Why Does It Hurt When I Poop?
Dealing with painful bowel movements
There are a number of things that might cause pain when you poop. Many of them are nothing to worry about, and some should be followed up on with a doctor. Diet, medications, physical activity, even your emotions can affect your bowel movements — and that can result in some minor or temporary pain. Below, we’ll offer some of the answers to the question “Why does it hurt when I poop?”
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One of the first and most common things you’ll hear associated with pooping pain is hemorrhoids. Depending on your age, you may have also heard hemorrhoids referred to as piles. Without getting too medical, a hemorrhoid is basically one or more swollen veins in the anus or rectum. Hemorrhoids can be internal and you might not ever be aware of them, or they can be external and cause enough pain to make sitting uncomfortable — to the point where some sufferers use donut cushions to avoid pressure in that sensitive area.
Hemorrhoid symptoms can include:
- Bright red blood on the toilet paper after pooping
- Pain when pooping
- Lumps near the anus that are itchy or painful
- Sharp pain or intense itching of the anus
- Anal leakage.
As always, medical problems are best addressed by medical professionals and you should consult your doctor about treatment and prevention of hemorrhoid pain while pooping. Serious cases may require surgical removal.
Following are some recommended procedures for dealing with hemorrhoid pain:
- Add more fiber to your diet or take fiber supplements to make passing stool easier.
- Take regular sitz baths — a shallow, warm bath that cleans and increases circulation to the anal and rectal region.
- Daily warm baths — at least 10 minutes — will have the same benefits as a sitz bath.
- While we’re on the topic of baths, keep your anus clean using warm water, unscented soap, and thorough rinsing.
- Treat itching or burning sensations with a topical hemorrhoid cream.
- Take NSAIDs — nonsteroidal anti-inflammatory drugs — such as naproxen (Aleve) or ibuprofen (Advil).
- Use a soft toilet paper for wiping. Dabbers or sprayers for moistening the toilet paper are available and helpful to reduce friction and irritation.
- Consider using a bidet or bidet toilet seat for thorough yet gentler cleaning.
- Use a cold compress to bring down swelling.
Fissures are a fancy name for tiny cuts or cracks in the anus skin. As you can imagine, such anal fissures can easily cause pain when pooping.
You can suspect anal fissures if you notice any of the following symptoms:
- Bright red blood on toilet paper when wiping
- Intense pain or stinging sensation when pooping
- Anal itching or burning sensation
- Skin outgrowths may occur near the fissure(s)
- An area that looks torn near the anus.
Although they’re not a common topic of conversation, anal fissures are common and typically not serious. If some care is taken, they will generally heal in two to four weeks.
You can reduce pain while pooping by treating anal fissures with one or more of the following:
- Add more fiber to your diet, or use fiber supplements. As with many painful pooping situations, easing the passage of stool means less wear and tear on your body
- Make sure your hydrated — again, to keep your stool soft and malleable
- Take over the counter stool softeners but follow instructions closely
- Take regular sitz baths — a shallow, warm bath that cleans and increases circulation to the anal and rectal region
- Apply pain relief ointments specifically intended for the anal/rectal area, for example, lidocaine.
- Use hydrocortisone creams to reduce inflammation.
Not only can it cause pooping pain on its own, the straining from constipation can also lead to other pain causes including the anal fissures and hemorrhoids mentioned above.
Constipation is generally defined as a significant decrease in your usual bowel movement frequency, and most often includes hard stool.
The pain from constipation is usually duller than other pains, and tends to be more internal, in your lower gut. Common symptoms are listed below:
- Bloating or cramping in your lower abdomen or even back
- The sensation that something is blocking your intestines
- Hard, “dry” poop that comes out in smaller pellets or chunks
- Pain in your abdomen or anus while pooping
- Feeling like you still need to poop right after, or shortly after, having a bowel movement.
The best way to deal with constipation is to avoid it. The following suggestions can help prevent constipation and/or treat existing constipation.
- The number one treatment is increasing the fiber in your diet
- Fiber works best with fluid, so make sure you’re hydrated
- Anecdotal evidence indicates caffeine and alcohol can cause constipation, so reduce consumption
- Reduce constipation causing foods such as dairy and meat
- Add probiotics, found in Greek yogurts for example, to your diet
- Don’t hold poop in and get to the toilet as quickly as possible when you feel the urge
- Exercise has been found to increase bowel movements and decrease constipation — especially exercise that benefits core muscles
- Over the counter laxatives can be tried but only as a one-time, short-term solution.
Unfortunately, the opposite of constipation, diarrhea, can also cause pain when pooping. Most often, the diarrhea itself (thin, watery, frequent bowel movements) doesn’t cause the pain, but passing a lot of stool and frequent wiping can irritate the skin at and around the anus.
Diarrhea symptoms and effects include:
- Frequent need to poop
- Large volumes of poop, though watery and loose
- Feeling bloated
- Stomach cramps or pain
- Blood in the stool
- Treating and avoiding diarrhea includes following the recommendations below:
Stay hydrated. You are losing large amounts of fluid and they need to be replaced
- The above being said, if you’re traveling, avoid tap water or uncooked food prepared/washed with tap water
- Before travelling, ask a doctor about medications and vaccines that can prevent diarrhea
- Wash food properly and cook it thoroughly
- Leftovers should be refrigerated immediately
- Wash your hands thoroughly after using the bathroom and before preparing food or eating.
Inflammatory Bowel Disease ( IBD )
Inflammatory Bowel Disease is a catch-all label that includes anything that causes inflammation in the digestive tract. These include, but are not limited to, irritable bowel syndrome (often confused with inflammatory bowel disease), Crohn’s disease, and ulcerative colitis.
IBD symptoms can include pain while pooping, but many are also similar to other illnesses or conditions. If you suspect you have inflammatory bowel disease — IBD — you should consult a doctor as soon as possible.
IBD symptoms include:
Weight loss for seemingly no reason
- General exhaustion
- Blood in your poop
- General or sharp pain in your abdomen
- Loss of appetite.
Prevention and treatment of IBD can include:
- A diet low in dairy and meat, and careful monitoring of fiber intake
- Reducing alcohol and caffeine consumption
- Anti-inflammatory medications including olsalazine or mesalamine.
- Antibiotics, including metronidazole
- Immunosuppressants including azathioprine or methotrexate
- Immune system controls, including natalizumab or adalimumab (commonly known as Humira)
- Diarrhea medicine
- Pain medication — as prescribed by a doctor, since some pain meds can create more problems than they solve
- If intestinal bleeding is detected or suspected, iron supplements my be recommended to prevent anemia
- If Crohn’s disease is suspected or diagnosed, calcium supplements and/or vitamin D may be prescribed
- In extreme cases (not common), removal of sections of the rectum or colon may be needed and waste redirected from the small intestine to the anus, or small intestine to a collection device outside the body.
It’s simple to understand why proctitis can cause pain while pooping, since the lining of the rectum is inflamed, and then irritated during a bowel movement. Proctitis commonly occurs as the result of sexually transmitted infections, inflammatory bowel issues, and radiation therapy.
As well as pain while pooping, proctitis symptoms include
- Frequent urge to poop
- Blood with your poop or on the toilet paper after wiping
- A mucus-like discharge.
Prevention or treatment of proctitis includes:
- Safe sex, due to STD’s causing it. Use condoms and avoid sexual contact with anyone who does, or may have, a sexually transmitted disease
- Stool softeners to reduce irritation when passing stool
- Medical treatments including antibiotics, antiviral meds, other prescribed medications and, in some cases, surgery to remove damaged parts of the colon.
STI’s — Syphilis or Chlamydia
Mention was made above regarding sexually transmitted infections (or sexually transmitted diseases — STD’s). Among others, if syphilis or chlamydia are spread through anal sex, it can result in swelling of the rectum which would cause pain while pooping. Treatment needs to be taken care of by a doctor.
HPV — Human Papillomavirus
HPV can create warts on or around the anus (resulting in painful bowel movements) as well as genitals, mouth, and/or throat. Prevention relies on safe sex or getting the HPV vaccine. Treatment requires professional medical assessment and care.
Anal Cancer, Rectal Cancer
Before you self-diagnose and panic, realize that anal or rectal cancer is rarely the cause of painful pooping. It’s included here simply because there IS a possibility.
Other than painful bowel movements, symptoms of rectal or anal cancer include:
- Frequent constipation or frequent diarrhea
- Small or thin poop
- Unusual discharge
- Sudden changes in poop shape or color
- Blood on the toilet paper when wiping or in poop
- New or unusual bumps on or near the anus that cause pain when pressure is applied
- Consistent abdominal aches or cramps
- Abnormal exhaustion
- Abnormal weight loss
- Anal itching
- Excessive gas or a bloated feeling.
Obviously, anal cancer or rectal cancer would require professional medical attention. Although the above symptoms can be caused by many other things, it is best to mention them to a doctor.
Should I See A Doctor?
When possible, any or the above symptoms should be mentioned to a doctor, especially if they occur frequently or for an extended time. Some of the symptoms that immediate attention should be sought for include:
- Bleeding or any unusual discharge when pooping
- New lumps on or near the anus, especially if painful
- Any bleeding or pain that lasts for more than seven days
- Severe abdominal pain or cramps
- Severe back pain or cramping
- Unusual fatigue
- Experiencing pain after sex, especially unprotected sex.
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