Pain During Bowel Movements

7 Causes You May Not Have Considered

Pain is never pleasant, but pain during bowel movements can be especially anxiety-provoking. For one, there can be anticipatory anxiety because you know that at some point the next trip to the bathroom will be coming.

Woman on bed bent over in pain
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Pain during bowel movements can also be worrisome due to a fear that there might be something seriously wrong. An occasional fleeting twinge might not be a big deal, but the ongoing or severe pain is a sign that something is wrong and should not be ignored.

In this overview, we will discuss some of the more common causes of pain during bowel movements.

Anal or Rectal Pain

For some people, pain during bowel movements has to do with the process of the stool making its way out of the body. Here are two of the more common reasons for this symptom.


Hemorrhoids are swollen veins in the anus and rectum, most frequently caused by constipation. In addition to pain during bowel movements, other symptoms of hemorrhoids include rectal itching and the appearance of small amounts of bright red blood seen on toilet paper as you wipe.

Anal Fissures

An anal fissure is a tear in the lining of the anus. Such tears are often the result of the passage of hard stool. In addition to pain during a bowel movement, other symptoms of an anal fissure include itching and bright red blood on the stool.

Generally speaking, bright red blood is an indication that the bleeding is situated nearer the rectum and anus. Dark blood or tarry stools are signs that bleeding is occurring further up in the intestines or stomach.

Intestinal Causes

The following are three of the more common health conditions in which pain in the form of intestinal spasms and cramping is associated with bowel movements.

Inflammatory Bowel Disease (IBD)

Abdominal pain is also a symptom of inflammatory bowel disease, a group of inflammatory disorders comprised of Crohn's disease, and ulcerative colitis. The pain is the result of the inflammation of the intestinal tract that characterizes both diseases.

Other symptoms of IBD include blood and/or mucus in the stool, diarrhea, fever, and appetite and/or weight loss.

Irritable Bowel Syndrome (IBS)

Pain associated with bowel movements is a hallmark symptom of irritable bowel syndrome, although it is not known exactly what is behind the pain. Other symptoms include constipation, diarrhea, gas and bloating, mucus in the stool, and a feeling of incomplete evacuation.

According to the Rome IV criteria for diagnosis, IBS pain may get better or worse before, during, or after you defecate. This is a change from the previous Rome III criteria which says pain should be relieved by a bowel movement.

Colon Cancer

Colon cancer occurs in the large intestine and is known to affect bowel habits. Symptoms include cramping, bloating, and abdominal pain. Although pain during bowel movements may or may or may not occur, rectal bleeding is common.

Unlike hemorrhoids and anal fissures, the rectal blood seen with colon cancer will usually be dark rather than bright red. There may also be blood in stools or tarry stools.


Pregnancy does all sorts of weird things to your body. For some people, this includes a problem with pain during bowel movements. Part of the problem may lie in the fact that hormonal changes associated with pregnancy affect the functioning and sensitivity of the intestines.

Another factor may be that the weight of the developing fetus puts pressure on the organs of the digestive tract. These changes may increase the risk of painful bowel movements as well as constipation, bloating, hemorrhoids, and flatulence.


If you are a woman and your experience of pain during bowel movements are accompanied by other gynecological symptoms, the problem may be endometriosis. Endometriosis is the result of endometrial tissue growing outside the uterus.

Endometriosis occurs more frequently in women who have never given birth, started having periods at an early age, are going through menopause at an older age, or have short or especially heavy periods.

There are a wide variety of symptoms of endometriosis, with painful bowel movements being one of the more prominent.

A Word From Verywell

It is important never to self-diagnose the cause of painful bowel movement, especially if the condition is severe, persistent, or worsening. Instead, let your doctor know about your symptoms so that you can obtain an accurate diagnosis and effective treatment plan.

If you are still unable to find relief, ask your doctor for a referral to a gastroenterologist who is specially trained to identify and treat disorders of the bowel and intestinal tract.

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Article Sources
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Additional Reading
  • Minocha, A. & Adamec, C. (2011) The Encyclopedia of the Digestive System and Digestive Disorders (2nd Ed.) New York:Facts on File.