What causes rectal pain when sitting? How can I alleviate rectal discomfort? When should I contact a doctor about my rectal pain? Get the answers to these questions and more in this comprehensive guide.

Understanding Rectal Pain: Causes and Types

Rectal pain can arise from a variety of underlying conditions, ranging from common issues like hemorrhoids to more complex disorders such as endometriosis. The timing and nature of the pain can provide valuable clues about the potential cause. Let’s explore some of the common causes of rectal pain based on when it typically occurs.

Rectal Pain When Sitting

One of the most common causes of rectal pain when sitting is hemorrhoids, also known as piles. Hemorrhoids are swollen and inflamed veins around the anus or in the lower rectum. External hemorrhoids can be particularly bothersome, causing an aching or pain when sitting. Other symptoms of external hemorrhoids may include anal itching, hard and sensitive lumps around the anus, and anal ache or pain.

Internal hemorrhoids that have prolapsed, or bulged out into the rectum, can also lead to rectal discomfort, pain, and a sensation of pressure.

Rectal Pain When Walking

Thrombosed external hemorrhoids, characterized by a sudden appearance of a painful anal mass, can cause discomfort when walking, sitting, or during bowel movements. The pain may worsen during the first 48 hours but then gradually ease off over the following days. Bleeding may also occur if the skin covering the blood clot opens.

Rectal Pain When Urinating

Prostatitis, or inflammation of the prostate gland, can lead to rectal pain or pressure, along with other symptoms such as a throbbing sensation in the rectal area, frequent urination, low urine output, a burning or stinging sensation when urinating, and even erectile dysfunction.

Rectal Pain When Lying Down

Levator syndrome (LS) is a condition characterized by episodic pain in the rectum or bony structures at the base of the spine. It is likely caused by spasms in the levator muscles of the pelvic floor. Sitting or lying down can worsen the symptoms of LS.

Rectal Pain at Night

Proctalgia fugax (PF) is a condition that causes sudden and intense pain in the rectum, often at night, which can wake a person from sleep. This pain is likely due to spasms in the rectum or pelvic floor muscles.

Rectal Pain When Coughing

Rectal prolapse, a condition in which the rectum drops through the anus, can lead to pressure and pain in the rectum or anus, especially when straining, such as during coughing, sneezing, or heavy lifting. Other symptoms of rectal prolapse may include mucus in the stool, bleeding from the rectum or anus, constipation, and an inability to control bowel movements.

Rectal Pain During Ovulation

In some cases, severe rectal pain can be a sign of an underlying condition, such as endometriosis. Endometriosis is a disorder in which tissue similar to the uterus lining grows in abnormal places, including the bowels. This can cause pressure on the rectal wall, leading to rectal pain.

Remedies for Rectal Pain

The treatment for rectal pain will depend on the underlying cause. For conditions like hemorrhoids, over-the-counter remedies such as topical creams, suppositories, or sitz baths may provide relief. For more severe or persistent rectal pain, it is important to consult a healthcare professional for proper diagnosis and treatment.

When to Seek Medical Attention

If rectal pain persists, worsens, or is accompanied by other concerning symptoms such as rectal bleeding, difficulty with bowel movements, or unexplained weight loss, it is important to seek medical attention. A healthcare provider can perform a thorough evaluation, determine the underlying cause, and recommend the appropriate treatment plan.

Key Takeaways

• Rectal pain can have various causes, including hemorrhoids, prostatitis, levator syndrome, rectal prolapse, and endometriosis.
• The timing and nature of the pain can provide clues about the potential cause, such as pain when sitting, walking, urinating, lying down, at night, or during coughing or ovulation.
• Over-the-counter remedies may provide relief for some conditions, but persistent or severe rectal pain requires medical attention for proper diagnosis and treatment.
• If rectal pain persists, worsens, or is accompanied by other concerning symptoms, it is important to consult a healthcare provider.

Remember, understanding the underlying cause of your rectal pain is the first step toward finding effective relief and preventing further complications. If you are experiencing any persistent or concerning rectal symptoms, don’t hesitate to speak with a healthcare professional.

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

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19July

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.
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General urinalysis (Urine analysis with sediment microscopy)

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

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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 the 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 scan 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 in the anus – causes and treatment

Varieties of pain in the anus and rectum

Pain in the anus can be different: sharp, shooting or aching, constant or intermittent. It can occur regardless of what a person is doing, or with reference to certain actions (for example, appear during a long sitting or after a bowel movement). In addition to pain, a person may complain of itching or burning.

Pain, burning or itching in the anus can greatly reduce quality of life and in some cases indicate serious health problems. Therefore, if any discomfort occurs, it is recommended to consult a doctor: timely therapy will alleviate symptoms and prevent complications.

Discomfort of any degree in the anus is not the norm, such a condition should not be tolerated. In addition, most symptoms disappear within a few days after the start of treatment.

Possible causes of pain in the anus

Unpleasant sensations in the anus may occur due to hemorrhoids, anal fissures, fistulas or abscesses, infectious inflammations, helminthic invasion, polyps or malignant formations.

Parasitic infection (pinworms) – one of the causes of severe itching in the anus, especially at night. Worms live in the intestines and feed on the food that a person eats. Itching is due to the worms crawling out to lay eggs and irritate the skin around the anus. Other symptoms of infection may include abdominal pain and blood in the stool.

Pinworms can cause severe itching around the anus at night

Hemorrhoids are one of the manifestations of varicose veins. It is accompanied by the formation of venous nodes in the lower part of the rectum – in front of the anus or around the anus from the outside. Most of the time, hemorrhoids may not cause discomfort, but during the period of exacerbations, the nodes swell and increase in volume, itching and pain appear in the anus, traces of blood may remain on the toilet paper.

Characteristic symptoms of hemorrhoids: pain and itching in the anus, formation of venous nodes, bleeding

Anal fissure is a violation of the integrity of the rectal mucosa in the anus. Anal fissures are characterized by sharp cutting pain in the anus and a burning sensation that occurs during defecation, and then can persist for several more hours. There is usually a small amount of bright scarlet blood on toilet paper.

Anal fistula – an infectious disease in which pus accumulates in the subcutaneous fatty tissue in the region of the rectum, and then exits through the formed canal near the anus. The formation of a fistula is accompanied by irritation of the skin around the anus, constant throbbing pain is possible, traces of blood and pus may remain on the toilet paper.

Anal polyp is a neoplasm in the anal canal that often accompanies chronic inflammatory processes in the large intestine. Signs of a polyp may include rectal bleeding, a change in the nature of the stool (atypical constipation or diarrhea that does not go away for more than a week), pain in the anus, a general feeling of fatigue.

Anal Cancer is a rare disease that may have no symptoms or may have symptoms similar to hemorrhoids or anal fissure. Pain or itching around the anus, discharge of mucus or blood, lumps around the anus, changes in the nature of the stool (may become more liquid or loose), and in some cases, the inability to control bowel movements (fecal incontinence).

Crohn’s disease (inflammatory bowel disease) is a chronic autoimmune disease in which deep slit-like ulcers appear in different parts of the gastrointestinal tract. Crohn’s disease is often accompanied by diarrhea, general fatigue, and weight loss.

Ulcerative colitis is an inflammatory bowel disease in which ulcers are found only in the large intestine (including the rectum). Pathology may be accompanied by pain in the anus and diarrhea with blood.

Ulcerative colitis is characterized by the formation of ulcers on the lining of the colon

Other reasons. Pain may not only be due to damage or inflammation of the anal canal and surrounding areas. Unpleasant pulling, pressing or shooting sensations in the anus (as well as in the perineum, lower back and even in the legs) sometimes occur with pathologies of the genitourinary system or gastrointestinal tract, for example, with renal colic, appendicitis.

In women, pain and a feeling of fullness in the anus may occur during menstruation – this condition is physiological and is considered a variant of the norm.

In men, pain in the anus can be a symptom of an exacerbation of prostatitis – inflammation of the prostate gland located between the intestines and the bladder.

Pain, itching or burning in the anus do not always indicate pathological conditions: sometimes discomfort can occur as a reaction to a cosmetic product, fabric dye or a spicy dish eaten the day before. Also, pain can be caused by damage resulting from careless sexual contacts.

What to do if you experience pain in the anus

If the anus hurts due to minor injuries, reactions to cosmetics or spicy food, no action is needed: the discomfort will go away on its own in 1-2 days.

If discomfort persists, see a doctor. He will conduct an examination to exclude damage and pathologies, prescribe treatment or additional studies to establish the cause of discomfort.

Seek medical attention as soon as possible if symptoms worsen or cause concern.

Symptoms that require immediate medical attention:

• very severe pain in the anus;
• pain that persists for several days;
• blood in stool (on toilet paper) that does not go away for several days;
• massive anal bleeding during defecation;
• pain accompanied by high fever with chills and general deterioration of well-being;
• stool color change to black or dark red.

These are signs that indicate dangerous conditions, such as internal bleeding, inflammation, or the development of neoplasms.

Diagnostics

Diagnosis of diseases that may have caused pain or discomfort in the anus includes a physical examination and laboratory tests.

During a physical examination , the doctor checks the condition of the external surface of the anus and palpates the anal canal and rectum – this allows you to detect a violation of the integrity of the mucous membranes (anal fissures), benign neoplasms (polyps) or malignant tumors, inflammation of the rectal mucosa (proctitis ) or adipose tissue surrounding the rectum (paraproctitis), as well as rectal prolapse, hemorrhoids, fistulas and other disorders.

laboratory tests help to clarify the diagnosis – for example, to identify inflammation, identify the pathogen, exclude damage to intestinal tissues.

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To find out if there is an infection with worms, scraping, fecal or blood tests are prescribed.

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Cal 0 ₽ 9000 3 Differential diagnosis of helminthiases IgG (n/col)

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If oncological diseases are suspected, a number of tests are prescribed that allow to identify pathology or predisposition to it at an early stage.

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Which doctors to contact for pain in the anus

Since pain, itching and burning in the anus can be caused by various pathologies and conditions, it may be necessary to consult several specialists.

First of all, you should contact a proctologist – a doctor who deals with the treatment and prevention of diseases of the colon and anal area. He will conduct an examination to exclude anal fissures, hemorrhoids, polyps and malignant neoplasms.

If no proctological pathology is identified, the doctor may recommend a visit to other specialists, such as a dermatologist or urologist.

Pain in the anus during pregnancy

During pregnancy, pain in the anus can be caused by increased uterine pressure on the intestines and inferior vena cava, hormonal changes, or digestive disorders. The most common causes are exacerbated hemorrhoids and damage to the mucous membrane of the anus and rectum (anal fissure).

Pain in these pathologies can be either slight, aching or pressing, or sharp and very strong. For any discomfort in the anus during pregnancy, you should contact a proctologist. He will carefully examine the anus area, determine the cause of discomfort and prescribe therapy.

As a rule, the treatment of pregnant women with pain in the anus is limited to the use of topical preparations (ointments or rectal suppositories) containing healing and analgesic components. In addition, the doctor may prescribe home remedies (baths with herbal decoctions, contrast douches) and a diet for regular, soft stools that do not injure damaged mucous membranes.

Pain in the anus in children

Discomfort in the anus is common in children who attend kindergarten or elementary school. If it is inconvenient for a child to go to the toilet in a public place, a habit is formed to endure until home, constipation may occur. At the same time, the rectum is constantly filled, and its contents press on the anus.

The habit of enduring until home leads to constipation in a child

Infection with worms can also cause pain, burning or itching in children. If the child does not yet speak (or is embarrassed to share intimate details with parents), the pathology can be determined by indirect signs: irritability, tearfulness, redness in the anus.

Even with severe symptoms suggestive of worm infestation, parasites can be difficult to identify. Therefore, the doctor may prescribe several tests at once: scraping, examination of feces and even blood.

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For treatment, antihelminthic drugs are prescribed – the doctor selects them according to the results of the tests, taking into account the characteristics of the parasites, as well as the age, weight and health of the child. As an additional therapy, enterosorbents are indicated (these drugs remove toxins from the body formed during the destruction of parasites), probiotics to restore normal intestinal microflora and antihistamines.

Treatment

Treatment of pain in the anus depends on what causes it. In most cases, local preparations are sufficient, but sometimes systemic drugs (for example, antibiotics) or surgical treatment must be used.

Conservative therapy

In case of damage to the mucous membranes, painkillers and healing ointments or suppositories are prescribed. With irritation in the anus, the doctor may also recommend herbal tea baths to relieve inflammation and soothe the skin.

If the pain is caused by constipation, a diet is prescribed so that the stools are softer and the trips to the toilet are regular. If necessary, the doctor will recommend laxatives.

If the pain is caused by infection, a course of antibiotics will be required.

To get rid of hemorrhoids, the doctor may suggest conservative methods of treatment – sclerotherapy (injection of a special solution into the hemorrhoid, which causes the node to shrink), electrotherapy (exposure to the nodes with an electric current), infrared coagulation (exposure to the nodes with infrared light, which slows down the blood supply to the node and contributes to its reduction).