Rectal Pain

Rectal Pain Overview

Rectal pain is a common problem. Most people have experienced it at least once in their lives. It usually appears as a mild irritation, but sometimes the pain can be so severe that it can be incapacitating.

Rectal Pain Causes

Many conditions may cause rectal pain. Most are not serious.

Common causes of rectal pain:

• Hemorrhoids: Hemorrhoids (a painful swelling of a vein or veins at the anus) are a common problem affecting up to 25% of American adults. They are usually caused by straining during bowel movements. Heavy lifting and childbirth are also common causes.
• Anal fissure: An anal fissure is a small tear in the skin at the opening of the rectum. It is caused when a large, hard stool is passed and excessively stretches the rectum. This problem can also occur in people whose anal sphincter tone (the muscle that controls the anal opening) is too tight and cannot relax to pass the stool.
• Proctalgia fugax: Proctalgia fugax involves fleeting rectal pain and occurs in 8% of Americans. This disorder occurs more commonly in women and in people younger than 45 years. Although the exact cause of the pain is not known, many doctors believe spasm of the anal sphincter muscle is the origin of this pain.
• Levator ani syndrome: Levator ani syndrome affects 6% of the US population and occurs in women slightly more often than it occurs in men. The term levator ani refers to the group of muscles that surrounds and supports the anus. Spasms of these muscles are believed to cause rectal pain.

Less likely reasons for rectal pain

• Cancer
• Infection, including anorectal abscesses or proctitis
• Inflammatory bowel disease, such as ulcerative colitis or Crohn's disease
• Foreign bodies in the rectum or rectal prolapse

Rectal Pain Symptoms

The pain of proctalgia fugax is sudden and intense, usually lasting less than a minute. But in some rare cases, the spasm can go on for an hour. It is described as a sharp, stabbing, or cramplike pain occurring at the anal opening. The pain can awaken you from a sound sleep. The attacks seem to occur in clusters, appearing daily for a while then disappearing for weeks or months.

The pain of levator ani syndrome is felt higher up inside the rectal passage and feels like a tight pressure. The sensation is made worse by sitting and improves with walking or standing. The pain usually lasts 20 minutes or longer and tends to reoccur at regular intervals.

Most hemorrhoids only cause a mild discomfort, but the pain can become severe if the hemorrhoid thromboses. This occurs when the blood in the hemorrhoid clots. The symptoms are an excruciating throbbing or stabbing pain that begins suddenly and can last for 4 days.

An anal fissure causes a tearing or knifelike pain when it first occurs and turns into a dull ache that can last for hours. The tearing of the skin may also cause a small amount of bleeding. Each bowel movement irritates the injured skin producing a sharp pain. The pain can be so intense that most people try to delay having a bowel movement, which only causes a harder stool and more pain when it is passed.