Hemorrhoids are swollen veins under or on top of the skin in the anus. Both can make passing a bowel movement painful.
Pain When You Poop? Here’s What Your Body Is Trying to Tell You
This might be a little personal, but does it hurt when you poop? If you have trouble on the toilet, you shouldn’t just grin and bear it.
We spoke to Niket Sonpal, MD, a New York-based internist and gastroenterologist, to understand the most common causes for an achy anus when you go number two, plus ways to prevent painful poops and soothe your sore butt.
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Tip
If your anal pain does not subside within 24 to 48 hours, you experience ongoing rectal bleeding, you have a mass that does not improve or you’re running a fever along with anal pain, you should see a doctor, according to the American Society of Colon and Rectal Surgeons (ASCRS).
1. You’re Constipated
It’s probably no surprise that constipation is a common culprit for painful poops.
“Constipation is painful for two reasons: the strain of pushing and how hard the stool is,” Dr. Sonpal says. “Stool that is too hard or large to pass will cause pain during a bowel movement because the muscles are stretching.”
To make matters worse, when you strain regularly or sit on the toilet too long, you increase pressure in the lower rectum, which may result in painful hemorrhoids (more on this later), according to the Mayo Clinic.
The fix: To help prevent constipation (and hemorrhoids), consume high-fiber foods, drink six to eight glasses of water daily and exercise regularly, per the Mayo Clinic. Also, avoid straining and sitting for extended periods, and hit the bathroom as soon as you feel the urge to go.
If you’re already constipated, try a stool softener like MiraLAX or Colace.
2. You’ve Got Diarrhea
Conversely, diarrhea could be the source of your discomfort on the toilet.
“Because diarrhea speeds up the digestion process, food is oftentimes not broken down fully,” Dr. Sonpal says. This means that stomach acids, digestive enzymes and bile may be present, which can cause a burning sensation in the rectum during a bowel movement.
And if you ate spicy food, you might also have to contend with capsaicin (the active ingredient in hot peppers) passing in your stool, Dr. Sonpal says. This chemical compound can irritate digestive tissue and trigger a burning feeling with diarrhea.
What’s more, “food that hasn’t been processed entirely may cause physical trauma to the rectum, leading to pain,” Dr. Sonpal says. “Large, rough foods and those with seeds, shells or pods can rub against or cut the rectum’s delicate tissue.”
Adding insult to injury, wiping — which, let’s be honest, you do more of when your poops are runny — can irritate your butt too. “Wiping too hard can also cause small tears,” Dr. Sonpal says.
The fix: “To treat diarrhea, eat a diet high in fiber to make stools more solid and increase liquid intake,” Dr. Sonpal recommends.
3. You Have Hemorrhoids
Hemorrhoids can cause a world of hurt when you’re trying to take care of business in the bathroom. But what are they, exactly?
“Hemorrhoids are swollen veins in the lower part of the rectum and anus,” Dr. Sonpal says. “The blood vessels’ walls are often stretched so thin, the veins bulge and become irritated, even more during a bowel movement.”
The fix: Mild cases of hemorrhoids only cause pain when you poop (because the blood vessels stretch) and usually go away on their own, Dr. Sonpal says.
However, more severe hemorrhoids might hurt throughout the day and may need an over-the-counter cream like Preparation H, he says.
4. You’ve Got an Anal Fissure
If your butt bothers you when you have a bowel movement, you might be experiencing an anal fissure.
“An anal fissure is a tear in the anus, exposing the delicate lining of the anal sphincter,” Dr. Sonpal says. “This tear may cause the muscle to spasm, which pulls the edges of the fissure.”
Sometimes caused by physical trauma, childbirth or a sexually transmitted infection, anal fissures can be very painful during poop sessions when the tear stretches, Dr. Sonpal explains.
The fix: But they can be easily treated with a multipronged approach. For starters, Dr. Sonpal suggests upping your fiber and liquid intake to soften stool, which will make it easier to pass and cause less pain (and stretching).
Plus, soaking in warm water and applying a nitroglycerin cream like Fissure Control from Forces of Nature (to increase blood flow to the fissure) helps the sphincter to relax and promotes healing, he says.
“You can also try an anesthetic cream like lidocaine hydrochloride to reduce pain,” Dr. Sonpal adds. “However, if the anal fissure is unresponsive to these treatments, a doctor may recommend surgery to remove it.”
5. You Have Pelvic Floor Issues
Pelvic floor problems can produce pain while you poop, too.
“When there is dysfunction in the pelvic floor, one is unable to control muscles that help you complete a bowel movement,” Dr. Sonpal says.
In addition to uncomfortable bowel movements, you might also experience unexplained lower back and pelvic pain and constipation.
The fix: “Treatment usually involves behavioral changes (like avoiding pushing or straining during a bowel movement), learning how to relax the pelvic floor muscles, warm baths, yoga, relaxants like diazepam and physical therapy,” Dr. Sonpal says.
What can make passing stool painful?
Painful bowel movements can cause a great deal of discomfort. There are many possible causes ranging from constipation to anal cancer.
It is normal to occasionally experience mild pain during bowel movements. However, when this happens regularly, it could indicate an underlying medical condition.
In this article, we cover 10 possible causes of painful bowel movements and how to treat them. We also explain when it is necessary to see a doctor.
A person may experience a painful bowel movement for a number of reasons, including:
1. Constipation
A person can become constipated for multiple reasons, such as:
- a hardening of stool due to a lack of fiber or water
- a slowing of intestinal movements
- as a side effect of a medication
- emotional issues
Healthcare providers may use the Rome IV criteria to diagnose constipation. To receive a diagnosis of constipation, two or more of the following symptoms must be present for at least 1 month in infants and children up to 4 years old:
- passing two or fewer bowel movements in a week
- if they usually have complete control of their bowels, having at least one accidental bowel movement per week
- a history of fecal withholding, or not using the bathroom despite having an urge
- passing hard and painful stools
A doctor may diagnose chronic constipation in a child over 4 years old if these symptoms persist for at least 2 months.
Health professionals tend to recommend increasing water and fiber intake or taking fiber supplements as the first steps in treating constipation.
If symptoms persist despite making these dietary changes, taking over-the-counter (OTC) laxatives is also a good treatment option. A pharmacist can advise on the best product in each case.
If there is no movement within 2–3 days, or if pain develops or worsens, it is important to seek medical attention immediately.
2. Anal fissures
An anal fissure is a tear in the skin around the anus. Anal fissures can occur as a result of constipation or passing hard stools. Anal penetration can also cause a fissure.
Other possible causes include:
- sexually transmitted infections (STIs)
- chronic diarrhea
- inflammatory bowel disease
- human papillomavirus
- anal cancer
- vaginal delivery
- surgery
If constipation has caused an anal fissure, a healthcare provider may recommend taking stool softeners to help it heal.
Lidocaine jelly is also helpful for reducing the pain of an anal fissure. A doctor may also suggest nitroglycerin or nifedipine ointments. Both drugs will increase blood flow to the anus, which helps the body heal the injury.
People with chronic anal fissures may need surgery. Another treatment option for more severe cases is to inject botulinum toxin A (Botox).
3. Hemorrhoids
Hemorrhoids are swollen veins under or on top of the skin in the anus. Both can make passing a bowel movement painful.
Sometimes, people will also see blood on the toilet paper or in the toilet bowl.
Several OTC treatments are available for hemorrhoids, such as hydrocortisone. More severe hemorrhoids may require surgery, however.
Doctors and pharmacists will recommend that people with hemorrhoids keep their stools as soft as possible. This will help ease the pain of passing a bowel movement over a hemorrhoid.
4. Diarrhea
Passing three or more loose or watery bowel movements per day may indicate diarrhea . Chronic cases of diarrhea can last for longer than 4 weeks.
To treat diarrhea, a health professional may recommend loperamide (Imodium). If an infection is causing the diarrhea, a person will need to take antibiotics.
Chronic or bloody diarrhea requires prompt medical attention.
5. Food intolerances and sensitivities
People with food intolerances or sensitivities may experience painful bowel movements or diarrhea if they eat certain foods. Common examples include lactose and glucose intolerances.
The best form of treatment is to avoid eating any foods that the person knows can trigger a reaction.
6. Inflammatory bowel disease
The two types of inflammatory bowel disease are ulcerative colitis and Crohn’s disease.
People with ulcerative colitis may experience bloody diarrhea with or without mucus. Episodes of diarrhea can cause pain during bowel movements. Other symptoms of ulcerative colitis may include:
- urgently needing to pass stools
- abdominal pain
- weight loss
People with Crohn’s disease may experience some different symptoms . For example, they may feel abdominal pain on the lower right side or have diarrhea without any blood.
Treatments for both ulcerative colitis and Crohn’s disease, such as prednisone, work to suppress the immune system. These medications reduce inflammation to manage the symptoms.
Some people may need to take corticosteroids regularly as a long term treatment.
7. Proctitis and anusitis
Proctitis refers to inflammation in the rectum. Anusitis, meanwhile, is inflammation in the anus. These conditions share many symptoms with hemorrhoids.
To treat proctitis and anusitis, it is necessary for a doctor to first understand the cause. Several factors can lead to proctitis or anusitis, including:
- ulcerative colitis
- STIs
- colon infections
- certain medications
- consuming a diet too rich in citrus, coffee, cola, beer, garlic, spices, or sauces
8. Anal cancer
Anal cancer can cause tumors to develop around the anus that make bowel movements painful. Other symptoms of anal cancer include:
- bleeding from the anus
- pain or irritation in the anus or pelvis
- weight loss
- feeling a weight in the anus or rectum
- incontinence
- severe constipation
It is important to consult a doctor immediately if these symptoms occur.
9. Endometriosis
In endometriosis, tissue that normally lines the uterus develops in other areas of the body, such as the ovaries.
Researchers estimate that 3.8% to 37% of endometriosis cases affect the bowel. Symptoms of this condition include:
- pain during bowel movements
- mucus in the stool
- bleeding from the rectum
- diarrhea or constipation
- bloating
Health professionals tend to treat bowel endometriosis using hormonal therapy or surgery.
10. Skin conditions
Some chronic skin conditions, including eczema and psoriasis, can cause rashes to develop on the anus. Passing a bowel movement over an irritated area of skin can be painful.
Sometimes, painful genital warts can also develop on or near the anus.
Painful bowel movements have many potential causes. Some — including constipation, diarrhea, and hemorrhoids — are treatable at home. However, other causes may require medical attention.
People who find blood in their stools or feel severe pain during bowel movements should see a doctor for advice and treatment.
People experiencing diarrhea should drink plenty of water to avoid dehydration. Doctors recommend also following the BRAT diet, which focuses on:
Following a diet rich in fiber is essential for preventing constipation and keeping good bowel health. Getting regular physical activity also helps prevent constipation.
Keeping the bowel healthy requires daily care. It is important to eat fiber rich foods and drink enough water. Many causes of painful bowel movements are preventable.
Some people have conditions or infections that cause painful bowel movements. These are not always treatable with OTC remedies, so it may be necessary to see a doctor.
Last medically reviewed on September 25, 2019
- Food Allergy
- Crohn’s / IBD
- GastroIntestinal / Gastroenterology
- Nutrition / Diet
How we reviewed this article:
Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
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