9 Rectal Pain Causes, Symptoms and Relief Options

Understand your rectal pain symptoms, including 9 causes & treatment options for your rectal pain.

This symptom can also be referred to as: anal pain

Rectal Pain Symptom Checker

Take a quiz to find out what might be causing your rectal pain

Contents

  1. Symptoms
  2. Causes
  3. 9 Possible Rectal Pain Conditions
  4. Treatments and Relief
  5. FAQs
  6. Questions Your Doctor May Ask
  7. Statistics
  8. Related Articles
  9. References

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 [2].

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 [2,3].

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 [4]. In the case of hemorrhoids, the blood vessels of the veins carrying blood away from the rectum start to leak blood [5]. 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 [6].
  • 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 [7].
  • 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 [8]. Additionally, some rare musculoskeletal conditions can cause rectal pain due to hypersensitivity or muscle spasms, such as proctalgia fugax and myofascial pelvic pain syndrome [9].
  • 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 [10,11].

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 [2,12]. Rectal ulcer syndrome is another cause of rectal inflammation that may be due to the immune system targeting the rectal tissue [13].
  • Infection: A number of different viral, bacterial, and parasitic infections can lead to rectal pain [10,12,14]. You are most susceptible if you engage in anal sex, [10] travel to places where parasitic infections are endemic, [14] or if you have any cuts in the anal or rectal area [15].

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 [2,15].
  • 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 [16].

9 Possible 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.

Hemorrhoids

Hemorrhoids, also known as piles, are swollen veins in your anus and lower rectum that can cause pain, itching, and rectal bleeding. Hemorrhoids may be seen or felt on the outside of the anus (external) or may be hidden from view inside of the rectum.

Hemorrhoids are common occurring in 10 million Am...

Read more

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 objec...

Read more

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

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 doctor

Rectal Pain Symptom Checker

Take a quiz to find out what might be causing your rectal pain

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

Coccydynia

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

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 inflammation of the prostate gland, located between the bladder and penis, which produces fluid that nourishes and protects sperm. Chronic prostatitis is distinguished from acute prostatitis in that chronic prostatitis has caused symptoms for at least three...

Read more

Cellulitis

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.

Symptom 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

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

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 [19]
  • You are experiencing rectal bleeding that is accompanied by lightheadedness or dizziness [18,19]
  • 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 [17]
  • You develop any open wounds in the anorectal area [17]

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 [3].
  • 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 [5].

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

To diagnose this condition, your doctor would likely ask the following questions:

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

If you've answered yes to one or more of these questions

Please take a quiz to find out what might be causing your rectal pain. These questions are also covered.

Rectal Pain Quiz

Rectal Pain Symptom Checker Statistics

People who have experienced rectal pain have also experienced:

  • 8% Abdominal Pain (Stomach Ache)
  • 5% Rectal Bleeding
  • 4% Anal Itching

People who have experienced rectal pain were most often matched with:

  • 33% Hemorrhoids
  • 33% Anal Fissure
  • 33% Chronic Or Recurrent Hemorrhoids

People who have experienced rectal pain had symptoms persist for:

  • 31% Over a month
  • 27% Less than a week
  • 22% Less than a day

Source: Aggregated and anonymized results from Buoy Assistant (a.k.a. the quiz).

Rectal Pain Symptom Checker

Take a quiz to find out what might be causing your rectal pain

References

  1. Proctalgia. MUSC Health. MUSC Health Link
  2. Anal Pain (Proctalgia). NHS. Updated July 26, 2016. NHS Link
  3. Anal Discomfort and How to Deal with It. IFFGD. Updated September 9, 2015. IFFGD Link
  4. Kessels IM, Ftterer JJ, Sultan AH, Kluivers KB. Clinical Symptoms Related to Anal Sphincter Defects and Atrophy on External Phased-Array MR Imaging. International Urogynecology Journal. 2015;26(11):1619-1627. NCBI Link
  5. Self-Help Steps to Get Through Hemorrhoid Flare-Ups. Harvard Medical School: Harvard Health Publishing. Published July 2013. Harvard Health Publishing Link
  6. Poinier AC, Husney A, Mercer CD, eds. Rectal Prolapse. University of Michigan: Michigan Medicine. Updated May 5, 2017. UofM Health Link
  7. Disorders of the Large Intestine. IFFGD. Updated March 24, 2016. IFFGD Link
  8. Moghaddasi M, Aghaii M, Mamarabadi M. Perianal Pain as a Presentation of Lumbosacral Neurofibroma: A Case Report. Journal of Neurological Surgery Reports. 2014;75(2):e191-e193. NCBI Link
  9. Bharucha AE, Trabuco E. Functional and Chronic Anorectal and Pelvic Pain Disorders. Gastroenterology Clinics of North America. 2008;37(3):685-ix. NCBI Link
  10. Anal Cancer. NHS. Updated September 8, 2018. NHS Link.
  11. Colorectal Polyps. Virginia Mason Medical Center. Virginia Mason Medical Center Link
  12. Phillips MM, Zieve D, Conaway B, eds. Proctitis. Mount Sinai. Updated April 24, 2017. Mount Sinai Link
  13. Torres C, Khaikin M, Bracho J, et al. Solitary Rectal Ulcer Syndrome: Clinical Findings, Surgical Treatment, and Outcomes. International Journal of Colorectal Disease. 2007;22(11):1389-1393. NCBI Link.
  14. Yau AH, Chu K, Yang HM, Ko HH. Rectal Ulcers Induced By Systemic Lupus Erythematosus. BMJ Case Reports. 2014;2014:bcr2014205776. NCBI Link
  15. Cho DH, Lee SH, Jung MJ, Lee JG. Management of Perirectal Laceration Without Fecal Diversion: A Case Report. Journal of the Korean Society of Traumatology. 2017;30(2):55-58. Journal of the Korean Society of Traumatology Link
  16. Pelvic Floor Dysfunction Expanded Version. American Society of Colon and Rectal Surgeons. ASCRS Link
  17. Safar B, Sands D. Perianal Crohn's Disease. Clinics in Colon and Rectal Surgery. 2007;20(4):282-93. NCBI Link
  18. When to Go to the ER. UnitedRegional Physician Group. UR Physician Group Link
  19. Rectal Bleeding. Cleveland Clinic. Updated January 27, 2015. Cleveland Clinic Link