Read below about rectal pain, including causes, treatment options and remedies. Or get a personalized analysis of your rectal pain from our A.I. health assistant. At Buoy, we build tools that help you know what’s wrong right now and how to get the right care.

This symptom can also be referred to as:
Anal pain

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Rectal Pain Symptoms

Whether prolonged or intermittent, rectal pain can be a very unnerving symptom. Sometimes the origin of rectal pain is clear, but at other times the origin of the pain is more mysterious. [2]

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

Oftentimes these rectal pain symptoms are self-limited. However, if you experience any of the above symptoms frequently or for a prolonged period of time, it is best to make an appointment with your doctor. [2]

Rectal Pain Causes Overview

Rectal pain occurs because the nerves in the rectal, pelvic, or anal area are transmitting pain signals to the brain. The nerves that transmit these pain signals receive sensory information from muscles, bones, and skin layers in the area, so there are a number of different possible causes for rectal pain symptoms. [1,3] While there are many different possible causes for rectal pain, they can be classified in the following manner:

Systemic disease causes:

  • Rectal atrophy: As part of the aging process, the skin and muscle tissues that form the rectum become weaker, 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 a problem causing inflammation in structures near the rectum, it's possible for one to experience "referred pain" in the rectum even though there is no rectal involvement. 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:

  • Autoimmune disease: Patients with autoimmune diseases that affect the gastrointestinal tract, such as Crohn's Disease or ulcerative colitis, can experience painful inflammatory episodes that cause rectal pain. [2,12] Rectal ulcer syndrome is another much less common 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] Those who are most susceptible to such infections include those who engage in anal sex, [10] those who have traveled to places where parasitic infections are endemic, [14] or those who have any cuts in the anal or rectal area that could allow pathogens to enter. [15]

Environmental causes:

  • 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 constraining the bowel wall or the growth of a colorectal tumor that then blocks passage through the intestinal lumen. While most cases of bowel obstruction will primarily cause abdominal pain, it is possible for one to also experience rectal pain in such instances. [16]

A.I. Health Assistant Causes for Rectal Pain

The list below shows results from the use of our A.I. Health Assistant by Buoy users who experienced rectal pain. This list does not constitute medical advice.

  1. 1.Hemorrhoids

    Hemorrhoids are a very common condition that affects more 50% of the population, typically after the age of 30. Hemorrhoids are enlarged, bulging blood vessels in the anus that can bleed or clot.

    Chronic and can worsen with time. But, 90% of people are successfully managed with non-surgical treatments.

    Rarity:
    Common
    Top Symptoms:
    constipation, rectal pain, rectal bleeding, pain when passing stools, anal itching
    Symptoms that never occur with hemorrhoids:
    unintentional weight loss
    Urgency:
    Self-treatment
  2. 2.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.

    Conservative treatment leads to 50% healing rate. More aggressive treatments are needed for those with chronic anal fissures.

    Rarity:
    Common
    Top Symptoms:
    rectal pain, pain when passing stools, painful rectal bleeding, hard stools, mild rectal bleeding
    Symptoms that never occur with anal fissure:
    unintentional weight loss
    Urgency:
    Self-treatment
  3. 3.Chronic or Recurrent Hemorrhoids

    Hemorrhoids are a very common condition that affects more 50% of the population, typically after the age of 30. Hemorrhoids are the "varicose veins of the anus and rectum" - enlarged, bulging blood vessels in the anus that can bleed or clot.

    Chronic hemorrhoids can worsen with time. But, 90% of people are successfully managed with non-surgical treatments.

    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
  4. 4.Piriformis Syndrome

    Piriformis syndrome is a condition when a muscle spanning the lower spine to the top of the thighbone presses upon the sciatic nerve, causing pain and numbness.

    1-2 months

    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 Checker

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  5. 5.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.

    60% of people will heal with the pain-relieving cream. 30% will require a surgical option.

    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
  6. 6.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.

    May take weeks to months for significant pain relief to set in.

    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
  7. 7.Chronic Prostatitis

    Prostatitis is swelling and irritation of the prostate gland. The prostate gland sits under the bladder, near the rectum, and produces the fluid that carries sperm.

    1/3 of men say symptoms go away by themselves after 1 year. With treatment, course is dependent on underlying cause.

    Rarity:
    Common
    Top Symptoms:
    urinary changes, painful urination, testicle pain, frequent urination, penis pain
    Urgency:
    Primary care doctor
  8. 8.Cellulitis

    Facial cellulitis is a skin infection that typically comes from other parts of the face like the mouth or the sinuses and needs antibiotic treatment. Symptoms can be pain, redness, warmth and swelling of the affected area.

    Dependent on severity of infection

    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
  9. 9.Colonic Neoplasm

    Colonic neoplasm is a disorder of the large intestine. It often causes abdominal pain, cramping, changes in bowel habits, and fatigue.

    The treatment & prognosis for colonic neoplasm are variable and dependent on the disease severity.

    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. However, as rectal pain can be a symptom of a serious underlying issue, it is very important to seek the appropriate medical guidance. [2] When deciding whether to make a doctor's appointment, go to the emergency room, or just try some small changes at home, consider the following:

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 F). [18]
  • Your pain is accompanied by constipation and a complete absence of flatulence. [20]

Schedule an appointment with your doctor if:

  • You have rectal pain mainly in the context of defecation. [2]
  • You notice blood-tinged feces or droplets of blood on the toilet paper or in the toilet bowl after defecation. [2]
  • You experience intermittent attacks or spasms of severe rectal pain lasting <5 minutes. [21]
  • You notice any new skin growths in the anorectal area. [17]
  • You develop any open wounds in the anorectal area. [17]

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

  • 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]
  • For low-grade hemorrhoids, a number of over-the-counter topical analgesics and corticosteroid creams and ointments can be used for temporary relief of associated itching, bleeding, or pain. However, these should not be used for longer than 7-10 days, as prolonged use can irritate the skin. Ultimately, it is best to ask for the advice of a physician in order to address the underlying rectal pain cause and find 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 either direct immediate trauma, repetitive minor trauma, childbirth, arthritis, as well as bone spurs. Additionally, less common causes include depression, as well as various types of benign or malignant tumors. [16] None of these causes are known for also causing rectal pain, though tumors can if they grow large enough. However, this is uncommon. [21]

Why do I have rectal pain when I poop?

Rectal pain may be caused by many things. Common questions to determine the cause include the quality of feces and whether or not blood is present in the bowl, in the feces, or on the feces. Blood present in the feces is often a sign of a small tear, called an anal fissure, which can hurt or burn during defecation. [2] A much rarer cause includes proctalgia fugax in which the muscles of the anus and rectum spasm in association with pain. [2]

What causes spasms in the rectal area?

Proctalgia fugax is an uncommon disorder in which muscle spasms or growth of muscles surrounding the rectum and anus, nerve compression of the pudendal nerve, innervating the perinuem, and stress and other psychological concerns contribute to rectal area spasms. It is known that increased severity and duration of pain is associated with more tense pain in the anal area. [2,8]

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. Pains during defecation can be caused by hemorrhoids or anal fissures. Pains following a duration of constipation can be because of distention of the rectus. To find the cause of sharp pains during defecation, it is necessary to both examine and ask about associated symptoms individually. If you are experiencing sharp pains with no known cause, seek medical evaluation. [2,3]

Why do I have rectal pain while sitting?

Rectal pain while sitting may be pain in the tailbone (coccydynia) caused by continued sitting and pressure upon it from sitting on a seat with inadequate padding. Anal fissures can also cause pain when sitting as pressure is exerted on the anal tears that are present. Bruises from trauma can also cause pain while sitting. [2,16]

Questions Your Doctor May Ask About Rectal Pain

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

If you've answered yes to one or more of these questions, try our rectal pain symptom checker to find out more.

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 had symptoms persist for:

    • 31% Over a Month
    • 27% Less Than a Week
    • 22% Less Than a Day
  • People who have experienced rectal pain were most often matched with:

    • 33% Hemorrhoids
    • 33% Anal Fissure
    • 33% Chronic or Recurrent Hemorrhoids
  • Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

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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, Fütterer 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.
  20. Gastrointestinal Complications (PDQ). Siteman Cancer Center. Updated May 10, 2017. Siteman Cancer Center Link.
  21. Rare and Uncommon Symptoms of Colon Cancer. Regional Cancer Care Associates. Published September 20, 2018. RCCA Link.