Common Causes of Rectal Pain

Pain in the rectum is a common experience and is not, in general, due to a serious medical condition. However, the pain can be intense and worrying. Here are the main causes of rectal pain, plus advice to calm the pain caused by each.

Anal Fissure

An anal fissure is a small tear in the skin at the opening of the rectum. It is usually caused as a result of straining and stretching the rectum when passing a hard stool. Anal fissures can also occur if the anal sphincter (the muscle that controls the anal opening) is too tight to pass stools. The pain is a sharp knifelike pain that returns during the times when the anal opening is irritated. It can be very painful during bowel movements especially if you get constipated or dehydrated. A dull throbbing pain may then take over and it may last for hours. You may see blood in your stool or on the toilet paper when you wipe.

Helpful home treatments: Eating a high fiber diet with fruit and vegetables softens the stool, making bowel movement less painful. You should also drink more liquids. You might consider using an over-the-counter stool softener. To relieve pain, take a sitz bath. This involves sitting in warm water two or three times a day for 20 minutes. It reduces the pain and helps heal the fissure. You can discuss with your doctor whether to use other remedies such as numbing cream, hydrocortisone cream, Preparation H. You may also wish to switch to moist baby wipes rather than using toilet paper.

Hemorrhoids

Hemorrhoids are swollen veins in the anus that are estimated to affect over half of all American adults.

They are also a common cause of fresh blood in bowel movements. Hemorrhoids are very painful if bowel movements are hard, but it is usually a general discomfort. If the hemorrhoids burst, the pain may be very intense, beginning suddenly and lasting for several days. If you have severe anal pain and rectal bleeding, seek care immediately.

Helpful home treatments: Take a warm sitz bath for 20 minutes three times a day. Eat a high fiber diet, drink lots of fluids, and take a fiber supplement to soften bowel movements so using the bathroom will be less painful. Apply a hemorrhoid cream and take over-the-counter pain relievers to decrease the pain. Don't strain when you defecate and don't sit on the toilet for long periods of time. See your doctor if your symptoms don't go away after one week.

Levator Ani Syndrome

Although more prevalent in women, levator ani syndrome is characterized by apparent spasms in the group of muscles that surround and support the anus. It is not known why it occurs, but it can be very painful and can last up to 20 minutes. The pain is often worse when sitting and is felt high up inside the rectum.

Helpful home treatments: Warm (not hot) sitz baths can help. You can also use over-the-counter pain relievers.

Proctalgia Fugax

Proctalgia fugax is a variation of levator syndrome with fleeting pain. The cause of proctalgia fugax pain is unknown. It is a sudden, brief and intense pain at the anal opening that usually only lasts for a minute or so, but can wake you up. It may occur in clusters, then go away and return weeks or months later. 

Helpful home treatments: As with levator syndrome, warm sitz baths and over-the-counter pain relievers are recommended.

Less Common Causes of Anal Pain

There are medical conditions that have associated rectal pain, cancer, foreign bodies in the rectum, rectal prolapse, infections and inflammatory diseases such as Crohn's disease and ulcerative colitis, and thrombosed hemorrhoids. All of these diseases are accompanied by different symptoms and a doctor will have to provide diagnosis and treatment.

Seek urgent medical intervention if:

• Your pain becomes more severe and regular
• You have a fever
• You have an infectious rectal discharge
• The pain spreads to other areas of your body
• You have a large bleed or increasing amount of blood loss
• You have suffered a recent physical trauma

If you are concerned with any physical symptoms then you should always see your doctor.

Still, it is better not to be complacent and get a diagnosis so that you know what you are dealing with and so you can then get the best treatments to relieve the problem.