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9 Rectal Pain Causes, Symptoms and Relief Options

Rectal pain can be sharp or itchy, and hurt when you sit or walk. It is often caused by pressure from constipation, irritation from hemorrhoids, or an anal fissure. There are creams that can ease inflammation and pain, and ways to treat the underlying conditions.
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Last updated June 26, 2024

Rectal pain quiz

Take a quiz to find out what's causing your pain.

7 most common cause(s)

Rectal pain quiz

Take a quiz to find out what's causing your pain.

Take rectal pain quiz

Rectal pain symptoms

Rectal pain can be a strange symptom, and you might try to ignore it; however, this is probably difficult if it persists. The origin of rectal pain is sometimes clear, but at other times the origin of the pain is more mysterious.

Common accompanying symptoms of rectal pain

It is important to take note of the timing of the pain and any associated rectal pain symptoms, such as:

  • Rectal bleeding
  • Anal or rectal muscle spasms
  • Incontinence
  • Anal or rectal skin tags, bumps, or growths
  • Open anal or rectal wounds
  • Itchiness, burning, or sensitivity affected area
  • Constipation

Rectal pain symptoms are often self-limited, meaning they go away on their own. However, if you frequently experience any of the above symptoms or they're lasting, it is best to make an appointment with your doctor.

Rectal pain causes

Rectal pain occurs because the nerves in the rectal, pelvic, or anal area are transmitting pain signals to the brain. There are a number of different possible causes of rectal pain.

Systemic disease causes

Rectal pain may be due to systemic disease, such as the following.

  • Rectal atrophy: The skin and muscle tissues that form the rectum become weaker as you age, which can lead to a number of problems including hemorrhoids and rectal prolapse. In the case of hemorrhoids, the blood vessels of the veins carrying blood away from the rectum start to leak blood. On the other hand, rectal prolapse occurs when the muscles holding the rectum in place become weaker, causing the rectum to drop below its normal position and sometimes beyond the anus.
  • Digestive disorders: There are a number of different digestive problems that can cause rectal pain. Ultimately, any condition that causes either excessive bowel movements or constipation can cause rectal pain symptoms.
  • Musculoskeletal and referred pain: Any time there is inflammation in structures near the rectum, it's possible for to experience "referred pain" in the rectum. Common causes of such referred pain include pelvic or prostate infection and sacral hypersensitivity. Additionally, some rare musculoskeletal conditions can cause rectal pain due to hypersensitivity or muscle spasms, such as proctalgia fugax and myofascial pelvic pain syndrome.
  • Tumor: A number of different benign and cancerous growths can lead to rectal pain that is often accompanied by rectal bleeding. The most common examples in this category include colorectal cancer, anal cancer, and rectal polyps.

Inflammatory or infectious causes

Rectal pain may be the result of inflammation or infections, such as the following.

  • Autoimmune disease: People with autoimmune diseases that affect the gastrointestinal tract, such as Crohn Disease or ulcerative colitis, can experience painful inflammatory episodes that cause rectal pain. Rectal ulcer syndrome is another cause of rectal inflammation that may be due to the immune system targeting the rectal tissue.
  • Infection: A number of different viral, bacterial, and parasitic infections can lead to rectal pain. You are most susceptible if you engage in anal sex, travel to places where parasitic infections are endemic, or if you have any cuts in the anal or rectal area.

Environmental causes

Environmental causes of rectal pain may be related to habits or certain events.

  • Mechanical irritation: Any form of mechanical irritation to the anorectal area can lead to rectal pain. In some cases, a tear in the lining of the anus or rectum can occur due to irritation associated with constipation, diarrhea, or anal penetration with a foreign body.
  • Obstruction: Colorectal obstruction refers to an interruption of the normal flow of bowel contents. This can happen for a number of different reasons, such as an abdominal stricture that's affecting the bowel wall or growth of a colorectal tumor. Most cases of bowel obstruction will primarily cause abdominal pain; however, it is possible to also experience rectal pain.

9 rectal pain conditions

The list below shows results from the use of our quiz by Buoy users who experienced rectal pain. This list does not constitute medical advice and may not accurately represent what you have.

Piriformis syndrome

Piriformis syndrome

The two piriformis muscles, left and right, each run from the base of the pelvis to the top of the thighbone. The two sciatic nerves, left and right, are each attached to the spine and run down between the pelvic bone and the piriformis muscle to the back of each leg.

If the piriformis muscle is damaged through sudden trauma, or through overuse as in sports, the resulting inflammation or spasm of the muscle can trap the sciatic nerve between the pelvic bone and the muscle.

Piriformis syndrome is most often found in women over 30.

Symptoms include pain over one or both sides of the low back, and shooting pain (sciatica) down one or both legs.

Diagnosis is made through physical examination and sometimes imaging such as CT scan or MRI.

Treatment involves rest; over-the-counter, nonsteroidal anti-inflammatory drugs; physical therapy; therapeutic injections; and, rarely, surgery.

The best prevention is a good regimen of stretching before exercise, to help prevent damage to the piriformis.

Rarity: Common

Top Symptoms: pelvis pain, butt pain, pain when passing stools, leg numbness, hip pain

Symptoms that never occur with piriformis syndrome: involuntary defecation, leaking urine

Urgency: Primary care docto


Hemorrhoids, or "piles," are swollen veins in the anus or rectum. They may be located inside the rectum (internal) or outside the body at the anus (external.)

The condition is caused by straining during bowel movements and/or from increased pressure during pregnancy and childbirth.

Hemorrhoids are a common occurrence, especially in older people. Pregnant women are susceptible, as is anyone who has chronic constipation or is obese.

Symptoms include discomfort, pain, pressure, and itching. There may be small amounts of bleeding during bowel movements, though some hemorrhoids cause no symptoms at all.

Severe pain can indicate a thrombosed hemorrhoid, meaning a clot has formed within it. This is not serious but the pain can be debilitating and requires treatment right away. Also, rectal bleeding can also be a sign of more serious diseases such as diverticulitis or cancer and should always be diagnosed by a medical provider.

Diagnosis is made through physical examination and sometimes through colonoscopy.

Treatment begins with good hygiene, cold compresses, and over-the-counter pain relievers. Surgery may be done for some cases.

Colonic neoplasm

Colonic neoplasm means "new tissue" growing in the colon, or large intestine. This neoplasm may be either benign (not cancerous) or malignant (cancer.)

The exact cause of any cancer remains unknown. Risk factors seem to be:

  • Being over fifty years of age.
  • Family history of the disease.
  • A high-fat, low-fiber diet, typical in the modern world
  • Chronic inflammatory diseases of the colon such as Crohn's disease.
  • Smoking and alcohol use.
  • Diabetes, obesity, and inactivity.

The earliest symptoms are usually polyps, small growths within the colon which can be detected on colonoscopy and removed before they can become cancerous. Later symptoms may be unexplained fatigue; change in bowel habits; persistent abdominal discomfort such as gas or cramps; blood in stool; or rectal bleeding.

Diagnosis is made through colonoscopy and sometimes blood testing.

Treatment is done through surgery, which may be minor or extensive; and through chemotherapy with radiation therapy, usually done before and after surgery. Supportive care to keep the patient comfortable is also an important part of treatment.

Rarity: Rare

Top Symptoms: fatigue, stomach bloating, stool changes, diarrhea, constipation

Urgency: Primary care doctor


The tailbone, called the coccyx, is the lowest part of the spine. Coccydynia is pain around the area of the tailbone, which is triggered by activities that cause pressure on the tailbone such as sitting on a hard chair. Symptoms get better with standing or walking. Doctors are not completely sure what causes this pain.

You can safely treat this condition on your own. This condition has no directed treatment, so you are advised to take over-the-counter pain medication and take pressure off the tailbone by sitting on a soft cushion whenever possible.

Rarity: Uncommon

Top Symptoms: back pain, lower back pain, painful sex, back pain that shoots to the butt, constant butt pain

Symptoms that always occur with coccydynia: constant butt pain

Symptoms that never occur with coccydynia: warm and red tailbone swelling

Urgency: Self-treatment

Chronic prostatitis

Chronic prostatitis is an ongoing inflammation or infection of the prostate gland, the small, walnut-shaped organ just below the bladder in men.

Prostatitis is most often due to common bacteria in the urine causing infection. It may also be caused by surgery or other trauma setting up an inflammation. In some cases, the cause remains unknown.

Men of all ages are susceptible. Risk factors include a past urinary tract infection; using a catheter for urination; or pelvic trauma from bike riding or horseback riding.

Symptoms include pain in the abdomen, low back, groin, and genitals; frequent need to urinate; pain, burning, and difficulty when urinating; urine that is cloudy or bloody; and painful ejaculation.

A medical provider should be seen for these symptoms, since a bacterial infection can spread and lead to scarring, pain, and infertility.

Diagnosis is made through urine tests, blood tests, and ultrasound or CT scan.

Treatment involves antibiotics for bacterial prostatitis, though if all the bacteria are not destroyed the disease can become chronic. Nonsteroidal anti-inflammatory drugs are also helpful.


Cellulitis is a bacterial infection of the deep layers of the skin. It can appear anywhere on the body but is most common on the feet, lower legs, and face.

The condition can develop if Staphylococcus bacteria enter broken skin through a cut, scrape, or existing skin infection such as impetigo or eczema.

Most susceptible are those with a weakened immune system, as from corticosteroids or chemotherapy, or with impaired circulation from diabetes or any vascular disease.

Symptoms arise somewhat gradually and include sore, reddened skin.

If not treated, the infection can become severe, form pus, and destroy the tissue around it. In rare cases, the infection can cause blood poisoning or meningitis.

Symptoms of severe pain, fever, cold sweats, and fast heartbeat should be seen immediately by a medical provider.

Diagnosis is made through physical examination.

Treatment consists of antibiotics, keeping the wound clean, and sometimes surgery to remove any dead tissue. Cellulitis often recurs, so it is important to treat any underlying conditions and improve the immune system with rest and good nutrition.

Rarity: Uncommon

Top Symptoms: fever, chills, facial redness, swollen face, face pain

Symptoms that always occur with cellulitis: facial redness, area of skin redness

Urgency: Primary care doctor

Anal fissure

An anal fissure is a break, or tear, in the mucous membrane lining of the anus. The anus is the opening at the end of the digestive tract where stool leaves the body.

A fissure is caused primarily by constipation, which leads to straining to pass large hard stools; trauma caused by insertion of objects or by anal sex; and illnesses such as any type of inflammatory bowel disease or sexually transmitted disease.

Symptoms include pain and bleeding during and after a bowel movement; discomfort and difficulty with urination; and a visible tear, resembling a crack, in the anal tissue that may have a foul-smelling discharge.

Diagnosis is made through physical examination.

Treatment primarily involves relieving constipation, and the straining it causes, by adding fiber and more fluids to the diet; and easing anal irritation by soaking in a warm bath and gently cleansing the tissues of the anus. In some cases, medicated creams or suppositories may be prescribed.

Chronic or recurrent hemorrhoids

Chronic, or recurrent, hemorrhoids are swollen veins in the anus and rectum that never really resolve and may be symptomatic more or less constantly.

Hemorrhoids are caused by anything that puts pressure on the anus from the inside, such as straining during bowel movements; constipation; pregnancy; or anal intercourse.

Most susceptible are pregnant women and older people, though anyone can be affected.

Symptoms include a small amount of bleeding during or after a bowel movement, as well as discomfort, itching, or swelling around the anus.

A medical provider can suggest treatment to ease the symptoms of chronic hemorrhoids, as well as make certain of the diagnosis since other, more serious conditions can have symptoms similar to hemorrhoids.

Diagnosis is made through patient history and physical examination.

Treatment most often involves simple lifestyle changes such as drinking more water; adding fiber-rich foods to the diet; using fiber supplements and stool softeners; not delaying, or straining, to pass a bowel movement; and using topical medications. Surgical procedures to remove the hemorrhoid can be used in some cases.

Rarity: Common

Top Symptoms: rectal bleeding, rectal pain, pain when passing stools, anal itching, painless rectal bleeding

Symptoms that never occur with chronic or recurrent hemorrhoids: unintentional weight loss

Urgency: Self-treatment

Chronic anal fissure

Anal fissures are splits or tears in the part of the anus closest outside of the body. They're very common and typically affect the young and middle-aged and both genders, equally. 11% of people will have an anal fissure in their lifetime.

Rarity: Uncommon

Top Symptoms: rectal pain, pain when passing stools, painful rectal bleeding, hard stools, mild rectal bleeding

Symptoms that never occur with chronic anal fissure: unintentional weight loss

Urgency: Primary care doctor

Rectal pain treatments and relief

Rectal pain can be uncomfortable, but it can also feel like an awkward issue to discuss with a physician. Rectal pain can be a sign of a serious underlying issue, so it is important to seek medical guidance.

When rectal pain is an emergency

You should head to the emergency room if:

  • You are experiencing profuse rectal bleeding: Especially if bleeding occurs in the absence of defecation
  • You are experiencing rectal bleeding that is accompanied by lightheadedness or dizziness
  • Your pain is accompanied by persistent high fever: >103 degrees Fahrenheit
  • Your pain is accompanied by constipation and a complete absence of flatulence

When to see a doctor for rectal pain

Schedule an appointment with your doctor if:

  • You have rectal pain mainly in the context of defecation
  • You notice blood-tinged feces: Or droplets of blood on the toilet paper or in the toilet bowl after defecation.
  • You experience intermittent attacks or spasms of severe rectal pain lasting more than 5 minutes
  • You notice any new skin growths in the anorectal area
  • You develop any open wounds in the anorectal area

At-home treatments for rectal pain

Sometimes you can try a few things at home before seeking medical attention for rectal pain symptoms.

  • Increase your water and fiber intake: If you suspect that your rectal pain is in any way associated with constipation or difficulty passing stool, try drinking more fluids and adding more fiber-rich foods (such as fresh fruits and vegetables) to your diet.
  • To address hemorrhoids or irritation: For low-grade hemorrhoids, a number of over-the-counter topical medications can be used for temporary relief of itching, bleeding, or pain. However, these should not be used for longer than seven to 10 days, as prolonged use can irritate the skin. It is best to consult your physician for a long-term solution.

FAQs about rectal pain

Here are some frequently asked questions about rectal pain.

Can tailbone pain cause rectal pain?

Tailbone pain is commonly known as coccydynia. Coccydynia can be caused by a number of things, including trauma, childbirth, arthritis, or bone spurs. Less common associated causes include depression as well as various types of tumors.

Why do I have rectal pain when I poop?

Rectal pain may be caused by many things. You should consider what kind of stool you are having as well as if there is blood present. The presence of blood is often a sign of a small tear, called an anal fissure, which can be painful or burning. Proctalgia fugax is a rarer cause in which the muscles of the anus and rectum spasm in association with pain.

What causes spasms in the rectal area?

Proctalgia fugax is an uncommon disorder in which muscle spasms affect the muscles surrounding the rectum and anus. Nerve compression of the pudendal nerve, stress, and other psychological concerns can contribute to spasms.

Why do I get a sharp pain in my anus?

Sharp pains in the anus are hard to identify in the absence of other symptoms. Pain while defecating can be caused by hemorrhoids or anal fissures. Pain following constipation can be due to rectal distension. To find the cause of sharp pains during defecation, it is necessary to examine associated symptoms individually. If you are experiencing sharp pains with no known cause, seek medical evaluation.

Why do I have rectal pain while sitting?

Pain while sitting may be due to continued pressure on the tailbone (coccydynia) or a poorly padded seat. Anal fissures and bruises from trauma can also cause pain while sitting.

Questions your doctor may ask about rectal pain

  • Have you had any changes in your weight?
  • Do your symptoms worsen when sitting?
  • Do you have a rash?
  • Are you sexually active?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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