What are the common causes of rectal pain. How can rectal pain be treated at home. When should you contact a doctor for rectal pain. What are the symptoms associated with different types of rectal pain. How is rectal pain diagnosed and treated by medical professionals.

Understanding the Anatomy: Rectum and Its Function

The rectum is a crucial component of the digestive system, located at the end of the large intestine and terminating at the anus. Its primary function is to store feces before elimination. Understanding the anatomy of the rectum is essential for comprehending the various causes of rectal pain and their associated symptoms.

What is the rectum’s role in digestion? The rectum serves as a temporary storage area for feces, allowing for controlled bowel movements. It also plays a part in absorbing water from waste material, contributing to the body’s hydration balance.

Common Causes of Rectal Pain When Sitting

Rectal pain while sitting can be particularly uncomfortable and may indicate various underlying conditions. One of the most frequent causes is hemorrhoids, also known as piles.

Hemorrhoids: A Leading Cause of Rectal Discomfort

Hemorrhoids are swollen and inflamed veins in the anus or lower rectum. They can be categorized as external or internal, with external hemorrhoids often causing more noticeable pain and discomfort when sitting.

What are the symptoms of external hemorrhoids? According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), external hemorrhoids may cause:

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

How long do external hemorrhoid symptoms typically last? The NIDDK states that symptoms of external hemorrhoids usually resolve within a few days. However, this can vary depending on the severity and individual circumstances.

Prolapsed Hemorrhoids: When Internal Becomes External

A prolapsed hemorrhoid occurs when an internal hemorrhoid bulges out into the rectum. This condition can cause significant rectal discomfort, pain, and pressure.

How do prolapsed hemorrhoids differ from regular internal hemorrhoids? While internal hemorrhoids that have not prolapsed are usually painless, they may cause rectal bleeding. Prolapsed hemorrhoids, on the other hand, can cause noticeable discomfort and a feeling of fullness in the rectal area.

Rectal Pain Experienced While Walking

Pain in the rectal area that occurs during walking can be particularly distressing and may indicate specific conditions.

Thrombosed External Hemorrhoids: A Painful Complication

A thrombosed external hemorrhoid is a blood clot that forms within an external hemorrhoid. This condition can cause significant pain and discomfort, especially when walking or sitting.

What are the symptoms of a thrombosed external hemorrhoid? According to the American Society of Colon and Rectal Surgeons (ASCRS), symptoms may include:

• Sudden onset of pain when walking or sitting
• Discomfort during bowel movements
• A noticeable anal mass that appears suddenly
• Potential bleeding if the skin covering the blood clot opens

How long does the pain from a thrombosed hemorrhoid last? The ASCRS notes that pain may worsen during the first 48 hours but typically begins to subside over the following few days.

Rectal Pain Associated with Urination

When rectal pain occurs in conjunction with urination, it may indicate issues involving the prostate gland or surrounding structures.

Prostatitis: Inflammation of the Prostate Gland

Prostatitis is an inflammation of the prostate gland, which is located below the bladder and in front of the rectum. This condition can cause pain or discomfort in the rectal area, particularly when urinating.

What causes prostatitis? Prostatitis often occurs when bacteria from the urine or rectum infect the prostate gland. This can lead to a range of symptoms affecting both urination and rectal comfort.

What are the symptoms of prostatitis? Common symptoms include:

• Pain or burning sensation when urinating
• Rectal pain or pressure
• Throbbing sensations in the rectal area
• Frequent urge to urinate
• Low urine output
• Pain in the pelvis or lower back
• Erectile dysfunction

Rectal Pain That Worsens When Lying Down

Some individuals may experience rectal pain that becomes more pronounced when lying down. This can be indicative of specific conditions affecting the pelvic floor muscles.

Levator Syndrome: Understanding Pelvic Floor Muscle Spasms

Levator syndrome (LS) is a condition characterized by episodic pain in the rectum or the bony structures at the base of the spine. While the exact cause of LS is unknown, it is believed to result from spasms in the levator muscles of the pelvic floor.

When do levator syndrome symptoms typically occur? LS symptoms may occur spontaneously or after having a bowel movement. The pain or dull ache can affect the rectum, anus, or tailbone.

How does posture affect levator syndrome symptoms? According to the ASCRS, sitting or lying down can exacerbate LS symptoms, making it particularly troublesome for individuals trying to rest or sleep.

Nighttime Rectal Pain: Causes and Concerns

Rectal pain that occurs primarily at night can be particularly disruptive to sleep and overall quality of life. One condition associated with nighttime rectal pain is proctalgia fugax.

Proctalgia Fugax: Sudden and Intense Rectal Pain

Proctalgia fugax (PF) is characterized by sudden and intense pain in the rectum that typically lasts for several minutes at a time. This condition often occurs at night and may wake a person from sleep, although it can also happen during the day.

What causes proctalgia fugax? PF is thought to result from spasms in the rectum or pelvic floor muscles. The exact trigger for these spasms is not always clear, but they can be quite distressing when they occur.

How long does a typical episode of proctalgia fugax last? Episodes of PF usually last for several minutes, but the intensity of the pain can vary from person to person.

Rectal Pain Triggered by Coughing or Straining

Rectal pain that occurs during activities that increase abdominal pressure, such as coughing or straining, may indicate structural issues within the rectum.

Rectal Prolapse: When the Rectum Drops

Rectal prolapse is a condition in which the rectum falls out of place and protrudes through the anus. This can cause significant discomfort and pain, particularly during activities that increase intra-abdominal pressure.

What are the symptoms of rectal prolapse? Symptoms may include:

• Feeling a bulge from the anus when straining
• Pressure and pain in the rectum or anus
• Mucus in stool
• Bleeding from the rectum or anus
• Constipation
• Difficulty controlling bowel movements

When is rectal prolapse most noticeable? Individuals with rectal prolapse may notice symptoms during activities that increase abdominal pressure, such as coughing, sneezing, or heavy lifting.

Rectal Pain Related to Menstrual Cycle and Reproductive Health

For some individuals, rectal pain may be associated with their menstrual cycle or underlying reproductive health conditions.

Endometriosis: When Uterine Tissue Affects the Rectum

Endometriosis is a condition in which tissue similar to the uterus lining grows in abnormal places, such as the bowels. When endometriosis affects the rectal area, it can cause pressure on the rectal wall and lead to various symptoms.

What are the symptoms of rectal endometriosis? Symptoms may include:

• Rectal pain
• Painful bowel movements
• Constipation
• Back pain
• Pain during ovulation or menstruation

How does endometriosis affect rectal pain throughout the menstrual cycle? Some individuals may experience more severe rectal pain during ovulation or menstruation due to hormonal fluctuations and the cyclical nature of endometriosis symptoms.

Home Remedies for Rectal Pain Relief

While medical treatment may be necessary for underlying conditions causing rectal pain, there are several home remedies that can provide relief for mild symptoms.

Sitz Baths: A Soothing Solution

Sitz baths involve sitting in warm water to soothe the rectal area. This can be particularly helpful for hemorrhoids and other conditions causing anal discomfort.

How to take a sitz bath:

1. Fill a bathtub or sitz bath container with a few inches of warm water
2. Sit in the water for 10-15 minutes
3. Gently pat the area dry afterward
4. Repeat 2-3 times daily as needed

Dietary Modifications for Rectal Health

Certain dietary changes can help alleviate rectal pain and promote overall digestive health.

What dietary changes can help with rectal pain?

• Increase fiber intake to soften stools and prevent constipation
• Stay hydrated to maintain proper stool consistency
• Avoid spicy or irritating foods that may exacerbate rectal discomfort
• Consider probiotics to support gut health

Over-the-Counter Pain Relief Options

For temporary relief of rectal pain, over-the-counter medications may be helpful.

What OTC options are available for rectal pain?

• Topical creams or ointments containing hydrocortisone for hemorrhoids
• Oral pain relievers such as acetaminophen or ibuprofen
• Stool softeners to ease bowel movements

When to Seek Medical Attention for Rectal Pain

While many cases of rectal pain can be managed at home, certain symptoms warrant professional medical evaluation.

Red Flags: Symptoms Requiring Immediate Attention

When should you contact a doctor for rectal pain? Seek medical attention if you experience:

• Severe or persistent pain that doesn’t improve with home remedies
• Rectal bleeding or blood in the stool
• Fever accompanying rectal pain
• Unexplained weight loss
• Changes in bowel habits lasting more than a few days
• Pain that interferes with daily activities or sleep

Diagnostic Procedures for Rectal Pain

How do doctors diagnose the cause of rectal pain? Diagnostic procedures may include:

• Physical examination, including a digital rectal exam
• Anoscopy or proctoscopy to visualize the anal canal and lower rectum
• Colonoscopy for a more comprehensive examination of the colon
• Imaging studies such as MRI or CT scans
• Blood tests to check for infection or other systemic issues

Treatment Options for Rectal Pain

The treatment for rectal pain depends on the underlying cause and may range from conservative measures to surgical interventions.

Conservative Treatments

What are some non-invasive treatments for rectal pain?

• Prescription medications to address specific conditions
• Physical therapy for pelvic floor muscle disorders
• Lifestyle modifications to improve bowel habits
• Biofeedback therapy for certain anorectal disorders

Surgical Interventions for Severe Cases

When might surgery be necessary for rectal pain? Surgical options may be considered for:

• Severe or recurring hemorrhoids
• Rectal prolapse
• Anal fissures that don’t respond to conservative treatment
• Removal of abnormal growths or tumors

The specific surgical approach will depend on the underlying condition and individual patient factors.

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.

Home treatment for anal fissures and list of drugs

Anal fissure is a disease of the internal mucosal wall of the anus. The anal fissure is located at the beginning of the anus, has a linear shape with a size of 1-10 mm. The disease causes severe pain and discomfort during bowel movements. In a neglected state, the anal fissure becomes chronic and increases in size, so it is recommended to immediately consult a proctologist and start treatment.

How to heal a fissure at home

In the early stages, anal fissure is treated conservatively using medications without surgery. The intake of alcohol and spicy foods is completely excluded from the diet. The work of the intestines is getting better, the feces are softened, the injury of the fissure in the anal canal is reduced. Oil micro enemas are applied before the stool (150 g of warm water + 50 g of sunflower oil). The solution is poured into a 200 ml pear. The procedure is carried out for 10-15 days. Manipulation will soften the dense feces that cause injury.

List of laxatives

Can be used as laxatives*:

• duphalac,
• mucofalk,
• forlax,
• exported,
• phytomucine.

* These drugs should not be considered as a recommendation. Each patient needs an individual selection of drugs. Before use, you should consult with a proctologist.

Rectal suppositories

After stools, it is recommended to rinse with warm water without using paper and take a warm bath for 10-20 minutes. Warm water helps to relax the muscles, reduces spasm of the sphincter, the pain fades. After taking water procedures, you can use candles:

• proctoglivenol,
• ultraproject,
• relief-advance,
• hepatrombin G,
• preparation h,
• natalsid.

Suppositories are inserted into the anus twice a day (morning and evening). Before use, the candle must be warmed and kneaded in the hands. After insertion, hold for 2-3 minutes and then push into the anal canal. Delaying the insertion will allow the candle to work better at the beginning of the anal canal.

These drugs and procedures will help you heal your anal fissure at an early stage. If the condition worsens, you should immediately consult a doctor. We strongly do not recommend starting self-treatment of anal fissure at home with an advanced stage of the disease.

Anal fissure ointments and creams

Topical ointments can be used alone to treat anal fissure at home. We offer a selection of effective remedies for anal fissures:

• Levomekol. Ointment accelerates metabolic processes and promotes rapid healing of wounds. Antiseptic substances in its composition can eliminate inflammation in the anus.

• Heparin ointment. The drug is often used to treat anal fissures on the advice of doctors.

• Ointment Ultraprokt. The use of the ointment helps to disinfect the treated area and accelerate wound healing. The drug has an analgesic effect.

• Solcoseryl ointment. The use of the drug allows you to accelerate the healing of wounds of the anus and return to a healthy lifestyle. Before use, it is necessary to apply the ointment on a swab and gently insert into the rectum.

• Ointment Rescuer. The drug is also used to accelerate the regeneration of wounds and the healing of anal fissures at home. The medicine contains natural ingredients that contribute to recovery.

It is recommended to consult a proctologist before use.

Doctors proctologists

Bagdasaryan Lev Karapetovich

Surgeon – coloproctologist, candidate of medical sciences, doctor of the highest category, member of the Association of Coloproctologists of Russia

Work experience: 44 years

4,000

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Bagdasaryan Samvel Lvovich

Surgeon-coloproctologist, candidate of medical sciences, member of the Association of Coloproctologists of Russia

Work experience: 20 years

3 500

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Myshlyaev Anton Vsevolodovich

Coloproctologist surgeon

Work experience: 7 years

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Treatment of hemorrhoids in at home: symptoms, tips and remedies

Sometimes we face such acute problems as hemorrhoids. Of course, all medical portals will tell you in a voice that at the first symptoms you should immediately consult a doctor. But what to do if the diagnosis has already been made?

First, let’s clarify what hemorrhoids are. In a sense, everyone has it – these are pillow-shaped clusters of veins that lie directly under the mucous membranes that line the lower rectum and anus. The condition that most of us call hemorrhoids develops when these veins swell and stretch, much like varicose veins in the legs. Because the blood vessels involved must constantly fight gravity to keep blood flowing back to the heart, some people believe that hemorrhoids are part of the price we pay to remain upright creatures. There is another, more capacious definition of hemorrhoids. “This is the name of the nodules, swollen veins in the anus and rectum, similar to varicose veins,” says the Mayo Clinic portal. Hemorrhoids can develop inside the rectum (internal) or under the skin around the anus (external).

According to statistics, three out of four adults suffer from this disease from time to time. Hemorrhoids have a number of causes, but often the cause is unknown. Fortunately, there are effective ways to treat hemorrhoids. Many people manage to completely get rid of the disease at home, simply by changing their lifestyle.

Symptoms of hemorrhoids

Signs of hemorrhoids largely depend on its type. There are two types of hemorrhoids: internal hemorrhoids, which occur in the lower part of the rectum, and external hemorrhoids, which develop under the skin around the anus. External hemorrhoids cause the most discomfort, as the skin that covers them is irritated and corroded. If a blood clot forms inside an external hemorrhoid, the pain may be sudden and severe. You may feel or see a lump around your anus. The clot usually dissolves, leaving excess skin (skin mark) that may itch or become irritated.

Internal hemorrhoids are usually painless, even if they cause bleeding. For example, you may see bright red blood on toilet paper or dripping down the toilet. Internal hemorrhoids can also prolapse or extend beyond the anus, causing several potential problems. When hemorrhoids come out, they can collect small amounts of mucus and tiny particles of stool, which cause an irritation called anal itching. Constant rubbing to reduce itching only makes the problem worse.

With external hemorrhoids, swollen veins are located near the anus. Its main symptoms are:

Internal hemorrhoids lie directly inside the rectum. Usually, these nodules cannot be seen or felt, and they rarely cause discomfort. But straining or irritating a bowel movement can cause:

• Painless bleeding during bowel movements. You may notice small amounts of bright red blood on the toilet paper or in the toilet

• Hemorrhoids pushing through the anus (prolapsed or protruding hemorrhoids) causing pain and irritation

• Thrombosed hemorrhoids. If blood accumulates in external hemorrhoids and forms a clot (thrombus). This, in turn, can lead to severe pain, swelling, inflammation, and the formation of a hard bump near the anus.

Stages of hemorrhoids

When symptoms of hemorrhoids develop, there are many treatment options, depending on the situation and the severity of the hemorrhoids. Internal hemorrhoids are classified according to the degree of prolapse below the scallop line into the anal canal.

Grade 1: Internal hemorrhoids protrude into the canal but do not protrude or fall completely. The nodes may bleed.

Grade 2: Hemorrhoids protrude beyond the anus when straining due to defecation or gas, but spontaneously return to their original internal position as soon as the tension subsides.

Grade 3: Hemorrhoids may protrude beyond the anal margin without any tension and require the patient to manually push them inwards.

When to see a doctor if you suspect hemorrhoids

If you notice slight bleeding or see blood on the toilet paper, this is already a reason to see a doctor. But do not assume that rectal bleeding is necessarily a sign of hemorrhoids. It is also common in other, more serious conditions, such as cancer of the rectum or anal canal.

Diagnosis of hemorrhoids

Hemorrhoids can usually be diagnosed based on a simple medical history and physical examination. External hemorrhoids are usually obvious, especially if a blood clot has formed. Your doctor may do a digital rectal examination to check for blood in the stool. She or he may also examine the anal canal with an anoscope, a short plastic tube inserted into the rectum with light. If there is evidence of rectal bleeding or microscopic blood in the stool, a flexible sigmoidoscopy or colonoscopy may be done to rule out other causes of bleeding, such as colorectal polyps or cancer, especially in people over 45 years of age.

Causes of hemorrhoids

Traditionally, hemorrhoids have been associated with chronic constipation, straining during a bowel movement, and prolonged sitting on the toilet, all of which interfere with blood flow in and out of the area, causing it to pool and vasodilate. This also explains why hemorrhoids are common during pregnancy when the enlarging uterus presses on the veins.

More recent studies show that patients with hemorrhoids tend to have higher anal tone at rest, i.e. anal smooth muscle tends to be tighter than average (even in the absence of tension). Constipation exacerbates these problems because straining during a bowel movement increases pressure in the anal canal and pushes the hemorrhoid against the sphincter muscle. Finally, the connective tissues that support and hold hemorrhoids in place can weaken with age, causing the hemorrhoids to bulge and prolapse.

The veins around the anus tend to stretch under pressure and may bulge or swell. Hemorrhoids can develop due to increased pressure in the lower rectum caused by:

• Tension during defecation

• Long sitting on the toilet

• Chronic diarrhea or constipation

• obese

• Pregnancy

• anal sex

• Improper diet

• Regular weight lifting

Risk factors for hemorrhoids

With age, the risk of hemorrhoids increases. This is because the tissues that support the veins in the rectum and anus can weaken and stretch. This can also happen during pregnancy: the baby’s weight puts a lot of pressure on the anal area as well. By age 50, about half of the population has experienced one or more of the classic symptoms, which include rectal pain, itching, bleeding, and possibly prolapse (hemorrhoids that protrude through the anal canal). Although hemorrhoids are rarely dangerous, they can be uncomfortable and even painful.

Complications of hemorrhoids

Complications of hemorrhoids are rare, but sometimes they occur:

• Anemia. In rare cases, chronic blood loss due to hemorrhoids can cause anemia, in which you don’t have enough healthy red blood cells to carry oxygen to your cells.

• Suffocated hemorrhoids. If the blood supply to internal hemorrhoids is cut off, the hemorrhoids can be “suffocated”, causing severe pain.

• Thrombus. Sometimes a blood clot is also formed with thrombosed hemorrhoids. While not dangerous, it can be very painful.

Prevention and treatment of hemorrhoids

The best way to prevent hemorrhoids is to make the stool soft and easy to pass through the anal canal. Regardless of the size or swelling of the hemorrhoids, treatment is not required if there are no symptoms. Prevention is perhaps the most effective treatment. Diet and adequate hydration are very important to maintain normal bowel movements. Symptoms of hemorrhoids can occur with hard stools and constipation, as well as with diarrhea and frequent bowel movements. People with constipation may need a high-fiber diet, adequate fluids, and stool softeners. People with too frequent bowel movements may need antidiarrheal drugs and dietary adjustments. These preventive measures reduce the strain required to empty the bowels, thereby reducing pressure in the blood vessels and preventing swelling. Internal hemorrhoids always remain bulging or protruding and are at risk of thrombosis or strangulation in case of anal muscle spasm.

Hemorrhoids of the 1st degree are treated symptomatically. Spasm of the anal muscles is possible. Warm sitz baths, sitting in a warm bath for 20 minutes two or three times a day, can help. Avoiding spicy foods can also prevent anal itching. Over-the-counter medications may be helpful.

To prevent hemorrhoids and reduce their symptoms, follow these tips:

• Eat foods high in fiber. Load up on fruits, vegetables, and whole grains. This will soften the stool and increase its volume, which will help avoid the tension that causes hemorrhoids. Add fiber to your diet slowly to avoid gas problems.

• Drink plenty of fluids. Preferably, six to eight glasses of water and other liquids (not counting alcohol) per day to keep stools soft.

• Consider fiber supplements. Most people don’t get enough fiber (20 to 30 grams per day) in their diet. Studies have shown that over-the-counter fiber supplements such as psyllium (Metamucil) or methylcellulose (Citrucel) improve the overall symptoms and bleeding of hemorrhoids.

• Don’t stress. Tension and holding the breath while trying to defecate create increased pressure in the veins of the lower rectum.

• Go to the toilet as soon as you feel the urge. If the urge passes, your stool may dry out and be harder to pass.

• Do exercises. Stay active to prevent constipation and relieve pressure on your veins from prolonged standing or sitting. Exercise can also help you shed excess weight, which can contribute to the development of hemorrhoids.

• Avoid prolonged sitting. Sitting too long, especially on the toilet, puts more pressure on the veins in the anus.

• Take a sitz bath. A bath with warm water can reduce itching, irritation and spasm of the sphincter muscle. Pharmacies sell small plastic tubs that fit over the toilet seat, or you can sit in a regular warm tub. Most experts recommend a 20-minute sitz bath after each bowel movement (which is hard to imagine in real life), or at least two or three times a week. Try to gently blot the anal area afterwards; do not rub or rub hard. You can also use a hair dryer to dry this area.

• Look for topical hemorrhoid relief. Over-the-counter hemorrhoid creams containing a local anesthetic can temporarily relieve pain. Witch hazel wipes are soothing and non-irritating. A small ice pack applied to the anal area for a few minutes can also help prevent pain. Finally, sitting on a cushion rather than on a hard surface helps reduce the swelling of existing hemorrhoids and prevents new ones from forming.

Top 5 remedies for hemorrhoids

№1 Napkins Proktolif, Moscow Pharmaceutical Factory, Russia

Napkins Proktolif – an effective and practical tool for the prevention of hemorrhoids and skin diseases. Thanks to the active ingredients, Proctoliph wipes have a wound-healing, capillary-protective and antipruritic effect and are widely used in proctology for the prevention and complex treatment of hemorrhoids. They eliminate burning, itching, pain, swelling, heal cracks.

Proctoliph wipes are also effectively used in dermatology and relieve inflammation in dermatitis of various etiologies, such as: exudative diathesis, rosacea, diaper rash; skin irritation from aggressive influences (thermal and sunburn, insect bites.

Napkins have wound-healing, capillary-protective and antipruritic action.

They prevent exacerbation and relieve inflammation of the rectum with hemorrhoids (eliminate burning, itching, pain, swelling, heal cracks).

Relieve inflammation of the skin in various dermatological diseases.

Proctoliph Hamamelis medical wipes 10 pcs. prophylaxis of hemorrhoids

Manufacturer: Moscow Pharmaceutical Factory, Russia

No.

2 Ointment for rectal and external use Relief, Bayer, Germany

Ointment with a vasoconstrictor component – phenylephrine. It is prescribed for the external manifestation of the disease, although the use of the internal variety of hemorrhoids is not excluded. The use of Relief ointment is indicated for chronic hemorrhoids and anal fissures.

The ointment has a vasoconstrictive effect by reducing the lumen of the vessels and helps to eliminate bleeding.

Relief ointment for rectal and external use tube 28.4 g

Producer: Bayer [Bayer], Greece

№3 Cream for rectal and external use Proktonis, VIS, Russia

Proktonis is a biologically active food supplement. Is not a medicine. Proctonis has a pronounced anti-inflammatory, antispasmodic and hemostatic effect.

• Normalizes the work of the gastrointestinal tract.

• Relieves pain from hemorrhoids.

• Eliminates flatulence.

• Can be used as a mild laxative.

Proktonis cream 30 ml

Producer: VIS OOO, Russia

No. 4 Ointment for rectal and external use Posterizan, Dr. Kade GmbH, Germany

A drug with anti-inflammatory and immunostimulating effects for topical use.

Cell wall antigens and metabolic products of Escherichia coli, when in contact with the rectal mucosa and skin of the anogenital area, increase local tissue resistance to the effects of pathogenic microflora. The drug stimulates the T-system of immunity, phagocytic activity of leukocytes and cells of the reticuloendothelial system, non-specific immunity factors, reduces exudation during inflammation, normalizes the permeability and tone of blood vessels, stimulates the regeneration of damaged tissues.

Hydrocortisone, when applied topically, has anti-inflammatory and anti-allergic effects. When applied to the affected surface reduces swelling, redness, itching.

Posterisan ointment for rectal and external use 25 g

Manufacturer: Dr.