Your bowel habits can change from day to day and can be affected by your diet, stress, activity level, and water intake. But, going number two shouldn’t be painful. If you often find yourself thinking, Why does it hurt when I poop? The answer is that you could have a health issue. A bowel movement is the last step as food moves through your digestive system when stool exits your body through your rectum and anus. The lining of the anal canal, located between the rectum and anus, features nerves that signal to the brain that the bowel is full and needs to be emptied. Muscles in your anus relax while the rectal lining contracts to push out the poop, explains Dr. Evelyn Darius, MD, a primary care physician at virtual health platform PlushCare, “Therefore, if any part of the anus or the rectum is damaged, it can present as pain when pooping.” There are several conditions that could cause pain during a bowel movement. We asked GI experts to explain why it might hurt to poop.
Why it hurts when you poop
1. You have an anal fissure
Anal fissures—or, tears in the lining of the rectum—are one of the most common conditions that make it painful to poop, Darius says. Anal fissures can be caused by chronic constipation, anal sex, straining to have a bowel movement, or a long period of diarrhea. Treatment for anal fissures includes preventing constipation by drinking more water or using stool softeners, according to Cleveland Clinic. Soaking in a warm bath, cleaning the anorectal area, avoiding straining during bowel movements, and applying petroleum jelly or hydrocortisone to the area. Sometimes, surgery is needed.
2. You have hemorrhoids
Hemorrhoids are enlarged veins that form inside or outside the anus and rectum, and they can be extremely painful, says Susan Wong, RN, BSN, also known as “Nurse Wong,” host of Butt Talks TV and author of “The Power of Pooping.” Anyone can get hemorrhoids, but they’re especially common during pregnancy, for those with chronic constipation or diarrhea, or when straining to have a bowel movement, according to Cleveland Clinic. While hemorrhoids usually go away on their own, treatments include over-the-counter medications, increasing your fiber and water intake, and taking stool softeners. In severe cases, surgery or other physician’s office treatments may be needed.
3. You’re constipated
Constipation occurs when you have fewer than three bowel movements a week, and your stools are dry, hard, and difficult to pass. This can be painful, Wong says, “Hard poops can irritate the anal passageway.” It happens when food moves too slowly through the digestive system, which gives the colon more time to absorb water from the waste, drying out your stool. Common causes of constipation include eating a low-fiber diet, not drinking enough water, not exercising, stress, not going to the bathroom when you need to, and taking certain medications, according to Cleveland Clinic.
4. You might have inflammatory bowel disease (IBD)
IBD is a group of conditions that can cause inflammation in the intestines, including ulcerative colitis, Crohn’s disease, and irritable bowel syndrome. These conditions can cause abdominal pain, constipation, and diarrhea. A colonoscopy, blood or stool test, or medical exam will diagnose these conditions. And, treatments can range from medications to surgery.
You have proctitis
Inflammation of the lining of the rectum, proctitis is caused by ulcerative colitis, Crohn’s disease, an STD, or other trauma to your anorectal area. It can cause anal or rectal pain, as well as abdominal pain or diarrhea. Your doctor will need to diagnose proctitis and can decide what the best treatment should be.
5. You’re having diarrhea
Diarrhea is common and can be caused by a number of things, like something you ate, food intolerances, infections, or IBD. And, it can make pooping painful. “Excessive diarrhea can cause skin breakdown around the opening of the anus that hurts when stool is in contact with the skin,” Wong says. Drinking plenty of water and eating the BRAT (bananas, rice, applesauce, and toast) diet can help improve diarrhea, she adds. If diarrhea doesn’t go away after a day or two, it’s a good idea to contact your doctor.
6. You could have an anorectal abscess or an anal fistula
An anorectal abscess is an accumulation of pus under the skin around the anus and rectum, Darius says. These abscesses can be caused by infections, IBD, or long-term inflammation in the rectum. Symptoms include pain in the anus, constipation, and painful bowel movements. An erupted abscess or complications from vaginal childbirth can cause an anal fistula, which is a tunnel that connects an abscess to an opening on the skin near the anus. An anal fistula can cause pain, swelling, and irritation around the anus, and painful bowel movements.
7. You might have endometriosis
Endometriosis is a condition that occurs when the inner lining of the uterus—known as the endometrium—grows outside the uterus. Parts of the endometrium can develop on the ovaries, fallopian tubes, the vagina, or the intestine. The condition is often symptom-free. In some cases, it can cause painful sex, abdominal cramps, back pain, and painful bowel movements.
When to worry about your painful bowel movements
When your painful pooping persists, it’s a good idea to make a doctor’s appointment, especially if you have other symptoms. “Pain when pooping that’s associated with bright red bleeding is a cause for alarm that should be reviewed by a doctor,” Darius says. There are some home remedies that you can try to reduce your risk for anal tears, constipation, and other pain in the anus or rectum, she adds. Some options include increasing your fiber intake—women need 21 to 25 grams per day, and men need 30 to 38g. You should also aim to drink at least six glasses of water a day. Finally, try using sitz baths, where you sit in warm, salty water so that it touches your anal area. Next, read about the best high-fiber foods.
Sources:
Dr. Evelyn Darius, MD, a primary care physician at virtual health platform PlushCareSusan Wong, RN, BSN, also known as “Nurse Wong,” host of Butt Talks TV and author of “The Power of Pooping"National Library of Medicine: Bowel Movement National Library of Medicine: How do bowel movements work? Cleveland Clinic: Anal FissuresCleveland Clinic: HemorrhoidsCleveland Clinic: ConstipationCleveland Clinic: Inflammatory Bowel Disease Cleveland Clinic: ProctitisCleveland Clinic: DiarrheaCleveland Clinic: Anal fistula Johns Hopkins Medicine: Anorectal Abscess Mayo Clinic: Chart of high-fiber foods
