Regrowth takes a long time; anywhere from six months to a year or more. Creating new functioning nerves is vital to prevent the pain from returning.
    • There is no evidence that opioids can help IBS. In fact, taking opioids can slow the gut, causing constipation, nausea, and vomiting. Learn more about opioid-Induced constipation
  • Psychological approaches
    The power of the mind can be harnessed to affect pain by sending signals or thoughts to close the pain gate. Techniques such as hypnosis, meditation, and cognitive behavioral therapy (CBT) can help ease symptoms and improve control over the disorder.

    Learn more about psychological approached in managing IBS 

  • Self-management
    Pain is an emotional experience, so taking steps to improve emotions can reduce the harmful effects of the pain even when it is still present. Tackling emotional and social health is essential to promote a sense of well-being, which counters negative expectations.

    Here are 10 things you can do to help reach treatment goals:

    1. Acceptance: Accept that the pain is there, and learn about the condition and its management
    2. Get involved: Take an active role in care by developing a partnership with healthcare providers
    3. Set priorities: Look beyond symptoms to establish what is important. Eliminate the rest
    4. Set realistic goals: Break larger goals into smaller, manageable steps. Celebrate when you reach goals, even small ones!
    5. Know your rights: You have the right to be treated with respect, to ask questions, voice your opinions, and to say no without guilt
    6. Recognize and accept emotions: Your mind and body are connected, and strong emotion affects pain. Acknowledge your emotions to reduce stress and manage pain.
    7. Relax: Exercises like hypnosis, meditation, yoga, or deep breathing can help reclaim control of the body and reduce pain.
    8. Exercise: Staying active can help increase your sense of control and divert attention from symptoms.
    9. Refocus: Focus on abilities instead of disabilities to help realize that you can live a normal life.
    10. Reach out: Share thoughts and feelings with healthcare providers, family, and friends. Seek support and healthy interaction.

How quickly does a central agent have effect on the pain?

There are two levels to taking one of these agents. At the first level the medication increases the brain’s ability to down-regulate nerve signals through the gate control mechanism, closing the gate to reduce pain. Within four to six weeks the pain is generally 30–50% better.

The second level is the neurogenesis, and that can take six months to a year or more. This is important to help prevent the pain from coming back, or relapsing.

The two effects are the physiologic effect of the pain control through the gating mechanism, and the neuroplastic effect through the brain to regrow those nerves that have been damaged by the chronic pain.

What kind of healthcare provider best treats IBS pain?

A gastroenterologist who works in neurogastroenterology addressing the brain-gut axis, or a primary care doctor who knows how to work with chronic pain is usually best to treat IBS pain. They may work with a multi-disciplinary team of therapists. Finding and working with a patient-centered healthcare provider familiar with the concepts presented here will help ensure the best care for chronic pain and other symptoms of IBS.

Be on the alert for pain management clinics that use opioids as treatment, which are not a treatment for IBS and may worsen symptoms. Pain is the dominant symptom of IBS. Like all functional gastrointestinal disorders, IBS is a disorder of brain–gut interactions. The pain in IBS is related to a change in the part of the brain that receives signals from the gut, which “turns up the volume” on sensations. This understanding of the brain–gut connection is essential, not only to the cause of the chronic pain, but also to its treatment. There is no cure for pain in IBS. However, there are a few options that can reduce and control the pain. These include self management, psychological approaches, and medications. Opioids are not a treatment for IBS pain; there is no evidence of long-term benefit. Finding and working with a patient-centered healthcare provider familiar with these concepts will help ensure the best available care for the chronic pain and other symptoms of IBS.

Putting it all Together

  • Brain imaging shows that people with IBS feel more pain than other people
  • Sensations travel from the gut through the spinal column to the brain where they are felt as pain.
  • The brain can modify the sensation of pain, either increasing or decreasing it
  • Therapy and medications can help reduce or prevent the pain from IBS
  • Strong painkillers like opioids should not be used for pain in IBS; in fact, they might increase pain.
  • Neurogastroenterologists or primary care doctors who know how to work with chronic pain are the best to help treat IBS pain 

Adapted from IFFGD Publication #274 “Understanding and Managing Pain in IBS” by Douglas A. Drossman, M.D., Center for Education and Practice of Biopsychosocial Care, Center for Functional GI and Motility Disorders at UNC, and Drossman Gastroenterology, Chapel Hill, NC. Adapted by Abigale Miller

For healthcare providers
Here is a video of a presentation by Douglas A. Drossman delivered at the UCLA GI Week 2016 on the topic, “State of the Art Lecture: Understanding and Management of Patients with Chronic Abdominal Pain and Narcotic Bowel Syndrome.”

We are grateful to The Allergan Foundation for a health and human services educational grant in support of this publication.

Diverticular disease and diverticulitis: Overview – InformedHealth.org


Diverticula are pouches in the lining of the intestine. They arise when the wall of the intestine bulges out through weak areas of intestinal muscle. The pouches are usually small and balloon-like, and the contents of the bowel (stool, or “poop”) might get into them. Although diverticula are often harmless, they may lead to bowel problems and cause pain. Simply put, there are three different conditions:

  • Diverticulosis: The lining of the intestine bulges out in a number of places, but this doesn’t cause any symptoms or problems.

  • Diverticular disease: The bulging pouches cause symptoms or lead to problems (complications).

  • Diverticulitis: The pouches are inflamed or infected.

Diverticula can cause recurring or permanent symptoms. This is referred to as chronic diverticular disease. Diverticulitis can usually be treated effectively, but may have serious consequences if the inflammation spreads.

Diverticula and diverticulitis


Most diverticula don’t cause any symptoms. Diverticular disease is typically associated with pain in the lower left side of the abdomen (tummy) or – less commonly – the right side. It can also lead to bloating, constipation or diarrhea. The symptoms often go away for a while, but may be constant. They commonly get worse after meals, and then better again after going to the toilet and having a bowel movement. Sometimes diverticula lead to bleeding too.

If they become inflamed (diverticulitis), they cause sudden dull pain in the abdomen, accompanied by a mild fever. Other symptoms include constipation, diarrhea, bloating, nausea and sometimes cramping too. Diverticulitis rarely leads to vomiting. If a doctor applies pressure to the abdomen, the tummy muscles automatically tense up (a reflex known as muscular defense). If they suddenly let go, the pain gets worse.

Causes and risk factors

Diverticula form in weak areas of the intestinal muscles. They usually arise in the sigmoid colon. This s-shaped section of the large intestine is roughly 40 to 45 centimeter long and found just in front of the rectum. The contents of the intestine put the most pressure on the muscular wall here.

Some people are more likely to develop diverticula because of their genes. Further risk factors include weak connective tissue and problems with the wave-like movements of the intestinal wall. Older and very overweight people are at greater risk, too.

The influence of lifestyle factors hasn’t yet been properly determined. A diet that is low in fiber can lead to constipation and hard stools, so it seems logical that too little fiber should increase the risk of diverticular disease. Eating a lot of red meat, smoking and not getting enough movement are also believed to be risk factors.

It’s still not clear how diverticula become inflamed and what increases the risk of this happening. But inflammation is believed to be more likely in areas of reduced blood supply and if hard lumps of stool form in the diverticula.

Complications are more common in people who have a weakened immune system (for instance, after an organ transplant) or severe kidney disease. The long-term use of particular medications probably increases the risk of more serious complications. These medications include non-steroidal anti-inflammatory drugs (NSAIDs), steroids, acetylsalicylic acid (the drug in medicines like Aspirin) and opiates.


Many people have diverticula without knowing it. They are more common in older age: About 10% of people under the age of 50 have diverticula, and about 50% of people over the age of 70 have them. They are equally common in men and women.

About 1% of all people who have diverticula develop diverticulitis within ten years. This inflammation can occur at any age.


Diverticula often remain unnoticed if they don’t cause any symptoms. But they sometimes lead to chronic digestive problems and pain, or may even become inflamed or infected.

Diverticulitis can usually be treated effectively and then goes away after a few weeks. But about 20% of those affected get diverticulitis again within a few years.

Diverticulitis can lead to complications if the inflammation spreads to the wall of the intestine, surrounding tissue or nearby organs. Abscesses (collections of pus) or fistulas may develop. A fistula is an unnatural tunnel-like passageway between two organs, for instance between the intestine and the bladder.

One rare but serious complication may arise if the wall of the intestine tears (intestinal perforation). If the contents of the intestine then leak out into the abdominal cavity, the inner lining of the tummy (peritoneum) may become inflamed, leading to a life-threatening condition known as peritonitis. This typically causes severe tummy pain, a hard abdominal wall, fever, nausea, a rapid heartbeat and general weakness. It is important to recognize these peritonitis symptoms and quickly seek medical help.

In some people, diverticula keep becoming inflamed despite having been treated successfully in the past. This can lead to scarring that causes the intestine to become narrow (stenosis), making it difficult for stool to pass through it. In extreme cases, the intestine becomes blocked (ileus). Some people have constant diverticula symptoms although their intestine isn’t inflamed. The risk of complications is greatest when someone has diverticulitis for the first time. After that, recurring inflammations are a lot less likely to lead to complications. The main consequences of recurring diverticulitis are chronic symptoms such as irregular bowel movements, bloating and abdominal pain.

It’s good to know that diverticula do not develop into bowel cancer. This kind of cancer develops from polyps in the bowel.


If you go to see a doctor about your symptoms, they will ask you about various things, such as your medical history and whether you are taking medication. This is followed by a physical examination where they listen to your tummy, and also feel your tummy and rectum. Depending on the symptoms, you may have blood and urine tests, and your temperature might be measured.  You will usually have an ultrasound scan as well. If there is still no clear diagnosis, you may need to have a CT (computed tomography) scan and perhaps a colonoscopy too (inspection of the inside of the intestine using a camera).

This can help to rule out other illnesses – the symptoms of diverticular disease are similar to the symptoms of conditions like appendicitis or irritable bowel syndrome (IBS).

Colonoscopies are too risky during acute diverticulitis. But people are often advised to have a colonoscopy about 4 to 6 weeks after the symptoms have cleared up. This is to make sure that they weren’t caused by polyps, bowel cancer or another illness.


Eating enough fiber helps to make sure that your stool doesn’t get too hard. So it would seem logical that fiber should prevent pain and inflammation in people with diverticula. There’s a lot of fiber in whole-grain foods, vegetables, legumes (e.g. beans, lentils) and fruits. Physical exercise stimulates digestion too, but it isn’t clear whether it can prevent the symptoms.

Sometimes people are advised to avoid certain foods – particularly nuts, grains, sweetcorn and popcorn. For a long time it was thought that fragments of these foods could get stuck in the diverticula and cause diverticulitis. But studies have shown that not to be true. So you don’t have to avoid eating nuts, for example.


Diverticula that don’t cause any symptoms don’t have to be treated. The treatment options for diverticulitis depend on how severe it is.

The aim of treatment is to

  • avoid potential complications and relieve acute symptoms,

  • prevent it from coming back, and

  • relieve chronic symptoms.

Diverticulitis inflammations are caused by a bacterial infection, so they can be treated with antibiotics. But people usually only need to use antibiotics if complications arise or if there’s an increased risk of them arising. Complications may have to be treated in hospital.

If acute diverticulitis doesn’t improve or someone has constant symptoms, the affected part of the large intestine can be surgically removed. Because of the associated risks, it’s important to carefully consider the pros and cons of surgery first. Serious complications such as peritonitis require immediate surgery, though.

For people who have chronic symptoms, it might be worth trying to eat more fiber. There’s not yet enough good research to be able to say whether probiotic food products can help.

Nowadays there’s good reason to believe that antibiotics and surgery often aren’t as necessary as previously thought.

Further information

When people are ill or need medical advice, they usually go to see their family doctor first. Read about how to find the right doctor, how to prepare for the appointment and what to remember.


  • IQWiG health information is written with the aim of helping
    people understand the advantages and disadvantages of the main treatment options and health
    care services.

    Because IQWiG is a German institute, some of the information provided here is specific to the
    German health care system. The suitability of any of the described options in an individual
    case can be determined by talking to a doctor. We do not offer individual consultations.

    Our information is based on the results of good-quality studies. It is written by a
    team of
    health care professionals, scientists and editors, and reviewed by external experts. You can
    find a detailed description of how our health information is produced and updated in
    our methods.

When to Take Stomach Pain and other GI Issues Seriously

Everyone experiences stomach pain or other gastrointestinal (GI) issues from time-to-time. Many times, these can be minor issues that resolve themselves over time. However, if you or a loved one are experiencing troubling gut pain for more than a few days, it might be time for you to schedule an appointment with your healthcare provider or a gastroenterologist. Common GI issues include food poisoning, a stomach virus, irritable bowel syndrome (IBS), celiac disease, or any number of other conditions, including inflammatory bowel disease (IBD), such as Crohn’s disease or ulcerative colitis.

The information below will help you understand your symptoms and provide tools for you to find a physician and share your GI symptoms with them. Below are descriptions for the most frequently experienced symptoms of IBD. 

Jump to:

Abdominal pain | Change in bowel movement frequency | Chronic diarrhea | Chronic constipation | Urgent bowel movements | Bloody bowel movements | Mucus in stool | Tenesmus | Nausea/vomiting | Other symptoms | Find care

Abdominal pain and stomach cramps

It is normal to have abdominal pain from time-to-time, caused by gas, stomach bugs, or even food poisoning. However, if you or a loved one is experiencing abdominal pain that you would describe as intense, crampy, and the pain doesn’t go away in a day or two, or has been present on and off for weeks or longer, it’s time to see a healthcare provider to find out what’s wrong.

Change in bowel movement frequency 

There is no magic number of bowel movements we should all be having each day.  Some people go three-to-four times a day, and that is normal for them. Others only move their bowels once a day and that is their normal. However, if you or a loved one experiences a significant change in bowel movement frequency, whether more or less often, it’s important to discuss this change with your healthcare provider.

Chronic diarrhea

We have all had diarrhea (loose or watery stool) at one time or another. It is unpleasant but usually resolves itself quickly. However, if you or a loved one is experiencing diarrhea frequently over several weeks, or if you are having loose stools multiple times a day, you should see a healthcare provider. You may want to consult with a gastroenterologist (a healthcare provider that specializes in GI issues) if your normal bowel movement frequency increases and if your stool is loose, watery or is accompanied by symptoms such as urgency or fatigue. 

Chronic constipation, or constipation alternating with diarrhea

It is normal to occasionally feel constipated—having difficulty moving bowels or infrequent bowel movements. There are a variety of reasons why someone may experience occasional constipation. But if you or a loved one is frequently experiencing constipation, or constipation alternating with diarrhea, it is important to see a healthcare provider or gastroenterologist. Your healthcare provider will be able to run tests to determine the cause of the constipation and recommend for the best course of treatment for you or your loved one.

Urgent bowel movements

Most people will at some point experience an urgent need to move their bowels and race to the bathroom. It can be stressful, especially when it’s hard to find a nearby restroom. If you experience this kind of urgency on a regular basis, or if find you are unable to hold back the bowel movement before reaching the bathroom, you should see a healthcare provider or gastroenterologist.

Bloody bowel movements or blood on toilet paper

There is nothing scarier than going to the bathroom and seeing blood in the toilet or on the toilet paper.  Bloody bowel movements or blood on toilet paper can be caused by several things, including anal fissures (small tear in anal canal), hemorrhoids (swollen, sometimes painful dilated veins on the inside or outside of your bottom), and other GI conditions, including IBD. If you are experiencing blood with bowel movements, you should schedule a visit to a gastroenterologist.

Mucus in stool

Mucus is a normal slippery and stringy fluid that is produced by many tissues in your body including your gut. Seeing some mucus in your stool is normal, especially after a gastrointestinal infection. However, if you or a loved one is seeing mucus in your stool regularly and/or you are experiencing pain or any of the symptoms above, it is time to consult your healthcare provider or a gastroenterologist. 

Feeling of incomplete bowel evacuation (tenesmus)

Have you ever thought you had to go to the bathroom and then got there and nothing came out? This feeling or sensation is called tenesmus. Tenesmus can have many causes, so it is important to discuss this feeling with your healthcare provider or gastroenterologist.

Feeling nauseous or vomiting

At some point in your life, you will feel nauseous (an uneasiness or queasiness of the abdomen) which can be accompanied by vomiting (also known as throwing up). The reasons we feel nauseous and/or vomit are many, including motion sickness, overeating, gastrointestinal infection, or a bowel obstruction (blockage). If you or a loved one frequently feels nauseous with or without vomiting, it’s important to schedule an appointment with your healthcare provider.  

Other symptoms to discuss with your healthcare provider

It is also common to experience other symptoms when living with IBD. Sometimes, these can occur before you experience any GI issues. If you notice any of the following, you should speak with your healthcare provider to figure out the cause.


Pain outside of the gut

Bodily aches and pains are a regular part of life. However, if you or a loved one is experiencing pain in your joints (like the knees, elbows, or fingers) along with some of the GI symptoms above, it is important to mention this during your appointment with your healthcare provider. Sharing this information will help guide your healthcare provider to the next steps in understanding what is causing your GI symptoms and pain. Sometimes, such as in some cases of IBD, certain kinds of gut problems can be accompanied by pain outside the gut.

You may also be experiencing other symptoms like joint pain or uveitis (inflammation of the eye). Learn more about the extraintestinal symptoms (symptoms outside of the GI tract).


Everyone gets tired and feels run down occasionally. Feeling fatigued is different from being tired.  Fatigue is long lasting and is often expressed by feeling tired all the time, or feeling sleepy, weak, and lacking energy for work, school, or other everyday activities. It is important to let your healthcare provider know how long you have felt fatigued and how it has impacted your daily life. 

Loss of appetite (not wanting to eat)

If you are feeling nauseous or vomiting, it is normal to lose your appetite. No one wants to eat when they are fearful of being sick. If not wanting to eat is accompanied by a gastrointestinal infection or overindulgence in food or drink, this is nothing to be concerned about. However, if you or a loved one are unable to eat due to loss of appetite, it’s important to discuss this symptom with your healthcare provider, including letting the doctor know how long you’ve been without an appetite. 

Weight loss

Unintentional weight loss is an important symptom to mention to your healthcare provider. Be sure to mention if the unintentional weight loss was also accompanied by loss of appetite, diarrhea, nausea, vomiting, or any of the other symptoms on this page. 

Delayed Growth and Puberty (children and teens)

While most symptoms of IBD are the same in children and adults, there are some differences. Children may additionally be affected by a delay in growth and puberty. In children, failing to meet height, weight, and puberty milestones can be concerning. If your child is also experiencing pain, diarrhea, or other symptoms mentioned here, it’s important to discuss these with their pediatrician so they can refer you to a pediatric gastroenterologist. 

Family History and Genetic Factors

Studies have shown that between 5% and 20% of people with IBD have a first-degree relative, such as a parent, child, or sibling, who also has one of the diseases.  Additionally, the risk of Crohn’s disease or ulcerative colitis is substantially higher when both parents have IBD.  Because early detection is important to limit progression of disease, knowing that you have a family history of IBD can put you on the alert for its warning signs. It is important to talk to your healthcare provider about your family history and how it may impact you and your family’s health.  

Sharing your symptoms

If you’ve experienced any of the symptoms listed above, it is important to tell your healthcare provider. When describing your GI and other symptoms, please share all your symptoms and how long you have been experiencing them. This information is important and will help your healthcare provider determine what tests or actions should be taken next.  

You may find it helpful to use a symptom tracker before your appointment to record all your GI and other symptoms. The Foundation offers an IBD symptom tracker which you can use when visiting your healthcare provider or a gastroenterologist. Please note this tracker is specific to IBD, so you may want to use the open space to note other symptoms that may not be included in this resource. 

How do I find a healthcare provider?

If you experience any of the symptoms outlined above, please consult with your healthcare provider. If you need a gastroenterologist who specializes in IBD, we are here to help—our Find a Medical Expert tool is a great place to start. There are many factors that go into finding the right gastroenterologist. You may want to consider the following questions and preferences when selecting your gastroenterologist:


Personal preferences

You may want to consider the following personal questions as you look for a gastroenterologist:

  1. How far are you willing to travel to see the gastroenterologist?
  2. Does the healthcare provider or office staff need to speak a second language?
  3. Do you have a preference when it comes to your physician’s gender?

It is important to understand your insurance coverage when seeking a gastroenterologist for the first time or for a second opinion. You may want to consider the following questions before your make an appointment:

  1. Does your insurance require a referral from your primary care provider to a gastroenterologist?
  2. Is the gastroenterologist in your insurance network?
  3. Does your insurance have a higher co-pay for specialists?
  4. How much of my deductible has been met? 

The Foundation has additional insurance information that may be useful as you plan a healthcare provider visit; please visit our Financial and Insurance Information  pages for more information. You can also contact our IBD Help Center at [email protected] or 1-888-MY-GUT-PAIN with specific questions.

Questions to ask the GI office

When selecting your gastroenterologist, you may consider the following questions:

  1. Is the healthcare provider board certified?
  2. What are their specialties? 
    • Some physicians have an expertise in liver diseases, IBS, or IBD.   You can find a healthcare provider’s specialty by visiting their website or asking the office staff when calling.
  3. Do they work with other gastroenterologists or GI surgeons who they can consult with?
Visit our Find a Medical Expert directory

The Foundation offers a listing of healthcare professionals including adult and pediatric gastroenterologists, nurse practitioners, physician assistants, nutritionists, and mental health clinicians on our Find a Medical Expert Directory. Each professional listed has expressed an interest in IBD by becoming a member of the Crohn’s & Colitis Foundation. If you need additional assistance finding a gastroenterologist, please contact the IBD Help Center; they will provide additional guidance and suggestions for locating a healthcare provider.   


Diagnosing the Patient with Abdominal Pain and Altered Bowel Habits: Is it Irritable Bowel Syndrome?

1. Fass R,
Longstreth GF,
Pimentel M,
Fullerton S,
Russak SM,
Chiou CF,

et al.
Evidence- and consensus-based practice guidelines for the diagnosis of irritable bowel syndrome. Arch Intern Med.

2. Longstreth GF.
Irritable bowel syndrome: diagnosis in the managed care era. Dig Dis Sci.

3. Talley NJ,
Gabriel SE,
Harmsen WS,
Zinsmeister AR,
Evans RW.
Medical costs in community subjects with irritable bowel syndrome. Gastroenterology.

4. Locke GR 3d,
Zinsmeister AR,
Talley NJ,
Fett SL,
Melton LJ.
Risk factors for irritable bowel syndrome: role of analgesics and food sensitivities. Am J Gastroenterol.

5. Locke GR 3d.
The epidemiology of functional gastrointestinal disorders in North America. Gastroenterol Clin North Am.

6. Maxwell PR,
Mendall MA,
Kumar D.
Irritable bowel syndrome. Lancet.

7. Croffie JM,
Fitzgerald JF,
Chong SK.
Recurrent abdominal pain in children: a retrospective study of outcome in a group referred to a pediatric gastroenterology practice. Clin Pediatr (Phila).

8. Smith RP.
Lower gastrointestinal disease in women. Obstet Gynecol Clin North Am.

9. Whitehead WE.
Patient subgroups in irritable bowel syndrome that can be defined by symptom evaluation and physical examination. Am J Med.

10. Dainese R,
Galliani EA,
De Lazzari F,
Di Leo V,
Naccarato R.
Discrepancies between reported food intolerance and sensitization test findings in irritable bowel syndrome patients. Am J Gastroenterol.

11. Lee JG,
Ellis K,
Melynk C.
Gastroenterologic disorders presenting as food intolerance. Immunol Allergy Clin North Am.

12. Horwitz BJ,
Fisher RS.
The irritable bowel syndrome. N Engl J Med.

13. Wackerbauer R,
Schmidt T,
Widmer R,
Pfeiffer A,
Morfill G,
Kaess H.
Discrimination of irritable bowel syndrome by nonlinear analysis of 24-h jejunal motility. Neurogastroenterol Motil.

14. Evans PR,
Bak YT,
Shuter B,
Hoschl R,
Kellow JE.
Gastro-paresis and small bowel dysmotility in irritable bowel syndrome. Dig Dis Sci.

15. Mertz H,
Naliboff B,
Munakata J,
Niazi N,
Mayer EA.
Altered rectal perception is a biological marker of patients with irritable bowel syndrome. Gastroenterology.

16. Olden KW,
Drossman DA.
Psychologic and psychiatric aspects of gastrointestinal disease. Med Clin North Am.

17. Goldberg J,
Davidson P.
A biopsychosocial understanding of the irritable bowel syndrome: a review. Can J Psychiatry.

18. Aaron LA,
Burke MM,
Buchwald D.
Overlapping conditions among patients with chronic fatigue syndrome, fibromyalgia, and temporomandibular disorder. Arch Intern Med.

19. Dalton CB,
Drossman DA.
Diagnosis and treatment of irritable bowel syndrome. Am Fam Physician.

20. Sanders DS,
Carter MJ,
Hurlstone DP,
Pearce A,
Ward AM,
McAlindon ME,

et al.
Association of adult coeliac disease with irritable bowel syndrome: a case-control study in patients fulfilling ROME II criteria referred to secondary care. Lancet.

21. Bonis PA,
Norton RA.
The challenge of irritable bowel syndrome. Am Fam Physician.

22. Hammer J,
Talley NJ.
Diagnostic criteria for the irritable bowel syndrome. Am J Med.

23. Thompson WG,
Longstreth GF,
Drossman DA,
Heaton KW,
Irvine EJ,
Muller-Lissner SA.
Functional bowel disorders and functional abdominal pain. Gut.
1999;45(suppl 2):43–7.

24. Francis CY,
Duffy JN,
Whorwell PJ,
Martin DF.
Does routine abdominal ultrasound enhance diagnostic accuracy in irritable bowel syndrome?. Am J Gastroenterol.

25. Harris MS.
Irritable bowel syndrome: a cost-effective approach for primary care physicians. Postgrad Med.

26. Schmulson MW,
Chang L.
Diagnostic approach to the patient with irritable bowel syndrome. Am J Med.

Irritable Bowel Syndrome (for Kids)

What Is Irritable Bowel Syndrome?

Your intestines (also called bowels) can have something called irritable bowel syndrome (IBS). It causes cramps, bloating (puffiness in your belly area), constipation (when you can’t poop), and diarrhea (when you poop too much).

If you have irritable bowel syndrome, there are ways to deal with or prevent these symptoms.

What Are the Signs & Symptoms of IBS?

Besides belly pain, cramps, bloating, diarrhea, constipation, kids with IBS also could have:

Kids with IBS may sometimes feel like they can’t quite finish going to the bathroom. Or, if they have gas, instead of passing it, it may feel trapped inside.

What Happens in Irritable Bowel Syndrome?

Irritable bowel syndrome is a problem with the way the large intestine (say: in-TES-tin), or colon, works. The large intestine absorbs water and nutrients from the partially digested food that enters it from the small intestine. Anything not absorbed slowly moves on a pathway out of your body. These undigested and unabsorbed food particles are also known as stool, a bowel movement, or poop.

Here’s why an intestine gets “irritable.” To have a bowel movement, the muscles in the colon and the rest of the body have to work together. If they don’t, what’s in the colon can’t move along as well as it should. It sort of stops and starts, doesn’t move, or sometimes moves too fast. This can hurt and make a kid feel bad. Doctors also believe that people with IBS may have more sensitive bowels. So what might be a little uncomfortable in one person causes serious pain for someone with IBS.

IBS isn’t fun, but the good news is that it doesn’t lead to more serious problems. It’s irritating, but it can be managed and kids can do whatever activities they like in spite of it.

Why Do Kids Get IBS?

No one really knows what causes IBS, but it tends to run in families.

Stress can affect kids with IBS too. Stress can speed up your colon and slow your stomach down. Stressful feelings also can be a trigger for IBS. Let’s say a kid has a big test at school the next day and really worries about it, that’s stress. Or if a kid’s parents argue a lot — that’s stress too. A kid in this situation can learn to handle stress in other ways, so IBS symptoms will go away or at least be less severe.

What kids eat can also be a trigger. This can be different for each kid. For example:

  • A high-fat diet may bother some kids.
  • Sugary drinks may cause diarrhea in other kids.
  • For other kids, eating big meals and spicy foods might cause problems.

What Will the Doctor Do?

Most kids get a stomachache, constipation, or diarrhea now and then. This doesn’t mean a kid has IBS.

But when a kid has these problems regularly, a doctor may think it could be IBS. Here are some questions the doctor might ask:

  1. How often does the kid’s stomach hurt? Every week? Every 2 weeks? Every day? A kid with IBS will have a stomachache at least 12 weeks out of a year. That’s a lot!
  2. What makes that pain go away? If the pain stops after the kid poops, there’s a good chance it’s IBS.
  3. How often does the kid have to poop? With IBS, it could be more often or less often than usual.
  4. Now the gross one: What does the poop look like? Sometimes kids notice that their poop looks different than usual. It may be a different color, slimier, or contain something that looks like mucus (snot). That’s a real signal to the doctor that a kid might have IBS.

There is no test to diagnose IBS. Doctors often diagnose the problem just by listening to a person describe the symptoms. That’s why it’s really important for kids to talk with their parents and their doctor about their symptoms, even if it seems embarrassing.

How Is IBS Treated?

If IBS causes a lot of problems, the doctor might give a kid medicine to ease pain and manage gas, constipation, diarrhea, and the need to rush to the bathroom.

But kids also need to learn what makes the symptoms worse and avoid whatever it is. So try to figure out what seems to cause your IBS symptoms.

Keeping a diary is one way to do that. No, it’s not the kind of diary you write poems in. Think of it as a way to record what you eat and whether you had any IBS symptoms after that. You also might write down when you feel really anxious, like before a big test, to see if that makes the problem worse.

Each person’s food triggers may be a little different. But some common ones are:

  • big meals
  • spicy foods
  • high-fat foods
  • chocolate
  • some dairy products like ice cream or cheese

It’s not just what you do eat — what you don’t eat also may lead to IBS symptoms. Fruits, vegetables, and high-fiber foods like beans and popcorn can help keep your colon moving well. Drinking water can help a cranky colon too.

Learning how to handle stress can help kids, whether they have IBS or not. One way to do that is to talk about your problems with other people, such as parents and friends. Here are some questions to ask yourself:

  • Am I putting too much pressure on myself at school?
  • Am I getting enough sleep?
  • Do I get time to play and be active, such as riding a bike or playing basketball?
  • Do I skip breakfast and then get so hungry that I nearly inhale my lunch? Eating more slowly could help IBS symptoms.

It would be good to talk with a parent, or another trusted adult, about the answers to these questions. Just talking to someone can make you — and your irritable bowels — feel better!

Functional Abdominal Pain in Children


Abdominal pain that cannot be explained by any visible or detectable abnormality, after a thorough physical examination and appropriate further testing if needed, is known as functional abdominal pain. Functional abdominal pain can be intermittent (recurrent abdominal pain or RAP) or continuous. Although the exact cause is not known, nerve signals or chemicals secreted by the gut or brain, may cause the gut to be more sensitive to triggers that normally do not cause significant pain (such as stretching or gas bloating). Because of this change in bowel function, this type of abdominal pain is often referred to as “functional abdominal pain.”

Functional abdominal pain is one of the most common complaints of children and adolescents who are seen by gastroenterologists who care for young patients. In fact, almost a quarter of all children seen for stomach or intestinal complaints have functional abdominal pain.

Functional abdominal pain includes several different types of chronic abdominal pain, including recurrent abdominal pain, functional dyspepsia, and irritable bowel syndrome. Recurrent abdominal pain (RAP) was originally defined about 50 years ago as three or more bouts of abdominal pain (belly ache) in children 4-16 years old over a three-month period severe enough to interfere with his/her activities.


Usually, the pain is located around the umbilicus (belly button), however the pattern or location of abdominal pain is not always predictable. The pain may occur suddenly or slowly increase in severity. The pain may be constant or may increase and decrease in severity.

Some children with functional abdominal pain may experience dyspepsia, or upper abdominal pain associated with nausea, vomiting, and/or a feeling of fullness after just a few bites (early satiety). Others may experience abdominal pain with bowel movements. Pain that is usually relieved by bowel movements, or associated with changes in bowel movement habits (mainly constipation, diarrhea, or constipation alternating with diarrhea) is the classic irritable bowel syndrome (IBS).   


The trigger for functional abdominal pain varies from one patient to another, and may transform over time even in the same patient. The exact triggers may not be easily identified but may remain moving targets for treatment. Nerve signals or chemicals secreted by the gut or brain, may cause the gut to be more sensitive to triggers that normally do not cause significant pain (such as stretching or gas bloating). Because of this change in bowel function, this type of abdominal pain is often referred to as “functional abdominal pain.”

Most young children will point to the umbilicus (belly button) when asked to describe the location of abdominal pain. However, pain centered around the belly button could be due to a number of causes that should be considered when evaluating a child with chronic abdominal pain. Some of those causes are not very serious while other causes require close and long term care. Possible causes that should be considered based on the history, physical examination and testing, are acid reflux, constipation, lactose intolerance, parasitic infections of the small and large intestines, infections of the stomach with a germ called Helicobacter pylori (that is associated with ulcers in the first portion of the small bowel), inflammatory bowel diseases (IBD) such as Crohn’s disease and ulcerative colitis, celiac disease which is a sensitivity to cereal grains, food allergies, inflammation of the liver (hepatitis), gall bladder problems, an inflamed pancreas,  an intestinal obstruction (blockage), appendicitis, and many more rare disorders.

It must be emphasized that typically, none of these more severe problems cause abdominal pain in most children with chronic or recurrent bellyaches. Instead, the pain is usually “functional”.

Risk Factors

In some cases, children previously suffering from anxiety, depression and other psychiatric disorders may show an exaggerated pain response. Sometimes, the parent and the child may not be consciously aware of any stress or emotional disturbances. Other possible risk factors are thought to be physically or emotionally traumatic experiences, and preceding gastrointestinal infections. Parents and children need to be reassured that functional abdominal pain is not life threatening. However, functional abdominal pain may have negative effects on the child’s physical and psychological state. The pain may interfere with school attendance, participation in sports and other extra-curricular activities. Infrequently, it may affect appetite and sleep. The changes in the daily routine may affect the child’s mood and emotions, and in turn cause depression and anxiety.


Detailed information regarding the location of abdominal pain, the frequency (number of times per week) and duration of a typical episode, and association with other complaints will in most cases provide useful clues about the cause, and will guide further testing. Other important pieces of information, known as “red flags” or “alarm signs” that a physician may inquire about include weight loss, poor growth, fever, joint pains, mouth ulcers, unusual rashes, loss of appetite, blood that appears in the vomiting or stool, and night time awakening due to diarrhea and abdominal pain. The doctor will also ask about the effects of foods and beverages upon the pain, and relationship to stools, sleep, physical activities, and emotional stress.

The diagnosis of functional abdominal pain is often based on the report of symptoms and normal physical examination. It is also quite possible that the doctor may obtain some tests. The reason for these tests is to look for signs of any serious disease. These screening tests may initially include blood and stool tests. The results of screening tests often guide the doctor in deciding whether further tests are needed or whether a trial of diet changes, stress management or medication may be started. Testing should be limited if the history is typical for functional abdominal pain and the child’s physical examination is normal. In that case, many doctors prefer to treat without testing in order to avoid the discomfort of testing or the slight risk associated with testing. Of course, if the history, the physical examination, or the results of screening tests are abnormal, further testing may be required. This further testing may include a test to confirm lactose intolerance, ultrasound of the abdomen, a CT of the abdomen, and upper GI series (radiology test), and possibly an endoscopy (scope). The scope allows the doctor to use a special camera on the scope to look at the inner lining of the food pipe, stomach, first and last portion of the small intestine and the large intestine. At the time of the scope, biopsies (small pinches of the lining) are also obtained and examined under the microscope for signs of certain infections and disorders like IBD and celiac disease. Normal test results in a child without alarm signs or red flags strongly suggest RAP or one of the other types of functional abdominal pain, such as irritable bowel syndrome or functional dyspepsia.         


If a specific cause for abdominal pain is discovered during the evaluation, the physician will discuss specific management of conditions like constipation, lactose intolerance, infections, IBD, celiac disease, and food allergies. If no specific cause is found and functional abdominal pain is suspected, the child needs to be reassured that his or her abdominal pain is accepted as a real disorder and not something that is “just in the head”. The goal of managing functional abdominal pain is to provide a satisfactory quality of life through support, education, medicines and better coping skills.  Reassurance about the good outcome of functional abdominal pain and the positive aspects of the child’s health are crucial. Addressing the parents’ and child’s concerns and fears and identifying emotional or psychological stressors are also important. As noted before, some tests may be needed during the evaluation of functional abdominal pain, but it is also important for parents and children to know that doing too many unnecessary tests may be frustrating to the family and child. If functional abdominal pain is strongly suspected as the likely diagnosis, testing should be limited to the most useful, simple and relatively non-invasive tests. 

The child may benefit from certain dietary changes depending on his/her history. These are recommended on a case-by-case basis. The physician may advise avoidance of greasy and spicy foods, caffeine, juices, and carbonated drinks. Eliminating lactose (a natural sugar in milk and other dairy products) from the diet may benefit those who suffer from lactose intolerance in addition to functional abdominal pain. Some children with abdominal pain who also experience “gas” may improve by eating food slowly and by avoiding carbonated drinks, and gas forming foods such as cabbage, or beans. In addition, fruit drinks, sugar-free chewing gum, and sugar free candy sweetened with an alcohol called sorbitol should be avoided.  Sorbitol, which tastes sweet, cannot be properly digested, and when taken in large amounts, it can cause cramping, bloating, and even diarrhea.

Some children may be candidates for medications, if functional abdominal pain is significantly limiting the daily routine. These medications include anti-spasmodic medicines for those with crampy pain in relation to bowel movements, laxatives for those with constipation, and acid-suppressing medicines for those with pain and dyspepsia. If the child does not respond to any of these treatments, he or she may benefit from low doses of medicines called tricyclic antidepressants (used at much higher doses to treat depression). At low doses, these medicines can be excellent pain relievers for some children. A fearful, anxious, or depressed child however should be fully assessed by a psychiatrist or psychologist. Some psychological treatments that help children cope with functional abdominal pain and other stressors, include behavioral therapy, relaxation exercises and hypnosis. It is very important that the physician, parents, and school encourage the child resume a normal routine.   

Fortunately, the diagnosis of functional abdominal pain has a good outcome overall, with almost half of these children getting better on their own or with treatment within a few weeks to months. A supportive and understanding environment at home and school is important to keep the child physically and mentally healthy.

Author(s) and Publication Date(s)

Seema Khan, MD, Children’s National Medical Center, Washington, DC – Published August 2006. Updated December 2012.

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90,000 Pain during bowel movements: causes

To eliminate the painful sensations accompanying the act of defecation, it is necessary to determine their nature as accurately as possible. There can be many reasons . So, painful bowel movement in female representatives is caused by ovarian cyst , and in men, discomfort in the anus after defecation is often caused by inflammation of the prostate . However, more often pain during bowel movements, regardless of the patient’s gender, indicate acute hemorrhoids, anal fissure, paraproctitis, proctitis or rectal cancer.

1. For the acute form of hemorrhoids, the prolapse of hemorrhoids from the anus or their infringement is symptomatic. Since hemorrhoids are equipped with a large number of receptors, the disease is signaled by severe pain during bowel movements, when running or walking, sitting or lying down, sometimes also at rest.

The following accompanying symptoms are possible:

  1. burning and itching in the anus,
  2. blood from the anus during bowel movements,
  3. Sensation of a foreign body in the anus.

2. Anal fissure is a damage to the rectal mucosa in the anal sphincter region. Such damage is accompanied by severe pain that is difficult to ignore; it is localized in the anal canal and appears after defecation.

In addition to pain, the presence of anal fissures can be signaled by:

  1. spotting,
  2. itching in the anus,
  3. Anal sphincter spasm.

3. Paraproctitis is a purulent inflammation of the tissues that surround the rectum. A distinction should be made between acute and chronic paraproctitis. Depending on the location of the abscess, paraproctitis is divided into subcutaneous, intrasphincteric, ischiorectal (sciatic-rectal) and pelviorectal.

Symptoms of acute subcutaneous paraproctitis:

  1. acute pain in the anus that increases during bowel movements, movement and straining,
  2. swelling of the perineal region,
  3. skin redness and swelling,
  4. Purulent lump in the anus,
  5. increased body temperature, chills.

With sciatic-rectal paraproctitis, the pain is dull and felt deeper than with subcutaneous inflammation.

4. Proctitis – inflammation of the rectal mucosa. Acute proctitis can take many forms.

Frequent symptoms:

  1. severe pain in the rectal region, aggravated by bowel movements and radiating to the perineum,
  2. Unusually frequent urge to defecate,
  3. burning in the anus, the sensation of the presence of a foreign body,
  4. stool violation,
  5. bloody discharge from the rectum,
  6. increased body temperature, weakness.

5. Also, pain during bowel movements can signal the presence of cancer . For colorectal cancer, impurities of blood in the feces, pain in the lower abdomen, in the genitals and in the hips are symptomatic.

The choice of a method for treating anal fissures and other pathological conditions is carried out by the doctor differentially according to the results of the examination and depends on the nature of the disease and its clinical manifestations. In any case, discomfort in the anus after a bowel movement cannot be ignored by the proctologist.


Reasons to contact


  • Minor traces of blood on toilet paper
  • single drops of blood on feces
  • copious discharge of blood during bowel movements
  • traces of blood on underwear

One of the most common symptoms of rectal diseases is spotting.It can be as minimal traces of blood on toilet paper, as well as profuse bleeding. Blood is always an alarming symptom, because anal fissures, hemorrhoids, inflammatory bowel and anorectal diseases, and, of course, various tumors can be the reason for the appearance of blood. Therefore, it is necessary to consult a doctor as soon as possible in order to find out the cause and start treatment on time.

2. Discomfort in the anus.

  • itching
  • burning
  • feeling of incomplete bowel movement
  • foreign body sensation in the anus

Discomfort in the anus occurs for various reasons and is often the first sign of chronic hemorrhoids or anal fissure.They can also be manifestations of inflammation of the skin around the anus or are caused by prolapse of the rectal walls, which can eventually turn into rectal prolapse. Despite its insignificance, discomfort can be the only symptom of serious illness.

3. Pain.

  • Acute burning pains in the anus during or immediately after a bowel movement
  • Slight pulling or aching pains at rest or after a bowel movement
  • Pain in the anus or coccyx, aggravated by pressing or sitting
  • recurrent aching pain in the coccyx and pain in the lower abdomen

Pain is always an alarming symptom.Almost half of patients go to the proctologist with complaints of pain. The cause of the pain can be different. Acute pain is usually associated with the formation of an anal fissure or with an acute inflammatory disease of the anorectal region (acute hemorrhoids, acute paraproctitis). Pulling or aching pains are often accompanied by various exacerbations of chronic diseases or a mild inflammatory process. Also, pain can be a sign of inflammatory diseases or tumors of the colon.One way or another, the appearance of pain of any nature is a reason for an urgent visit to a doctor.

4. New growths in the anus.

  • dense rounded formation
  • loose formations of irregular shape
  • Painful lump under the skin near the anus
  • Some neoplasm that protrudes from the rectum after a bowel movement

If you find “some kind of lump” in the anus, do not self-medicate and do not wait for it to “pass by itself.”Most often, neoplasms require surgical treatment (papillomas, condylomas, anal polyps, hypertrophied anal fringes and papillae). Also, the “lump” may be an inflamed hemorrhoid or “signal tubercle” in anal fissures. Any neoplasm should be diagnosed by a doctor who will help you choose the best treatment or removal option.

5. Foreign body of the rectum.

If, for some reason, something foreign (for example, a condom or sex toys) turned out to be in the rectum, then you should not try to remove this object yourself.Without the necessary skills and tools, you can injure your rectum or push the foreign body even deeper. Entrust the solution to this intimate problem to a proctologist.

90,000 Pain in the anus. Diagnostics and treatment in Rostov-on-Don

Severe soreness or moderate discomfort in the anus or deeper can be attributed to a variety of causes. Pain can be paroxysmal or prolonged in time.

Manifest independently or accompanied by other symptoms – blood, mucus, stool disorders, constipation.

Regardless of the characteristics, it is important to consult a proctologist as soon as possible and find out the true cause of the ailment.

Causes of pain in the anus

Soreness can be provoked by causes directly related to the anal canal and intestines, or it will be radiating (reflected) pain from closely located organs.

We must not forget about the likelihood of smooth muscle spasm. It is necessary to respond promptly to symptoms in case of bleeding, fever, as well as emerging weakness, loss of appetite and body weight.

One can calm down only after establishing the cause of the problem through examination and prescribing treatment. When you have received confirmation from the doctor that nothing threatens you, and you calmly solve the problem by following the recommendations.

Violation of the integrity of the mucous membrane

Here, the cause may be injuries sustained during difficult bowel movements, the formation of anal fissures, ulcers, areas of erosion, the formation of fistulous passages.

Micro-tears after sexual experiments are also in this category if the patient has not followed safety precautions.


This list may include polyps, papillomas, benign and malignant formations that can cause painful bowel movements, blockage of the canal lumen, or signal pain by affecting nearby nerve endings.

Radiating pain

Women often experience reflected pain when they have problems with the reproductive system.Also, the problem may lie in a tumor that has arisen along the nerve that innervates the anus.

Appendicitis, adhesive disease, helminthiasis, intestinal infections, Crohn’s disease – all of this can also send painful signals to the anus.

Inflammatory processes

Paraproctitis, abscesses – another cause of pain. The period of growth of the abscess becomes especially painful, after spontaneous opening or artificial drainage, the pain weakens.

Hemorrhoidal disease

Here, the discomfort is mainly associated with thrombosis of the node. Hemorrhoids are also accompanied by injuries to protruding areas, prolapse of internal nodes, regular constipation and provokes the development of sphincter spasm due to the growing fear of painful bowel movements.

Anal spasms

The rectum has a large number of nerve endings on its posterior surface. Problems in this area easily provoke involuntary stimulation of the muscular sphincters of the anus, which leads to painful spasms.

Reasons to contact a proctologist

In Rostov-on-Don, there are highly qualified doctors-proctologists who will help not only stop painful symptoms, but also carry out diagnostics using modern equipment.

Treatment will depend on the results of the examination: conservative or surgical, it will certainly allow you to quickly recover and return a high level of well-being.

You may also be interested in hemorrhoid treatment

The author of the article is a doctor proctologist

Edelgeriev Magomed Omarovich

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90,000 Pain during bowel movements | Clinic “Movement”

The act of defecation is a very important and at the same time very complex process. We are all adults and must understand that in case of any disturbances in the work of the intestines, we must not be shy and hide our problems. In the modern world, a lot of information comes to us every day.Nowadays there is a rather aggressive advertising of drugs, and the neighbor knows medicine better than any doctor, as he watches medical programs. Of course, such programs are very important, as they conduct educational work, but after watching them, a person will not become a doctor. Therefore, when a statement sounds from the TV screen that a certain medicine will forever save you from problems, pay attention, below it is always written about the need to consult a specialist.

Returning to the problem of painful bowel movements, there are several aspects to consider.Several components take part in the process itself: 1) the large intestine, namely its distal parts – the sigmoid and rectum; 2) the pelvic floor muscles – the sphincter and levators (muscles that change the angle of the anal canal). It is important to understand that there are no nerve endings in the mucous membrane of the rectum and sigmoid colon, therefore, as long as this or that process develops only within the boundaries of the inner layer, a person will not experience any painful sensations. For example, contrary to the general opinion, even the advanced stage of chronic hemorrhoids does not manifest itself as a pain syndrome.

Pain appears only when the pathological process affects the deeper, muscle layers, or spreads to the skin around the anus. This is a very important fact, since sometimes it is of decisive importance in diagnostics. For example, with the same chronic hemorrhoids, with the appearance of pain, it can be concluded that the disease progresses and the formation of external nodes, which no longer respond to treatment using non-surgical techniques, but require surgical intervention.

If discomfort during the act of defecation is manifested by pain or pain in the lower abdomen, one can suspect an inflammatory process of the sigmoid or rectum, and affecting the muscle layer, which means it is quite neglected. The causes of such inflammation are usually divided into 3 groups: 1) infection of the rectum and sigmoid colon, including viral. Diagnosis can be made by examining mucosal scrapings. 2) Alimentary disorders (disorders of the entire gastrointestinal tract), such as acute pancreatitis, cholecystitis, gastritis, gastric ulcer, etc.3) Serious disorders of the intestinal flora – dysbiosis (after antibiotic therapy, interventions on the gastrointestinal tract). It is clear that the cause is very important to establish in order to effectively treat. Unfortunately, such a pain syndrome can also be caused by malignant diseases of the rectum and sigmoid colon.

If the pain bothers mainly in the anal area, is given to the coccyx area, this may indicate pathological processes that involve the muscles of the pelvis, namely the sphincter of the anal canal – anal fissure, fistula, paraproctitis, etc.e. As a rule, all these diseases are difficult to respond to drug therapy, require surgical intervention, and the sooner it is performed, the better.

Therefore, you do not need to hide your problems and bring them to the level of unsolvable ones. It is never a shame to seek help from a specialist, in this case a coloproctologist. In Volgograd, our clinic has extensive experience in helping patients with coloproctological profile.

90,000 Anus cancer – clinic “Dobrobut”

The anal opening has internal and external sphincters formed by muscle rings (locking muscles).The main function of this anatomical formation is the ejection of feces (defecation), and the sphincters control this process. Frequent pathologies of this area are hemorrhoids, mucosal defect, and tumors (malignant or benign) are less common.

Despite the fact that malignant tumors occur quite rarely, they require timely and correct diagnosis and adequate therapy. Anal cancer is more common in 45-50 years. Women with neoplasia of the vulva or uterus are at risk of developing anal cancer, so this pathology is mostly associated with genital malignant diseases, and not with tumors of the gastrointestinal tract.


Histological distinguish 4 forms of cancer in this area:

  • Squamous – this epithelium lines the anal canal. This is the most common form, which occurs in 55% of cases and has a tendency to ulceration (covered with ulcers).
  • Adenocarcinoma develops from the glandular epithelium of this area and accounts for 5-6%.
  • Basaloid (24-30%) develops at the transition of the columnar epithelium to the flat epithelium.
  • Melanoma originates from skin cells and is dark in color.

Such an extensive histological picture is associated with the diversity of the epithelium.

Causes of cancer

The causes of cancer of the anus are not completely known. But the factors that increase the likelihood of its occurrence have been precisely established:

  • State of immunodeficiency – an example is HIV infection and weakness after treatment with immunosuppressants.
  • Human papillomavirus infection.First, condylomas appear in this area, which can provoke the appearance of cancer. Particular importance is attached to highly oncogenic HPV types 16 and 18.
  • Chronic diseases of this area, irritation and inflammation (polyps, fissure, fistula, hemorrhoids, proctitis).
  • Trauma to the anus during anal contact, medical procedures and research.
  • Radiation exposure – treatment of cancer of other localizations (uterus, prostate, bladder) with rays or contact with them due to the nature of professional activity.
  • Inhalation of chemicals, including smoking.
  • Over 50 years of age when there is a risk of tissue transformation.

Anal cancer: symptoms

In 19-20% of cases, the disease does not manifest itself. A common and first complaint with a tumor of this localization is discomfort and anal itching. Chronic itching develops gradually, but brings incredible discomfort to the patient’s life. At the same time, the skin around the anus can be dry or with elements of moist eczema, ulcers and enlarged skin folds.Itching is often the patient’s only complaint.

Subsequently, a slight periodic pain in the anus is added during bowel emptying and blood appears in the feces or bleeding from the anal canal. Over time, the severity of pain increases, it becomes constant (does not depend on bowel movements) and unbearable in the late stage. Pain may spread to the genitals, perineum and lower abdomen. Pain and itching are associated with a large number of nerve endings, swelling and muscle spasm.

Many people complain of a feeling of pressure in the passage and stool disturbance (constipation). The patient is forced to push during bowel movements. If the tumor grows into the vagina, a rectovaginal fistula is formed in women, through which feces enter the body. When it spreads to the urethra or prostate, urinary disturbances appear. In advanced cases, weakness, exhaustion are noted, and with the destruction of sphincter tissues, fecal incontinence.

When identifying the first suspicious symptoms that do not disappear for a long time and progress, it is necessary to consult a proctologist-oncologist.


External examination and digital examination make it possible to determine non-healing ulcers outside or formation inside the canal, as well as its size. After examination, the doctor can detect traces of blood on the glove. In the groin area, enlarged lymph nodes are determined.

Anoscopy is a detailed examination of the anal canal with a special device. It gives a more complete picture of the location and size, possibly biopsy (tissue sampling).

Biopsy of suspicious tissue with subsequent histological examination allows you to remove this diagnosis in favor of polyp and fissure, or to confirm with an accurate determination of the type of cancer.

With a confirmed diagnosis, colonoscopy, MRI (or computed tomography) are used, which make it possible to determine the prevalence of the oncological process, that is, metastasis.

Women are necessarily assigned a gynecological examination for neoplasms of the cervix, given that these oncopathologies coexist.

Anal cancer: treatment

Therapy includes a wide range of methods: radiation, chemotherapy and surgical.The choice is determined by the stage, location, size and occurrence of complications.

This issue is resolved after a consultation of an oncologist, surgeon and radiotherapist. The main principle of treatment is the combination: chemoradiation therapy, which is prescribed for 5-6 weeks, radio and two cycles of chemotherapy.

Ionizing radiation is effective in squamous cell carcinoma, so the surgical method may not be used, and this makes it possible to preserve the function of the anal sphincters.

Radiotherapy can be remote and interstitial (using radio needles with 60Co).During the procedure, the region of the inguinal lymph nodes is irradiated. In parallel, hyperthermia (local heating of the neoplasm by ultra-high frequency irradiation) can be used.

Modern linear accelerators allow precise radiation treatment without damaging healthy tissues.

Chemotherapy doubles the effect of radiotherapy because it affects neoplasms and metastases. The combined use of these two methods with a small size of the formation is considered as an alternative to surgery.

Surgical intervention is recommended:

  • at an early stage, with a size of up to 2 cm and external localization – in this case, its complete local removal is possible;
  • for cancer recurrence after radio- and chemotherapy.
  • to alleviate the condition before combined chemoradiation therapy.

For local removal, a part of the anus with a neoplasm is operated on. After such an operation, problems with bowel function do not arise, since the sphincter is not affected.

Radical surgery (abdominal-perineal amputation) includes excision of the formation, the rectum, nearby tissues, the sphincter and the area around it. In this case, a permanent colostomy is formed – an artificially created hole in the abdominal wall for the passage of feces. With metastases, lymphadenectomy (removal of nodes) is mandatory.

Prognosis and prevention

There is no specific prevention of the disease, but to reduce the risk you need:

  • Proper diet rich in fiber (bran, fruits, berries, vegetables, whole grains).
  • Exclusion of fried foods, spicy foods, alcohol.
  • Regular bowel movements.
  • Hygiene of the anus (washing after bowel movements).
  • Avoiding excessive straining.
  • Increase in physical activity, which is especially important for people with a “sedentary” job.
  • Smoking cessation.
  • Condom use – reducing the risk of HPV infection and AIDS.
  • Examinations and examinations for risk groups (anoscopy and PAP test).

Anal cancer with early detection and treatment is not a death sentence. With a tumor less than 2-3 cm and no metastases, chemoradiation treatment is effective for 80% of patients. Surgical operation helps to achieve remission at 5 years old in 57-70%, and with metastases in 20-21%. Patients who have undergone extensive surgery for a recurrent disease are observed every 4-6 months with a mandatory examination of the inguinal lymph nodes and an annual X-ray examination of the chest and abdominal cavity.

Anal fissure or anal fissure

What is
anal fissure and what symptoms does it cause?

Anal fissure or anal fissure is
a small wound or fissure in the wall of the anus.Usually the fissure is located in the middle
lines, along the posterior semicircle of the anus (80%), in frequency the next place
the location of the fissure is the anterior midline of the anus (10%).

Typical symptoms are pain during and after
bowel movements and bleeding. Many patients may postpone due to pain.

What is
cause of anal fissure?

Anything that can injure or irritate the anus can cause fissure.Often
the cause is hard stools. The damaged area becomes inflamed and is accompanied by a strong contraction or spasm.
anal sphincter. As a result, the blood supply to the damaged area
deteriorates, which causes the sharp crack to turn into

Other causes of fissure are diarrhea and inflammation in the area
anal opening.

Anal fissure can be sharp (just
formed) or chronic (formed some time ago and often
repeats).Chronic fissures often have an associated small fissure
external hemorrhoid node, the so-called “duty node”, which when
exacerbation of the fissure can increase significantly.

How to treat
anal fissure?

Often, treating constipation or diarrhea can cure and
fissure. Acute fissure, as a rule, does not require surgical treatment, 90%
of them recover without treatment. The healing process is promoted
high-fiber diet, stool softeners
(eg lactulose), adequate fluid intake.Rich in fiber
diet can also help with diarrhea. Warm sitz baths
(40 ° with water) lasting 10-15
minutes 2-3 times a day
soften and relax the anal sphincter, which in turn helps to heal the fissure. May also be
special medications are also needed.

Use nitroglycerin ointment or diltiazem ointment to relax the anal sphincter. Applications are carried out
three times a day on the perianal skin.

Nitroglycerin ointment for this
moment in Estonia is not available.Ointment with
diltiazem is available from larger pharmacies on a prescription basis. It is advisable to use an ointment with
diltiazem after a sitz bath. It is important to use the ointment 10-15 minutes 90,096 before
bowel movements.

The most common
a side effect of diltiazem ointment is a headache (there are quite
rarely). In some patients, the ointment may aggravate / cause itching in the anus. In this case, it is necessary
stop treatment and consult a doctor. Treatment with diltiazem ointment is necessary
to be carried out consecutively for at least 8 weeks, if necessary up to 16 weeks
and longer.

Diltiazem ointment should not be used during pregnancy, as its safety for the fetus has not been proven. When
During pregnancy, you can use anesthetic ointments or topical gels.

Rectals are not suitable for anal fissure treatment.
candles, since when a suppository is inserted, sphincter spasm may increase and fissure
may be injured.

repeat anal fissure?

Anal fissures can easily recur.If we are dealing with a chronic disease, then very often the already recovered fissure can
repeat during an episode of constipation. Even if the pain and
bleeding is gone, you need to continue to consume enough fluid
and a diet rich in fiber to keep your bowel movements regular. If the problem
repeats for no apparent reason, some additional examinations may be needed.

What to do
if the fissure is not n
goes ?

If the fissure does not go away, the treatment should be reconsidered.Severe constipation, scarring, and spasm of the internal anal sphincter interfere with recovery.

If diltiazem ointment does not treat fissure or disease
quickly aggravates again after the end of the treatment course, then it is taken during
attention the next method of fissure treatment is botulinum toxin injection
(botox) into the internal sphincter of the anus. Botox lowers the tone of the anal sphincter for a couple of months, making the fissure possible
heal. If necessary, injections are given repeatedly.

Other diseases such as
inflammatory bowel disease, infections, and tumors can also cause similar symptoms.These diseases should be excluded in
patients who have persistent pain in the anus.

sometimes surgery is required?

Surgical treatment is very effective and risk
exacerbation of fissure after surgical treatment is very low. During the operation
a small incision is made near the anus and part of the tissue is cut
internal anal sphincter (lateral internal
sphincterotomy). It promotes healing of the crack,
reduces pain and cramps.If there is a hemorrhoidal nodule (“duty node”), then may
it may be necessary to remove it.

Complication of surgical treatment can be
fecal incontinence. Therefore, the need to apply this method is decided by
individually, based on a specific case.

Skol b by the time requires

It may take several months to heal, but the pain usually goes away in a few days.

Amount: dr.Kaisa Murumets, Dr. M a Rogot Peetsalu

90,000 Pain during bowel movements



















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