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5 Causes of Painful Pooping

Find out what is causing painful bowel movements and when to see a doctor.
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Written by
Shria Kumar, MD.
Last updated April 29, 2021

Painful pooping questionnaire

Use our free symptom checker to find out what's causing your pain.

Painful pooping questionnaire

Use our free symptom checker to find out what's causing your pain.

Painful pooping symptom checker

If you feel pain while you are having a bowel movement, you shouldn’t ignore it. Pain that affects the anus, the opening at the end of the digestive tract, can be uncomfortable but isn’t usually a sign of a serious illness.

It could be caused by constipation or irritation or small tears of the tissue surrounding the anus. Less commonly, pain while pooping can be a sign of anal cancer or other conditions that need to be treated by your doctor, so it’s important to know when you need medical attention.

Is painful poop something to worry about?

"Painful poop is always caused by something. Even if it’s not 'serious,' it’s important to evaluate your bowel habits, as it can be a sign of gut health. Pooping should not be painful." —Dr. Shria Kumar

Causes

1. Constipation

Symptoms

  • Pain while having a bowel movement
  • Hard, dry stool
  • Pain in your abdomen
  • Having fewer than 3 bowel movements a week
  • Straining to have bowel movements
  • Feeling as if there’s a blockage in your rectum that prevents bowel movements

Constipation is a common cause of pain while having a bowel movement. Ideally, your bowel movements should be soft and occur regularly (at least every 1 to 2 days). But when you’re constipated, your stool is harder and drier and you have less frequent bowel movements.

Constipation can cause pain in your abdomen as it travels through your intestines and hurts your anus when you’re having bowel movements.

The main causes of constipation are:

  • Lack of fiber in your diet
  • Not drinking enough water
  • Lack of exercise
  • Bowel surgeries
  • Recent infections or antibiotic use (both can change your stool’s consistency and frequency)
  • Iron supplements
  • Pregnancy
  • Changes in hormones (you can have changes in your bowel habits at certain times of your menstrual cycle)

Constipation can sometimes be a sign of a more serious problem, such as blockages in the colon or rectum or problems with nerves or muscles control pooping. See your doctor if you have constipation and symptoms like weight loss, severe pain, or bleeding.

You can treat constipation by adding more fiber to your diet, increasing water intake (aim to drink 2 to 4 liters per day), adding stool softeners, and getting regular exercise.

Stool softeners like Dulcolax and laxatives like Miralax are available at your pharmacy without a prescription, but your doctor can prescribe stronger laxatives if needed.

Painful pooping questionnaire

Use our free symptom checker to find out what's causing your pain.

Painful pooping symptom checker

2. Anal fissures

Symptoms

  • Pain while having a bowel movement
  • Pain after bowel movements that can last for several hours
  • Bright red blood on the stool or toilet paper after wiping
  • A crack in the skin around the anus
  • A small lump or skin tag near the anal fissure

Anal fissures are tears in the skin and tissue around your anus. They usually occur when you have to pass hard stool. Other causes include chronic diarrhea and anal intercourse.

Anal fissures usually heal on their own within 2 to 4 weeks. If they don’t, or you have severe anal pain or bleeding, see your doctor. Depending on the cause of the fissures, you may need to apply prescription creams to the anus, take medications or receive injections that relax the anal sphincter, or undergo surgery.

3. Hemorrhoids

Symptoms

Hemorrhoids are swollen and inflamed blood vessels around your anus (external hemorrhoids) or inside the rectum (internal hemorrhoids). If you have external hemorrhoids, they’ll likely be visible and easy to feel. This type of hemorrhoid hurts when you have a bowel movement and even when you sit.

The main causes of hemorrhoids are constipation and straining during bowel movements. Others include pregnancy and eating a low-fiber diet.

Hemorrhoids often go away when constipation and straining are treated (with fiber, drinking more fluids, exercise, etc). Over-the-counter (OTC) hemorrhoid creams, ointments, suppositories, and pads can also help.

If lifestyle changes and OTC treatments don’t work, your doctor may recommend an in-office procedure such as injections or using rubber bands at the base of the hemorrhoids to shrink them. In some cases, surgery may be needed.

4. Irritation of the skin around the anus

Symptoms

  • Pain while having a bowel movement
  • Redness, burning, or soreness around the anus

The skin around the anus can become irritated, usually from hard or large bowel movements and toilet paper wiping. Other causes include:

  • Diarrhea
  • Skin conditions like warts or eczema
  • Tight-fitting clothing that irritates the anal area
  • Trauma to the anus

If you are noticing pain or discomfort as you wipe the area, or if you are having persistent pain, you should see your doctor. Your doctor may recommend topical creams to help healing and stool softeners so that bowel movements won’t irritate the area more.

5. Anal cancer

Symptoms

  • Pain while having a bowel movement
  • Bleeding from the anus or rectum
  • A mass or growth in the anal canal
  • Anal itching

It’s not common, but anal cancer can cause pain during a bowel movement. This type of cancer is linked to an infection called human papillomavirus (HPV). HPV is a common sexually transmitted infection. The virus is found in most cases of anal cancer. (In fact, HPV is linked to several types of cancers and the Centers for Disease Control and Prevention (CDC) recommends older children and teenagers are given a vaccine against HPV.)

Anal cancer is usually treated with a combination of chemotherapy, radiation therapy, and surgery. The treatment depends on the stage, size, and other characteristics of the tumor.

Other possible causes

In women, endometriosis may also cause painful bowel movements. Endometriosis is when the normal uterine tissue (the endometrium) grows outside the uterus.

It’s often more than one cause

"A lot of the causes of painful poop overlap. For example, if you have an anal fissure, this is the likely cause of your pain. However, the underlying cause is likely constipation. There may also be associated hemorrhoids. Treating the anal fissure will improve the pain, but treating the constipation is also a key component to ensure healing and future prevention." —Dr. Kumar

Painful pooping questionnaire

Use our free symptom checker to find out what's causing your pain.

Painful pooping symptom checker

When to call the doctor

You should call your doctor if you have persistent pain (meaning more than one or two episodes of pain). Other reasons to call the doctor include:

Should I go to the ER for painful poop?

You should go to the emergency department if you have any of these signs of a more serious problem:

  • High fever
  • Severe pain (anal or abdominal)
  • Nausea
  • Dizziness
  • Vomiting
  • Lightheadedness or dizziness
  • Large amounts of bleeding or bleeding that won’t stop

What do you need to know to make a diagnosis?

"The first things I want to establish are what your bowel habits are like, and if there are recent changes to your bathroom habits. I also want to know about other symptoms, are you having fevers or chills? Weight loss? Abdominal pain? Have you traveled or taken any medications recently?" —Dr. Kumar

Treatments

Treatment depends on the underlying cause. Options include:

  • Eating more fiber
  • Drinking more water
  • Exercising regularly
  • Taking stool softeners
  • Topical creams or ointments
  • Sitz baths (warm shallow baths)
  • In-office treatments such as injections
  • Surgery
Share your story
Dr. Kumar is a gastroenterologist, who completed her fellowship at the Hospital of the University of Pennsylvania in Philadelphia. She received her undergraduate degrees in Religious Studies and Chemistry from New York University (2010) and graduated from the Albert Einstein College of Medicine (2014), where she was inducted into the Alpha Omega Alpha Honor Medical Society. She is completing her t...
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