What are the common causes of rectal pain. How does rectal pain manifest during different activities. When should you seek medical attention for rectal pain. What are effective treatments for various types of rectal discomfort.

Understanding Rectal Pain: A Comprehensive Overview

Rectal pain is a common yet often misunderstood condition that can significantly impact a person’s quality of life. This discomfort, which can range from a dull ache to sharp, intense pain, may occur in the rectum or anus area. While it’s natural to feel concerned about such symptoms, understanding the potential causes and available treatments can help alleviate anxiety and guide appropriate medical care.

Is rectal pain always a sign of a serious condition. Not necessarily. While some causes of rectal pain can be serious, many are benign and easily treatable. However, persistent or severe pain should always be evaluated by a healthcare professional to rule out more serious conditions.

Common Causes of Rectal Pain When Sitting

One of the most frequent triggers for rectal discomfort is the act of sitting. But what exactly causes this pain?

Hemorrhoids: A Leading Cause of Seated Discomfort

Hemorrhoids, often referred to as piles, are a common culprit behind rectal pain experienced while sitting. These swollen and inflamed veins around the anus or in the lower rectum can be either external or internal.

How do external hemorrhoids differ from internal ones in terms of symptoms. External hemorrhoids are typically more painful, especially when sitting, due to their location. They can cause:

• Anal itching
• Hard, sensitive lumps around the anus
• Anal ache or pain

Internal hemorrhoids, on the other hand, are usually painless unless they prolapse (bulge out into the rectum). When this occurs, they can cause significant discomfort, pain, and pressure in the rectal area.

Do hemorrhoids always require medical intervention. Not necessarily. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), symptoms of external hemorrhoids often resolve within a few days without treatment. However, persistent or severe symptoms should be evaluated by a healthcare provider.

Rectal Pain While Walking: Potential Causes and Concerns

Experiencing rectal pain while walking can be particularly distressing, as it interferes with daily activities. One common cause of this type of pain is a thrombosed external hemorrhoid.

Thrombosed External Hemorrhoids: A Painful Complication

A thrombosed external hemorrhoid occurs when a blood clot forms within an external hemorrhoid. This condition can cause significant pain not only while walking but also when sitting or during bowel movements.

What are the distinctive features of a thrombosed external hemorrhoid. According to the American Society of Colon and Rectal Surgeons (ASCRS), key characteristics include:

• Sudden onset of pain
• Presence of an anal mass
• Pain that worsens during the first 48 hours
• Potential bleeding if the skin covering the blood clot opens

How long does the pain from a thrombosed hemorrhoid typically last. While the initial pain can be severe, it often begins to subside after a few days. However, seeking medical attention can help manage symptoms and prevent complications.

Urinary-Related Rectal Pain: Understanding the Connection

Sometimes, rectal pain can be associated with urinary functions. One condition that exemplifies this connection is prostatitis.

Prostatitis: When the Prostate Causes Rectal Discomfort

Prostatitis is inflammation of the prostate gland, which is located below the bladder and in front of the rectum. This condition can cause pain not only when urinating but also in the rectal area.

What are the primary symptoms of prostatitis? Common signs include:

• Throbbing sensations in the rectal area
• Frequent need to urinate
• Low urine output
• Burning or stinging sensation when urinating
• Pain in the pelvis or lower back
• Erectile dysfunction

Why does prostatitis cause rectal pain? The proximity of the prostate to the rectum means that inflammation can put pressure on the rectal area, leading to discomfort or pain. Additionally, the infection causing prostatitis can sometimes spread to nearby tissues, exacerbating the pain.

Nocturnal Rectal Pain: Causes and Implications

Rectal pain that occurs at night or wakes a person from sleep can be particularly distressing. One condition known for causing such nocturnal discomfort is proctalgia fugax.

Proctalgia Fugax: The Midnight Menace

Proctalgia fugax (PF) is characterized by sudden and intense pain in the rectum that can last for several minutes at a time. While it can occur during the day, it’s notorious for striking at night, often waking sufferers from sleep.

What causes proctalgia fugax? The exact cause is not fully understood, but it’s believed to result from spasms in the rectum or pelvic floor muscles. These spasms can be triggered by stress, constipation, or other factors.

How can one manage proctalgia fugax? While the episodes are typically short-lived, they can be extremely uncomfortable. Some strategies that may help include:

• Applying heat to the affected area
• Taking warm baths
• Practicing relaxation techniques
• In some cases, medications prescribed by a healthcare provider

Is proctalgia fugax a sign of a more serious condition? Generally, PF is considered a benign condition. However, if episodes are frequent or accompanied by other symptoms, it’s important to consult with a healthcare provider to rule out other potential causes.

Rectal Pain During Physical Exertion: Causes and Concerns

Sometimes, rectal pain can be triggered or exacerbated by physical activities that increase intra-abdominal pressure, such as coughing, sneezing, or heavy lifting. One condition that exemplifies this is rectal prolapse.

Rectal Prolapse: When the Rectum Falls Out of Place

Rectal prolapse occurs when the rectum loses its normal attachments inside the body, causing it to slip out through the anus. This condition can cause significant discomfort and a range of symptoms.

What are the key symptoms of rectal prolapse? Common signs include:

• Feeling of a bulge or protrusion from the anus
• Pressure or pain in the rectum or anus
• Mucus in stool
• Bleeding from the rectum or anus
• Constipation
• Inability to control bowel movements (fecal incontinence)

Why does rectal prolapse cause pain during physical exertion? Activities that increase intra-abdominal pressure, such as coughing or heavy lifting, can cause the prolapsed rectum to protrude further, leading to increased discomfort or pain.

How is rectal prolapse treated? Treatment options vary depending on the severity of the prolapse and the patient’s overall health. They may include:

1. Dietary changes and stool softeners to ease bowel movements
2. Pelvic floor exercises to strengthen the muscles supporting the rectum
3. In severe cases, surgery may be necessary to repair the prolapse

Gynecological Conditions and Rectal Pain: An Often Overlooked Connection

For individuals with female reproductive organs, certain gynecological conditions can manifest as rectal pain. One such condition is endometriosis.

Endometriosis: When Uterine Tissue Causes Rectal Discomfort

Endometriosis is a condition where tissue similar to the lining of the uterus grows in abnormal locations, such as the bowels. When this occurs in the rectal area, it can lead to significant discomfort and a range of symptoms.

How does endometriosis cause rectal pain? When endometrial-like tissue grows on or near the rectum, it can cause:

• Pressure on the rectal wall
• Inflammation in the surrounding tissues
• Formation of adhesions (scar tissue) that can pull on the rectum

What are the symptoms of rectal endometriosis? Common signs include:

• Rectal pain, particularly during menstruation
• Painful bowel movements
• Constipation
• Back pain
• In some cases, rectal bleeding

How is rectal endometriosis diagnosed and treated? Diagnosis often involves a combination of physical examination, imaging studies (such as MRI or ultrasound), and sometimes laparoscopy. Treatment options may include:

1. Hormonal therapies to suppress endometrial growth
2. Pain management strategies
3. In severe cases, surgical removal of endometrial implants

Is rectal pain always a sign of endometriosis in individuals with female reproductive organs? No, rectal pain can have many causes unrelated to gynecological conditions. However, if rectal pain occurs cyclically with menstruation or is accompanied by other symptoms of endometriosis, it’s important to discuss this with a healthcare provider.

Diagnosing and Treating Rectal Pain: A Multifaceted Approach

Given the wide range of potential causes for rectal pain, accurate diagnosis is crucial for effective treatment. Healthcare providers typically use a combination of methods to determine the underlying cause of rectal discomfort.

Diagnostic Approaches for Rectal Pain

What are the common diagnostic methods for rectal pain? Healthcare providers may use several approaches, including:

• Detailed medical history and symptom review
• Physical examination, including digital rectal exam
• Anoscopy or proctoscopy to visually examine the anal canal and lower rectum
• Imaging studies such as MRI or CT scan
• In some cases, colonoscopy to examine the entire colon

Why is a comprehensive diagnostic approach important? Rectal pain can have numerous causes, some of which may be serious. A thorough evaluation helps ensure that the correct diagnosis is made and appropriate treatment is initiated.

Treatment Options for Rectal Pain

How is rectal pain treated? Treatment approaches vary widely depending on the underlying cause but may include:

1. Lifestyle modifications (e.g., dietary changes, increased fiber intake)
2. Topical treatments for conditions like hemorrhoids
3. Medications to manage pain, inflammation, or underlying conditions
4. Pelvic floor physical therapy
5. In some cases, surgical intervention

Is rectal pain always treatable? While many causes of rectal pain are highly treatable, some chronic conditions may require ongoing management. However, with proper diagnosis and treatment, most individuals can find significant relief from their symptoms.

When should you seek immediate medical attention for rectal pain? While many causes of rectal pain are not emergencies, certain symptoms warrant immediate medical evaluation, including:

• Severe, persistent pain
• Rectal bleeding, especially if it’s heavy or accompanied by dizziness
• High fever along with rectal pain
• Inability to have a bowel movement, especially if accompanied by severe abdominal pain

Understanding the various causes and manifestations of rectal pain is crucial for timely and effective treatment. While the prospect of discussing such symptoms may feel uncomfortable, it’s important to remember that healthcare providers are trained to address these issues with professionalism and empathy. By seeking appropriate care, individuals can often find relief from rectal pain and improve their overall quality of life.

Causes, remedies, and when to contact a doctor

Rectal pain can result from injury, inflammation, or infections that affect the rectum or anus. Hemorrhoids, prostatitis, and endometriosis are among many possible causes. Treatment will depend on the cause.

The rectum is a part of the digestive system that begins at the lower part of the large intestine and ends at the anus.

People may experience rectal pain at particular times, such as when sitting, walking, or during bowel movements. Depending on the underlying cause of the pain, people may experience additional symptoms, such as constipation, rectal bleeding, or pressure in the pelvic area.

There are many possible causes of rectal pain, so it is important for people to contact a healthcare professional for a diagnosis and appropriate treatment.

This article lists some potential causes of rectal pain according to when the pain is likely to occur. We also list remedies for rectal pain and possible accompanying symptoms. Finally, we provide information on diagnosis and when to contact a doctor.

Below are some potential causes of rectal pain. In some cases, they may occur alongside the appearance of symptoms.

When sitting

Hemorrhoids, also called piles, are swollen and inflamed veins around the anus or in the lower rectum. They can be external or internal.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), external hemorrhoids can cause rectal pain or ache when sitting.

Other possible symptoms include:

• anal itching
• hard, sensitive lumps around the anus
• anal ache or pain

The NIDDK states that the symptoms of external hemorrhoids typically resolve within a few days.

When an internal hemorrhoid bulges out into the rectum, it becomes a prolapsed hemorrhoid. This is a common cause of rectal discomfort, pain, and pressure.

Internal hemorrhoids that have not prolapsed are usually not painful, but people may experience bleeding from the rectum.

When walking

A thrombosed external hemorrhoid is a blood clot that occurs in an external hemorrhoid.

According to the American Society of Colon and Rectal Surgeons (ASCRS), large, thrombosed external hemorrhoids can cause pain when walking, when people sit, or during a bowel movement.

People may have an anal mass that appears suddenly and causes pain. According to the ASCRS, the pain may worsen during the first 48 hours but then ease off over the following few days. If the skin covering the blood clot opens, people may also experience bleeding.

When urinating

Prostatitis is inflammation of the prostate gland. The prostate gland is located below the bladder and in front of the rectum. Its primary function is to make seminal fluid.

Prostatitis occurs when the prostate becomes infected with bacteria from the urine or rectum. The condition may cause pain when urinating, along with rectal pain or pressure.

Other possible symptoms of prostatitis include:

• throbbing sensations in the rectal area
• frequent need to urinate
• low urine output
• a burning or stinging sensation when urinating
• pain in the pelvis or lower back
• erectile dysfunction

When lying down

Levator syndrome (LS) is a condition that causes episodic pain in the rectum or bony structures at the base of the spine. Experts do not know the exact cause of LS. However, it is likely due to the spasm of the levator muscles in the pelvic floor. People may experience spasms for no clear reason or after having a bowel movement.

LS can cause pain or a dull ache in the rectum, anus, or tailbone. According to the ASCRS, sitting or lying down can worsen LS symptoms.

At night

Proctalgia fugax (PF) is sudden and intense pain in the rectum that can last for several minutes at a time. The condition typically occurs at night and may wake a person from sleeping. However, it can also happen during the day.

PF likely occurs as a result of spasms in the rectum or pelvic floor muscles.

When coughing

Rectal prolapse is the medical term for when the rectum falls out of place and drops through the anus. A person who has a rectal prolapse may feel a bulge from their anus when straining, such as when coughing, sneezing, or heavy lifting.

Rectal prolapse can cause pressure and pain in the rectum or anus. Other symptoms may include:

• mucus in stool
• bleeding from the rectum or anus
• constipation
• an inability to control bowel movements

During ovulation

Some people may experience uncomfortable or painful symptoms during the ovulation phase of their menstrual cycle. In certain cases, severe pain can be a sign of an underlying health condition, such as endometriosis.

Endometriosis is a condition in which tissue similar to the uterus lining grows in abnormal places, such as the bowels. If endometriosis is present in the rectal area, it can cause pressure on the rectal wall, resulting in the following symptoms:

• rectal pain
• painful bowel movements
• constipation
• back pain

During a period

During menstruation, the body releases chemicals called prostaglandins. High levels of prostaglandins can cause the bowel wall to contract, causing pain, cramping, and diarrhea.

People with irritable bowel syndrome (IBS) may experience changes in their symptoms throughout the menstrual cycle, and these may correspond to natural hormone fluctuations. According to the Canadian Society of Intestinal Research, studies have found that people with IBS may experience an increase in rectal sensitivity during their period.

During pregnancy

A 2018 study assessed anal pain in 94 females in weeks 19–25 of pregnancy. Participants filled out a questionnaire reporting on anal symptoms throughout the following stages of pregnancy:

• the second and third trimester
• the postpartum period
• three months postpartum

According to the results, 68% of participants experienced anal symptoms, with anal pain being the most common. Other anal symptoms included:

• constipation
• an inability to control bowel movements
• hemorrhoidal complications
• anal fissures

Risk factors for anal symptoms included constipation and medical history of anal problems.

After a hysterectomy

A hysterectomy is a medical term for the removal of the uterus. In some cases, a hysterectomy can weaken the connective tissue between the rectum and the vagina. This can cause a rectocele, a type of prolapse in which the rectum pushes into the vagina.

People may experience symptoms of a rectocele in the rectum, vagina, or both. Symptoms may include:

• pressure in the pelvis
• pain in the abdomen or lower back
• a sensation of something falling down within the pelvis
• feeling a mass within the vagina
• vaginal bleeding that is not due to the menstrual cycle
• constipation
• difficulty having bowel movements
• bowels not feeling empty after a bowel movement
• in some cases, the inability to control a bowel movement

Standing up may worsen symptoms, whereas lying down may ease them.

Before or after a bowel movement

An anal fissure is a small tear in the lining of the anal canal, which is the end of the large intestine between the rectum and anus.

Anal fissures can cause sharp pain, which may begin with a bowel movement and can continue for a few minutes to hours. Other symptoms may include bright red blood in the stool or on toilet paper after having a bowel movement or a skin tag, or a small lump that appears near the anal fissure.

After a colonoscopy

A colonoscopy is a medical procedure that involves inserting a flexible tube called an endoscope into the anus and through the rectum to the colon. The scope has a camera attached, which allows a doctor to see inside the colon.

People may experience some mild pain or pressure during a colonoscopy. However, a doctor can provide a sedative to help reduce any discomfort.

Gentle movement and walking may help to alleviate any anal, rectal, or gas pains after the procedure.

During or after receptive anal intercourse or instrumentation

The skin around the rectum is very sensitive. Friction from sexual activity involving the anus or inserting objects into the rectum can cause injury, irritation, swelling, or bleeding.

Anal sex is mostly safe. If a person experiences pain during or after anal sex, they may need to increase lubrication.

Individuals who engage in unprotected anal intercourse are at a greater risk of anorectal infections. The most common symptom is a frequent or continuous urge to have a bowel movement. Other symptoms may also include anorectal pain or discomfort.

Learn about how to practice anal sex safely here.

Other medical conditions that can cause rectal pain include:

Inflammatory bowel disease

Inflammatory bowel disease (IBD) is a term for two conditions: Crohn’s disease and Ulcerative colitis (UC). These conditions cause chronic inflammation of the gastrointestinal tract.

Crohn’s most often affects the portion of the small intestine before the large intestine and colon. UC is a long-term condition where the colon and rectum become inflamed.

However, if UC only affects the rectum, it is called proctitis. People with this condition may experience pain in the rectal area.

Other symptoms include:

• tenesmus, a frequent desire to pass feces
• bloody diarrhea
• bleeding in the rectal area

Research has shown that proctitis has also resulted from medical procedures. Chronic radiation proctitis is a side effect that affects 5–20% of people receiving radiation treatment for cancer. A case report from 2000 also demonstrates that one person developed ulcerative proctitis 10 months after a fecal microbiota transplant.

Stercoral ulcers

Stercoral ulcers occur when a person has chronic constipation leading to stagnation of fecal matter.

Multiple areas of ulceration can present in the colon. The most common locations of ulceration are in the sigmoid colon and the rectum.

Anorectal cancer

Anorectal cancer refers to any cancer that affects the anus or rectum.

With anal cancer, a person may not experience symptoms straightaway. They may notice anal bleeding, which people often mistake for hemorrhoids.

Other symptoms of anal cancer include:

• rectal itching
• a lump where the anus opens
• a feeling of fullness or pain at the anus
• changes in bowel movements, including narrower stools
• anal discharge
• swollen lymph nodes at the anus or groin
• difficulty controlling bowel movements

Many of these symptoms may have causes that are not related to anorectal cancers. However, if a person notices these symptoms, it is important they contact a doctor.

The treatment options for rectal pain may vary depending on the underlying cause.

To relieve general pain around the rectum and anus, people can try the following:

• taking a sitz bath or sitting in warm water for a few minutes
• gently washing the area with lukewarm water, particularly after a bowel movement or sweating
• avoiding using any irritating detergents or soap
• wearing breathable, cotton underwear
• wearing loose, comfortable clothing
• avoiding sitting for long periods
• sitting on a cushion or rubber ring to relieve pressure
• taking over-the-counter pain medication to alleviate pain
• using a stool softener, making stools easier to pass
• eating a diet high in fiber and drinking plenty of water to prevent constipation and straining during a bowel movement
• taking any medications according to the prescribing doctor’s instructions

Some conditions may require surgical treatment if a person experiences severe or persistent symptoms that do not respond to more conservative treatment. Examples include:

• severe fissures
• severe fistulas
• severe hemorrhoids

A person who experiences rectal pain may also experience accompanying symptoms. Depending on the cause of the rectal pain, these may include:

• a feeling of pressure in the anal, rectal, or pelvic area
• a sensation of the bowels not emptying fully after a bowel movement
• difficulty having bowel movements
• gas and gas pains
• leakage or an inability to control bowel movements
• rectal or anal bleeding

A doctor may carry out a rectal examination to diagnose the cause of rectal pain.

During a rectal examination, a person will lie down on their left side, with their knees curled towards their chest. A doctor will then insert a lubricated, gloved finger into the rectum to feel for any problems. People may need to squeeze around the finger to test muscle function.

Depending on the person’s symptoms, a doctor may also carry out additional tests. These may include:

• Endorectal ultrasound: This allows a doctor to see images of the rectal wall and surrounding areas. It can be useful in showing rectoceles or rectal prolapse.
• Anorectal manometry: This test assesses the function and strength of muscles around the rectum.
• Videodefecogram: This is a specialized X-ray to show muscle function during bowel movements.

People who experience any of the following symptoms will need to contact a doctor:

• rectal pain that does not ease or eases and then returns
• severe pain or other symptoms
• ongoing rectal bleeding
• a visible or palpable mass that does not improve
• recent trauma to the anus

People may experience rectal pain for a variety of reasons, including pregnancy, hemorrhoids, and muscle spasms. Depending on the cause, symptoms may ease or worsen with a change of position, such as sitting, lying down, or walking.

People may be able to ease rectal pain with home remedies, such as taking a warm bath, sitting on a cushion, or taking pain relief medication.

A person will need to contact a doctor if they experience persistent or worsening rectal pain, rectal bleeding, or any other concerning symptoms.

Causes, remedies, and when to contact a doctor

Rectal pain can result from injury, inflammation, or infections that affect the rectum or anus. Hemorrhoids, prostatitis, and endometriosis are among many possible causes. Treatment will depend on the cause.

The rectum is a part of the digestive system that begins at the lower part of the large intestine and ends at the anus.

People may experience rectal pain at particular times, such as when sitting, walking, or during bowel movements. Depending on the underlying cause of the pain, people may experience additional symptoms, such as constipation, rectal bleeding, or pressure in the pelvic area.

There are many possible causes of rectal pain, so it is important for people to contact a healthcare professional for a diagnosis and appropriate treatment.

This article lists some potential causes of rectal pain according to when the pain is likely to occur. We also list remedies for rectal pain and possible accompanying symptoms. Finally, we provide information on diagnosis and when to contact a doctor.

Below are some potential causes of rectal pain. In some cases, they may occur alongside the appearance of symptoms.

When sitting

Hemorrhoids, also called piles, are swollen and inflamed veins around the anus or in the lower rectum. They can be external or internal.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), external hemorrhoids can cause rectal pain or ache when sitting.

Other possible symptoms include:

• anal itching
• hard, sensitive lumps around the anus
• anal ache or pain

The NIDDK states that the symptoms of external hemorrhoids typically resolve within a few days.

When an internal hemorrhoid bulges out into the rectum, it becomes a prolapsed hemorrhoid. This is a common cause of rectal discomfort, pain, and pressure.

Internal hemorrhoids that have not prolapsed are usually not painful, but people may experience bleeding from the rectum.

When walking

A thrombosed external hemorrhoid is a blood clot that occurs in an external hemorrhoid.

According to the American Society of Colon and Rectal Surgeons (ASCRS), large, thrombosed external hemorrhoids can cause pain when walking, when people sit, or during a bowel movement.

People may have an anal mass that appears suddenly and causes pain. According to the ASCRS, the pain may worsen during the first 48 hours but then ease off over the following few days. If the skin covering the blood clot opens, people may also experience bleeding.

When urinating

Prostatitis is inflammation of the prostate gland. The prostate gland is located below the bladder and in front of the rectum. Its primary function is to make seminal fluid.

Prostatitis occurs when the prostate becomes infected with bacteria from the urine or rectum. The condition may cause pain when urinating, along with rectal pain or pressure.

Other possible symptoms of prostatitis include:

• throbbing sensations in the rectal area
• frequent need to urinate
• low urine output
• a burning or stinging sensation when urinating
• pain in the pelvis or lower back
• erectile dysfunction

When lying down

Levator syndrome (LS) is a condition that causes episodic pain in the rectum or bony structures at the base of the spine. Experts do not know the exact cause of LS. However, it is likely due to the spasm of the levator muscles in the pelvic floor. People may experience spasms for no clear reason or after having a bowel movement.

LS can cause pain or a dull ache in the rectum, anus, or tailbone. According to the ASCRS, sitting or lying down can worsen LS symptoms.

At night

Proctalgia fugax (PF) is sudden and intense pain in the rectum that can last for several minutes at a time. The condition typically occurs at night and may wake a person from sleeping. However, it can also happen during the day.

PF likely occurs as a result of spasms in the rectum or pelvic floor muscles.

When coughing

Rectal prolapse is the medical term for when the rectum falls out of place and drops through the anus. A person who has a rectal prolapse may feel a bulge from their anus when straining, such as when coughing, sneezing, or heavy lifting.

Rectal prolapse can cause pressure and pain in the rectum or anus. Other symptoms may include:

• mucus in stool
• bleeding from the rectum or anus
• constipation
• an inability to control bowel movements

During ovulation

Some people may experience uncomfortable or painful symptoms during the ovulation phase of their menstrual cycle. In certain cases, severe pain can be a sign of an underlying health condition, such as endometriosis.

Endometriosis is a condition in which tissue similar to the uterus lining grows in abnormal places, such as the bowels. If endometriosis is present in the rectal area, it can cause pressure on the rectal wall, resulting in the following symptoms:

• rectal pain
• painful bowel movements
• constipation
• back pain

During a period

During menstruation, the body releases chemicals called prostaglandins. High levels of prostaglandins can cause the bowel wall to contract, causing pain, cramping, and diarrhea.

People with irritable bowel syndrome (IBS) may experience changes in their symptoms throughout the menstrual cycle, and these may correspond to natural hormone fluctuations. According to the Canadian Society of Intestinal Research, studies have found that people with IBS may experience an increase in rectal sensitivity during their period.

During pregnancy

A 2018 study assessed anal pain in 94 females in weeks 19–25 of pregnancy. Participants filled out a questionnaire reporting on anal symptoms throughout the following stages of pregnancy:

• the second and third trimester
• the postpartum period
• three months postpartum

According to the results, 68% of participants experienced anal symptoms, with anal pain being the most common. Other anal symptoms included:

• constipation
• an inability to control bowel movements
• hemorrhoidal complications
• anal fissures

Risk factors for anal symptoms included constipation and medical history of anal problems.

After a hysterectomy

A hysterectomy is a medical term for the removal of the uterus. In some cases, a hysterectomy can weaken the connective tissue between the rectum and the vagina. This can cause a rectocele, a type of prolapse in which the rectum pushes into the vagina.

People may experience symptoms of a rectocele in the rectum, vagina, or both. Symptoms may include:

• pressure in the pelvis
• pain in the abdomen or lower back
• a sensation of something falling down within the pelvis
• feeling a mass within the vagina
• vaginal bleeding that is not due to the menstrual cycle
• constipation
• difficulty having bowel movements
• bowels not feeling empty after a bowel movement
• in some cases, the inability to control a bowel movement

Standing up may worsen symptoms, whereas lying down may ease them.

Before or after a bowel movement

An anal fissure is a small tear in the lining of the anal canal, which is the end of the large intestine between the rectum and anus.

Anal fissures can cause sharp pain, which may begin with a bowel movement and can continue for a few minutes to hours. Other symptoms may include bright red blood in the stool or on toilet paper after having a bowel movement or a skin tag, or a small lump that appears near the anal fissure.

After a colonoscopy

A colonoscopy is a medical procedure that involves inserting a flexible tube called an endoscope into the anus and through the rectum to the colon. The scope has a camera attached, which allows a doctor to see inside the colon.

People may experience some mild pain or pressure during a colonoscopy. However, a doctor can provide a sedative to help reduce any discomfort.

Gentle movement and walking may help to alleviate any anal, rectal, or gas pains after the procedure.

During or after receptive anal intercourse or instrumentation

The skin around the rectum is very sensitive. Friction from sexual activity involving the anus or inserting objects into the rectum can cause injury, irritation, swelling, or bleeding.

Anal sex is mostly safe. If a person experiences pain during or after anal sex, they may need to increase lubrication.

Individuals who engage in unprotected anal intercourse are at a greater risk of anorectal infections. The most common symptom is a frequent or continuous urge to have a bowel movement. Other symptoms may also include anorectal pain or discomfort.

Learn about how to practice anal sex safely here.

Other medical conditions that can cause rectal pain include:

Inflammatory bowel disease

Inflammatory bowel disease (IBD) is a term for two conditions: Crohn’s disease and Ulcerative colitis (UC). These conditions cause chronic inflammation of the gastrointestinal tract.

Crohn’s most often affects the portion of the small intestine before the large intestine and colon. UC is a long-term condition where the colon and rectum become inflamed.

However, if UC only affects the rectum, it is called proctitis. People with this condition may experience pain in the rectal area.

Other symptoms include:

• tenesmus, a frequent desire to pass feces
• bloody diarrhea
• bleeding in the rectal area

Research has shown that proctitis has also resulted from medical procedures. Chronic radiation proctitis is a side effect that affects 5–20% of people receiving radiation treatment for cancer. A case report from 2000 also demonstrates that one person developed ulcerative proctitis 10 months after a fecal microbiota transplant.

Stercoral ulcers

Stercoral ulcers occur when a person has chronic constipation leading to stagnation of fecal matter.

Multiple areas of ulceration can present in the colon. The most common locations of ulceration are in the sigmoid colon and the rectum.

Anorectal cancer

Anorectal cancer refers to any cancer that affects the anus or rectum.

With anal cancer, a person may not experience symptoms straightaway. They may notice anal bleeding, which people often mistake for hemorrhoids.

Other symptoms of anal cancer include:

• rectal itching
• a lump where the anus opens
• a feeling of fullness or pain at the anus
• changes in bowel movements, including narrower stools
• anal discharge
• swollen lymph nodes at the anus or groin
• difficulty controlling bowel movements

Many of these symptoms may have causes that are not related to anorectal cancers. However, if a person notices these symptoms, it is important they contact a doctor.

The treatment options for rectal pain may vary depending on the underlying cause.

To relieve general pain around the rectum and anus, people can try the following:

• taking a sitz bath or sitting in warm water for a few minutes
• gently washing the area with lukewarm water, particularly after a bowel movement or sweating
• avoiding using any irritating detergents or soap
• wearing breathable, cotton underwear
• wearing loose, comfortable clothing
• avoiding sitting for long periods
• sitting on a cushion or rubber ring to relieve pressure
• taking over-the-counter pain medication to alleviate pain
• using a stool softener, making stools easier to pass
• eating a diet high in fiber and drinking plenty of water to prevent constipation and straining during a bowel movement
• taking any medications according to the prescribing doctor’s instructions

Some conditions may require surgical treatment if a person experiences severe or persistent symptoms that do not respond to more conservative treatment. Examples include:

• severe fissures
• severe fistulas
• severe hemorrhoids

A person who experiences rectal pain may also experience accompanying symptoms. Depending on the cause of the rectal pain, these may include:

• a feeling of pressure in the anal, rectal, or pelvic area
• a sensation of the bowels not emptying fully after a bowel movement
• difficulty having bowel movements
• gas and gas pains
• leakage or an inability to control bowel movements
• rectal or anal bleeding

A doctor may carry out a rectal examination to diagnose the cause of rectal pain.

During a rectal examination, a person will lie down on their left side, with their knees curled towards their chest. A doctor will then insert a lubricated, gloved finger into the rectum to feel for any problems. People may need to squeeze around the finger to test muscle function.

Depending on the person’s symptoms, a doctor may also carry out additional tests. These may include:

• Endorectal ultrasound: This allows a doctor to see images of the rectal wall and surrounding areas. It can be useful in showing rectoceles or rectal prolapse.
• Anorectal manometry: This test assesses the function and strength of muscles around the rectum.
• Videodefecogram: This is a specialized X-ray to show muscle function during bowel movements.

People who experience any of the following symptoms will need to contact a doctor:

• rectal pain that does not ease or eases and then returns
• severe pain or other symptoms
• ongoing rectal bleeding
• a visible or palpable mass that does not improve
• recent trauma to the anus

People may experience rectal pain for a variety of reasons, including pregnancy, hemorrhoids, and muscle spasms. Depending on the cause, symptoms may ease or worsen with a change of position, such as sitting, lying down, or walking.

People may be able to ease rectal pain with home remedies, such as taking a warm bath, sitting on a cushion, or taking pain relief medication.

A person will need to contact a doctor if they experience persistent or worsening rectal pain, rectal bleeding, or any other concerning symptoms.

Pain in the anus – the causes of occurrence, in what diseases it occurs, diagnosis and methods of treatment

Hemorrhoids

Pancreatitis

Gastritis

Diarrhea

83829July 19

Pain in the anus: causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment.

Definition

Pain that occurs in the anus (anus) is accompanied by significant discomfort, and its intensity is due to the presence of a significant number of nerve endings here.

Types of pain in the anus

Pain in the anus can be characterized as dull and aching, burning, sharp, piercing, spasmodic, radiating to the lower abdomen, coccyx and perineum. Often, a doctor can make a preliminary diagnosis based on the nature of the pain.

Pain may disturb when walking, sitting for a long time, at the time of defecation and immediately after it.

Possible causes of pain in the anus

The main causes of pain in the anus are diseases of the rectum. An assessment of their prevalence brings hemorrhoids to the first place. The initial symptoms of hemorrhoids are a feeling of incomplete emptying after defecation, discomfort and itching in the anus.

Pain with hemorrhoids appears only with a complication of the disease – prolapse and thrombosis of the hemorrhoid.

The development of hemorrhoids is caused by hereditary factors, as well as an unhealthy lifestyle, poor nutrition, and certain diseases, such as cirrhosis of the liver. Prolonged sitting, hot baths, heavy lifting, tight clothing – all these factors lead to venous congestion in the pelvic area and the formation of hemorrhoids. If at the same time the feces have a dense consistency due to a lack of fluid and plant fibers in food, then the act of defecation is accompanied by prolonged straining, which, in turn, contributes to the prolapse of nodes into the lumen of the rectum.

Hemorrhoids can occur with the abuse of laxatives and cleansing enemas.

Protrusion or prolapse of hemorrhoids, their infringement is accompanied by a feeling of pulling pain, fullness, itching. Symptoms are worse after spicy food, heavy physical labor, heavy lifting. Rupture of blood vessels leads to persistent bleeding, while clots of scarlet blood are clearly visible on the feces. A long-term disease leads to pain in the anus with any physical activity, being in an upright position or walking.

Among the diseases that cause pain in the anus, the second place is occupied by sphincteritis – inflammation of the mucous membrane of the circular obturator muscle. Sphincteritis most often develops against the background of diseases of the gastrointestinal tract: pancreatitis, peptic ulcer of the stomach and duodenum, chronic gastritis and duodenitis, irritable bowel syndrome. Constipation or diarrhea that accompanies these diseases increases the risk of developing inflammatory processes in the rectum. In the initial stage of the disease, patients complain of pain in the anus, burning and itching, which are aggravated by defecation. Then there are false urges to defecate and purulent discharge from the anus, so foaming mucus or pus is found on the feces. Sometimes pain can radiate to the perineum and neighboring organs.

The third place in the prevalence of diseases of the rectum, which give severe and persistent pain in the anus, is occupied by rectal fissures . This pathology is characterized by pain during and after defecation, and a small amount of blood may be released.

Cracks can be caused by congestion in the vascular network, a violation of neuromuscular regulation, and injuries. The latter are most often caused by damage to the intestinal mucosa with solid feces.

Often, cracks are combined with hemorrhoids, which is accompanied by prolapse of nodes and more profuse bleeding. The combination of these conditions leads to the formation of a vicious circle: pain during bowel movements causes spasm of the anal sphincter muscles, and spasm increases pain. Minor bleeding due to anal fissure occurs during or after a bowel movement. In the absence of timely treatment, the disease becomes chronic and is accompanied by inflammation of the surrounding tissues. Sometimes a crack leads to a fistula (fistula) – a pathological passage between the rectum and the surface of the skin near the anus.

Paraproctitis also leads to the formation of a fistula of the rectum. This is an acute inflammation of the tissues surrounding the rectum.

Paraproctitis is evidenced by increased pain, swelling in the anus, an increase in body temperature to 38 ° C and above.

The fistula may not close for several months, and then recur.

Malignant tumors that form in the anal region are characterized by pronounced symptoms: red blood in the stool, mucus admixture, pain in the anus (first during defecation, and then throughout the day), radiating to the genitals, thigh, bottom belly. Clinical symptoms of hemorrhoids and malignant tumors are similar to each other.

Pain in the anus is not necessarily associated with diseases of the rectum. It can be caused by pathologies of adjacent organs and tissues, in particular, epithelial coccygeal passage , which manifests itself as pain in the sacrum only in case of inflammation. This formation is formed during the period of embryonic development and is a narrow channel lined with epithelium, inside of which there are hair follicles and sebaceous glands.

Another cause of pain in the anus – coccygodynia – inflammation in the coccyx.

Most often, coccygodynia is caused by trauma to the coccyx as a result of a blow or fall.

In a significant proportion of cases, coccygodynia is a spasm of the deep muscles of the pelvic floor as a result of irritation of pain receptors in surrounding tissues during radiculopathy, difficult childbirth, and inflammatory diseases of the pelvic organs. Pain in the anus appears at a certain position of the body, during inclinations or the act of defecation.

Pain in the anus is also characteristic of prostatitis . In acute prostatitis, in addition to acute pain in the perineum, groin and in the anus, an increase in body temperature, painful urination and defecation are possible. However, more often prostatitis develops gradually, acquiring a chronic form. In this case, the patient is concerned about the same symptoms, but their severity is significantly reduced.

Diagnostics and examinations for pain in the anus

Diagnostics begins with a thorough questioning of the patient, during which the doctor specifies the intensity, duration and nature of the pain syndrome, previous and concomitant diseases. In addition, without fail, the doctor gives directions for clinical and biochemical blood tests, a general urine test.

Clinical blood test: general analysis, leukoformula, ESR (with microscopy of a blood smear in the presence of pathological changes)

Synonyms: Complete blood count, UAC. Full blood count, FBC, Complete blood count (CBC) with differential white blood cell count (CBC with diff), Hemogram.
Brief description of the study CBC: general a…

Up to 1 business day

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General urinalysis (Urine analysis with sediment microscopy)

Method of determination

Determination of physical and chemical parameters is carried out on an automatic analyzer using the “dry chemistry” method.

Hardware microscope…

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If anal pain is suspected, the doctor will perform a digital examination of the rectum. In the presence of a chronic crack, not only its localization is determined, but also the type of edges. With a digital examination, you can notice a fistula with a purulent discharge and determine the spastic contraction of the sphincter. In the presence of hemorrhoids, sigmoidoscopy is necessary.

If a digital examination reveals tenderness of the inner surface of the coccyx and its mobility, the doctor may prescribe an x-ray, which can detect subluxation of the coccyx, especially when dynamically examined in a sitting and lying position.

Radiography of the lumbar and sacral spine

X-ray examination to assess the condition and structural integrity of the vertebrae of the lumbosacral-coccygeal spine.

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If pelvic pain is suspected, an ultrasound of the abdominal cavity and small pelvis is prescribed, and for men, an ultrasound of the prostate gland.

Ultrasound of the pelvic organs (uterus, adnexa)

Ultrasound scanning of the female reproductive system to assess the shape and size, as well as exclude pathology.

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Ultrasound of the prostate

Ultrasound scanning of the prostate, giving an idea of ​​the condition of the prostate and the presence of pathology.

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Which doctors to contact for pain in the anus

If you experience pain in the anus, you should contact a proctologist or gastroenterologist. Women should be examined by a gynecologist. If a neurological nature of the pain is suspected, a consultation with a neurologist is required, and if the oncological nature of the pain is suspected, an oncologist or an oncourologist is involved in the treatment.

What to do in case of pain in the anus

Any diseases of the gastrointestinal tract are based on an unhealthy lifestyle and diet, therefore, when pain occurs in the anus, it is necessary first of all to correct the diet and drinking regimen. The next step is to reduce congestion in the veins by increasing physical activity, therapeutic exercises. When standing, it is advisable to use compression stockings and do gymnastics for the legs.

Treatment of pain in the anus

There are so many causes of pain in the anus that there is no one and the same way to treat all its varieties. Symptomatic treatment, that is, taking analgesics, can reduce the severity of pain, but does not eliminate its cause. Etiotropic therapy is selected individually and only after an accurate diagnosis has been made. It may include antibiotics, venotonics, hemostatic agents, antiplatelet drugs, etc.

Sources:

1. Kadyrov Z.A., Kryachko A.A., Aliev Z.O., Faniev M.V., Ishonakov Kh.S. Chronic inflammatory diseases of the rectum and prostate gland (literature review). Andrology and genital surgery, journal. T. 17, 2016. S. 12-19.
2. Clinical recommendations “Anal fissure”. Developed by: Association of Coloproctologists of Russia. – 2021.
3. Clinical guidelines “Polyp of the anal canal”. Developed by: Association of Coloproctologists of Russia. – 2020.
4. Clinical guidelines “Hemorrhoid”. Developed by: Association of Coloproctologists of Russia. – 2020.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

Pain and spasm in the anus

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3. Pain and spasm in the anus

Pain and spasm in the anus is one of the most about a malfunction in the intestinal tract, and specifically about the problem in the anus and colon. Pain can be of different nature:

• Pain is sudden, local, intense, burning and directly related to defecation – then most likely it is an acute anal fissure.
• Constant pain in the anal passage most often indicates thrombosis of hemorrhoids, acute paraproctitis or rectal fistula.
• Pressing pain, sometimes associated with defecation, usually accompanies colitis, proctitis.
• Accompanying defecation dull, burning pain can cause incomplete fistula of the rectum, cryptitis, papillitis.
• Discomfort in the rectum and in the anus, itching, burning, stabbing pain, often combined with bleeding – such complaints are characteristic of hemorrhoids.

In any case, you should not make a diagnosis yourself. Pain in the anus is already a signal for you that you need immediate consultation with a doctor – proctologist.

The most important thing is to identify the CAUSE of the pain!

Diseases that cause pain in the anus are treated by a proctologist. The clinic employs male and female proctologists. Our doctors are proctologists.

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• Diseases
• Diagnosis
• Treatment
• Causes

Do you feel pain in your anus?

This may be an alarming symptom of the following diseases:

• Hemorrhoids.
• Thrombosis of hemorrhoids.
• Anal fissures. Regular heavy discharge may indicate the presence of this disease.
• Anal polyps. There is also mucus or pus

It is necessary to start treatment, because the consequences can be unpredictable!

Diagnosis of any disease, proctological – is no exception, it is, first of all, an examination by a doctor. Based on what the doctor reveals during the examination, a diagnosis will be made and treatment will be prescribed. An examination by a proctologist at “Alan Clinic” gives a complete picture of your problem, since it is based on two pillars – the doctor’s experience and modern diagnostic equipment.

Comprehensive diagnostics in the Department of Proctology “Alan Clinic” includes:

• Digital examination of the rectum
• Hardware diagnostics
  • Videoanoscopy
  • Videorectoromanoscopy
• Doctor’s consultation with diagnosis.

Treatment of pain in the anus

Treatment is prescribed by a proctologist and carried out on the territory of the clinic, under the full control of the attending physician.