Causes of Painful Bowel Movements

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

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

Constipation

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

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

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

Hemorrhoids

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

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

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

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

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

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

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Anal Fissures

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

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

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

Ulcerative Colitis

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

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

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

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

Skin Conditions

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

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

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Infections

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

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

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

Endometriosis

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

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

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

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

Anal Cancer

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

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

WebMD Medical Reference Reviewed by Minesh Khatri, MD on April 25, 2019

Sources

SOURCES:

American Society of Colon and Rectal Surgeons: "Anal Pain."

Mayo Clinic: "Ulcerative Colitis," "Mayo Clinic Q&A: Painful Bowel Movements May Be Due to Anal Fissure," "Prostatitis."

Johns Hopkins Medicine: "Constipation," "Prostatitis."

Cedars-Sinai: "Endometriosis."

American Cancer Society: "Signs and Symptoms of Anal Cancer."

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