By Medicover Hospitals / 08 Mar 2021
Painful bowel movements are extremely common. Another term is dyschezia. Most people will experience a painful stool once. If this is a one-time or isolated event, you probably don't need to be too concerned. However, if you would describe most of your stools as painful, there could be an underlying cause.
- What is Painful bowel movements?
- When to visit a Doctor?
What is Painful bowel movements?
Painful bowel movements can cause a lot of discomforts. There are many potential causes. Some are easily treatable, but others like anal cancer can be more serious. It is normal to occasionally feel slight pain when having a bowel movement. However, when this happens regularly, it can show an underlying medical condition.
There are a variety of potential causes of painful stools. It is important to always see your doctor if you experience pain or discomfort. Here are some of the most common causes of pain during bowel movements.
Constipation and diarrhea:
Occasionally we eat something that doesn't agree with us, have unusual levels of stress, inadequate hydration, an interruption in our normal routine, or any other event that can cause an attack of constipation or diarrhea. Painful stools can accompany both diarrhea and constipation, but if you experience constipation or constant diarrhea, it is always important to see your doctor determine the cause.
Food intolerance, also known as food allergies, is a common culprit for painful stools. Two of the most common food sensitivities are lactose and gluten. Keep a food diary to track the foods you eat and whether you experience pain when moving your bowels to determine any correlation. Consult your doctor to investigate food sensitivities or potential allergies.
Hemorrhoids occur when there are swollen veins around the anus. Prolonged periods of sitting can cause this, straining to have a bowel movement, pregnancy, or weight gain.
A fissure is when you get a tear in the anus's skin; during a bowel movement, and it can be very painful. Cracks are most often caused by passing a hard stool, local trauma, or childbirth.
Proctitis (inflammation of the rectum) and anusitis (inflammation of the anus) have symptoms similar to those of hemorrhoids. However, proctitis and anusitis are usually caused by conditions such as ulcerative colitis, STIs or STDs, infections of the colon, or the consumption of certain medications or foods.
Inflammatory bowel syndrome:
If you experience pain before, during, and after a bowel movement as well as constipation, diarrhea, bloating, gas, and incomplete emptying of the bowel, you may have inflammatory bowel disease (IBS). See your physician for a proper diagnosis.
Side effects of other medical problems:
There is a wide range of medical conditions that can lead to painful stools as a side effect. These include (but are not limited to) irritable bowel syndrome ("IBS"), endometriosis, certain skin conditions, and certain cancers. Before jumping to the conclusion that you have any of these more serious medical conditions, it is essential to see a doctor.
- Hemorrhoids: More serious hemorrhoids may need to be removed surgically.
- Proctitis: Have an operation to remove damaged areas of your colon. Get treatments like argon plasma coagulation (APC) or electrocoagulation.
- Inflammatory bowel disease (IBD): Removal of parts of your colon or rectum, leaving a small pocket from your small intestine to your anus or outside of your body for collection.
- Diarrhea: Treatment for diarrhea usually involves rehydration, inserting an intravenous line if necessary, or antibiotics.
- Anal fissure: These are not too serious and usually go away without medical treatment in a little over a month.
- Endometriosis: Minimally invasive laser surgery to remove tissue. Last resort surgical removal of the uterus, cervix, and ovaries to stop menstruation and tissue growth.
- Anal or rectal cancer: Treatment for these cancers may include:
- chemotherapy injections or pills to kill cancer cells
- surgery to remove anal or rectal tumors and prevent the spread of cancerous tissue, possibly removing your entire rectum, anus, and parts of your colon if cancer has spread
- radiation therapy to kill cancer cells
- regorafenib (Stivarga) for advanced rectal cancer to stop the growth of cancer cells
When to visit a Doctor?
Seek immediate medical attention if you have:
- pain or bleeding for a week or more
- fever or unusual tiredness
- unusual bleeding or discharge when you poop
- pain or other symptoms after sex, especially with a new partner
- severe abdominal or back pain and cramps
- newly formed bumps near your anus
Try the following prevention tips for underlying causes:
- Take a hot bath for 10 minutes every day for pain relief.
- Apply a topical hemorrhoid cream for itching or burning.
- Eat more fiber foods or take fiber supplements, such as psyllium.
- Use a sitz bath.
- Wash your anus every time you bathe or shower with lukewarm water and mild, unscented soap.
- Use soft toilet paper when wiping. Consider using a bidet for a gentler cleaning.
- Apply a cold compress to help swell.
- Take nonsteroidal anti-inflammatory drugs (NSAIDs) for pain, including ibuprofen (Advil) or naproxen (Aleve).
- Drink plenty of water - at least 64 ounces a day - to stay hydrated.
- Cut back on caffeine and alcohol.
- Eat lots of fiber or take fiber supplements.
- Eat foods that contain probiotics, like Greek yogurt.
- Cut back on foods that can cause constipation, such as meat and dairy products.
- Do about 30 minutes of light exercises, such as walking or swimming, each day to keep your bowels moving.
- Go into the bathroom as you feel it coming to keep the stool from getting hard or stuck.
- Try laxatives for severe cases, but talk to your doctor before taking them.
- Use condoms or other protection when you have sex.
- Avoid sexual contact with anyone who has visible lumps or sores in the genital area.
- Take antibiotics or antivirals prescribed for infections, such as doxycycline (Vibramycin) or acyclovir (Zovirax).
- Take any medicine prescribed for the side effects of radiation, such as mesalamine (Canasa) or metronidazole (Flagyl).
- Take over-the-counter stool softeners to help soften the stool.
Inflammatory bowel disease (IBD):
- anti-inflammatory drugs, such as mesalamine (Delzicol) or olsalazine (Dipentum)
- immunosuppressants, such as azathioprine or methotrexate (Trexall)
- medicines to control your immune systems, such as adalimumab (Humira) or natalizumab (Tysabri)
- antibiotics for infections, such as metronidazole (Flagyl)
- medicines for diarrhea, such as methylcellulose (Citrucel) or loperamide (Imodium A-D)
- pain relievers, such as acetaminophen (Tylenol)
- iron supplements to limit anemia because of bleeding intestines
- calcium or vitamin D supplements to reduce your risk of osteoporosis from Crohn's disease
- a diet low in meat, low in dairy, and moderate in fiber with small amounts of caffeine and alcohol
- Wash your hands for at least 20 seconds with soap and water before and after eating
- Wash and cook food properly, eat it right away, and quickly put leftovers in the fridge
- Ask your doctor about antibiotics before you travel to a new country
- Do not drink tap water when traveling and do not eat food washed in tap water. Use only bottled water
- take stool softeners
- hydrate with water and water-rich foods
- eat about 20 to 35 grams of fiber per day
- taking a sitz bath to improve blood circulation and help muscles relax
- applying hydrocortisone cream or ointment to reduce inflammation
- using pain-relieving ointments, such as lidocaine, to reduce pain
- pain medications, such as ibuprofen (Advil)
- hormonal therapy to regulate tissue growth
- birth control, such as medroxyprogesterone (Depo-Provera) injections, to reduce tissue growth and symptoms
- gonadotropin-releasing hormone (GRNH) to reduce estrogen, which handles tissue growth
Frequently Asked Questions:
Hemorrhoids usually last for several days and recur often. Anal fissures often cause pain during and after a bowel movement, sometimes followed by shooting pain for several hours. They are also often associated with itching and blood on the toilet paper, in the toilet bowl, or on the surface of the stool.
Anal fissure causes bleeding and a severe burning sensation after a bowel movement. The pain is caused by spasms of the sphincter muscle, which is exposed to air through this tear. Pain with stool has been described as the sensation of razor blades.
Constipation - https://www.nejm.org/doi/full/10.1056/NEJMoa1310246
Hemorrhoids - https://www.aafp.org/afp/2018/0201/p172.html?fbclid=IwAR33NflE4M2zantPlXMxlNrRav0gjvFhQsEXZZsZixgQEp-q1oG9DsuZjaY