9 Rectal Pain Causes, Symptoms and Relief Options | Buoy (2022)

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

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.)

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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

Coccydynia

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.

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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

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.

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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.

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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

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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FAQs

What disease causes rectal pain? ›

Proctitis can cause rectal pain, diarrhea, bleeding and discharge, as well as the continuous feeling that you need to have a bowel movement. Proctitis symptoms can be short-lived, or they can become chronic.

What can cause rectal pressure and pain? ›

Possible causes of rectal pressure
  • Constipation. Constipation is when stool dries and hardens and is difficult to pass. ...
  • Diarrhea. Diarrhea happens when the stool doesn't solidify in your colon. ...
  • Hemorrhoids. ...
  • Anal fissure. ...
  • Coccydynia. ...
  • Anal cancer. ...
  • Diverticulitis. ...
  • Inflammatory bowel disease.

What causes rectal pain while sitting? ›

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.

Does rectal pain go away on its own? ›

Topic Overview. Rectal problems are common. Almost everyone will experience some rectal itching, pain, or bleeding at some time during his or her life. These problems are often minor and may go away on their own or with home treatment.

What is rectal pressure a symptom of? ›

Possible Causes

Anal fissure: A tear or crack in the anal canal. Constipation: Hard, difficult-to-pass stools. Diarrhea: Loose or liquid stools. Hemorrhoids: Swollen veins in the rectum or anus.

What doctor do you see for rectal pain? ›

Proctologists are doctors who specialize in colon and rectal issues. They focus on conditions that affect the lower digestive tract.

Can rectal pain be caused by stress? ›

Associated conditions for proctalgia fugax

Many times, an episode of these painful anal spasms can be associated with psychological issues like anxiety, depression, or stress. Other conditions that may have an association with proctalgia fugax are anal fissures and abscesses, as well as rectal cancer.

What foods cause rectal pain? ›

If your stools are hard, dry, and difficult to pass, then it's likely you're not getting enough fiber and water in your diet. If your diet is filled with foods like white bread, sugary cereal, cheese, milk, and processed foods like fast food and frozen entrees, then your diet may be contributing to your anal pain.

What are the most common rectal problems? ›

Problems with rectum are common. They include hemorrhoids, abscesses, incontinence and cancer. Many people are embarrassed to talk about rectal troubles. But seeing your doctor about problems in this area is important.

When should I go to the ER for rectal pain? ›

Seek immediate medical attention

A significant amount of rectal bleeding or rectal bleeding that won't stop, particularly if accompanied by lightheadedness, dizziness or feeling faint. Anal pain that gets much worse, spreads, or is accompanied by fever, chills or anal discharge.

Does rectal pain go away on its own? ›

Topic Overview. Rectal problems are common. Almost everyone will experience some rectal itching, pain, or bleeding at some time during his or her life. These problems are often minor and may go away on their own or with home treatment.

What does rectal pressure feel like? ›

Rectal pressure can make a person feel like they constantly have to use the toilet. Pressure in the rectum can be uncomfortable or even painful. The rectum is the final portion of the large intestine. Stool travels through it before exiting the anus.

What foods cause rectal pain? ›

If your stools are hard, dry, and difficult to pass, then it's likely you're not getting enough fiber and water in your diet. If your diet is filled with foods like white bread, sugary cereal, cheese, milk, and processed foods like fast food and frozen entrees, then your diet may be contributing to your anal pain.

What are the most common rectal problems? ›

Problems with rectum are common. They include hemorrhoids, abscesses, incontinence and cancer. Many people are embarrassed to talk about rectal troubles. But seeing your doctor about problems in this area is important.

When should I go to the ER for rectal pain? ›

Seek immediate medical attention

A significant amount of rectal bleeding or rectal bleeding that won't stop, particularly if accompanied by lightheadedness, dizziness or feeling faint. Anal pain that gets much worse, spreads, or is accompanied by fever, chills or anal discharge.

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