Pain During Bowel Movements

7 Causes You May Not Have Considered

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Pain during bowel movements can cause anxiety. First, you may worry about the next trip to the bathroom. Second, you may worry that something is really wrong with your health.

An occasional twinge while defecating might not be a big deal. But ongoing or severe pain is a sign something is wrong. You shouldn't ignore it.

This article looks at some common causes of pain during bowel movements.

Woman on bed bent over in pain
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Anal or Rectal Pain

Sometimes, pain during bowel movements has to do with pushing the stool out of your body. That can be caused by hemorrhoids or anal fissures.

Hemorrhoids

Hemorrhoids are swollen veins in the anus and rectum. They're usually caused by constipation.

In addition to pain during bowel movements, symptoms of hemorrhoids include:

  • Rectal itching
  • Small amounts of bright red blood on the toilet paper

Anal Fissures

An anal fissure is a tear in the lining of the anus. They're often caused by passing hard stool. On top of pain during bowel movements, symptoms include:

  • Itching
  • Bright red blood on the stool

Generally, bright red blood means the bleeding comes from near the rectum and anus. Bleeding farther up causes dark blood or tarry stools.

Recap

Ongoing pain with bowel movements is a signal that something is wrong. It may be anal or rectal pain. Those can come from hemorrhoids or anal fissures. Symptoms of both including itching and bright red blood.

Intestinal Causes

Three common health conditions involve pain from intestinal spasms and cramping associated with bowel movements.

Inflammatory Bowel Disease

Abdominal pain is a symptom of inflammatory bowel disease (IBD). That's a group of inflammatory disorders comprising Crohn's disease, and ulcerative colitis.

The pain comes from inflammation in the intestinal tract. Other IBD symptoms include:

  • Blood and/or mucus in the stool
  • Diarrhea
  • Fever
  • Reduced appetite
  • Weight loss

Irritable Bowel Syndrome

Pain with bowel movements is a hallmark symptom of irritable bowel syndrome (IBS). It's not known exactly what is behind the pain. Other symptoms include:

  • Constipation
  • Diarrhea
  • Gas and bloating
  • Mucus in the stool
  • Feelings of incomplete evacuation (like you still need to go)

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 can affect bowel habits. Sometimes it causes pain during bowel movements. Symptoms include:

  • Cramping
  • Bloating
  • Abdominal pain
  • Rectal bleeding

Unlike hemorrhoids and anal fissures, rectal blood from colon cancer is usually be dark rather than bright red. Stools may also be bloody or tarry.

Recap

Intestinal causes of painful bowel movements include Crohn's disease, ulcerative colitis, colon cancer, and possibly irritable bowel syndrome. Watch for bloody stools and other digestive symptoms.

Pregnancy

Pregnancy can cause pain during bowel movements. This may be due in part to hormonal changes that affect intestinal function and sensitivity.

Also, the weight of the developing fetus may put pressure on the organs of the digestive tract. These changes increase your risk of painful bowel movements plus:

  • Constipation
  • Bloating
  • Hemorrhoids
  • Flatulence (farting)

Endometriosis

If your bowl-movement pain goes along with other gynecological symptoms, the problem may be endometriosis. That's the result of endometrial tissue (uterine lining) growing outside the uterus.

Endometrosis has a wide variety of symptoms. Painful bowel movements are one of the more prominent. Others include:

  • Menstrual cramps
  • Heavy flow
  • Pelvic pain
  • Painful intercourse
  • Painful urination
  • Infertility
  • Nausea, bloating, and vomiting
  • Constipation and/or diarrhea

Endometriosis occurs more frequently in women who have never given birth, had periods early, are going through menopause late, or have short or especially heavy periods.

Summary

Frequent pain with bowel movements is a sign of a health problem. It may come from hemorrhoids or anal fissures. Watch for itching and bright red blood.

Crohn's disease, ulcerative colitis, colon cancer, and possibly irritable bowel syndrome can cause bowel movement pain as well. Bloody stools and other digestive symptoms can point to these causes.

The hormone changes of pregnancy affect intestinal sensitivity. That makes painful bowel movements common. Endometriosis also causes painful bowel movements due to uterine tissue growing where it's not supposed to be.

A Word From Verywell

Don't write off painful bowel movements as normal. That's especially important if the pain is severe, persistent, or getting worse.

Let your healthcare provider know about your symptoms. Then they can diagnose the problem and start treatment.

If you're not able to find relief, ask for a referral to a gastroenterologist. They're specially trained to identify and treat the bowel and intestinal tract.

Frequently Asked Questions

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14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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