- Constipation can cause stools that are hard and large, which can hurt when you pass them.
- Stressing your anal canal from constipation can also cause anal fissures, which are small tears.
Painful bowel movements may happen occasionally because of conditions that tend to go away on their own, like hemorrhoids or diarrhea. If it's a one-time occurrence, you probably don't need to worry.
However, if you regularly feel pain during bowel movements, there may be an underlying medical condition that requires medical attention, such as inflammatory bowel disease (IBD) and anal cancer.
Here are six potential causes of painful bowel movements and how you can treat them.
1. Constipation
If you have fewer than three bowel movements a week and they tend to be painful, chances are you're constipated.
Constipation causes stools that are hard, firm, and larger in size since they build up in the GI tract.
This can make them difficult and painful to pass through the anal canal, says Dr. Ellen Stein, associate professor of medicine in the Division of Gastroenterology and Hepatology at the Rutgers Robert Wood Johnson Medical School.
Watch out for other symptoms of constipation, which include:
- Straining to pass stools
- Stomach ache
- Cramps
- Bloating
- Feeling like you can't completely empty your bowels
- Feeling as if there's a blockage in the rectum that prevents you from passing stool
How to treat it: Constipation is usually treated by making diet and lifestyle changes first. It's important that you stay hydrated, get enough fiber, and exercise regularly, Stein says.
If diet and lifestyle changes aren't enough, consult your doctor about options like fiber supplements, laxatives, and prescription medications that soften the stool.
2. Hemorrhoids
Hemorrhoids are swollen, enlarged veins that develop inside the rectum or outside the anus, which can make your bowel movement uncomfortable or painful.
Some of the symptoms of hemorrhoids include:
- Rectal bleeding
- Pain in the anus, especially when seated
- Hard, tender lumps near the anus
- Itchy anus
How to treat it: Hemorrhoids usually go away on their own after about a week. However, larger hemorrhoid may require medicine or even surgery.
You can drink more water, increase fiber intake, and apply over-the-counter medications to ease your symptoms.
Quick tip: Hemorrhoids get worse with constipation since the straining to pass stool can exacerbate them. If you have both hemorrhoids and constipation, treat the constipation first, says Dr. Eugene Yen, gastroenterologist at Northwestern Medicine Lake Forest Hospital.
3. Anal fissures
"Anal fissures are small tears in the lining of the anal canal," Stein says. You can get them from stressing your anal canal, such as with severe diarrhea or constipation.
They often cause pain and bleeding with bowel movements.
Anal fissures have several symptoms, such as:
- A noticeable tear in the skin around the anus
- Bright red blood on the stool or toilet paper
- Pain that lasts up to several hours after the bowel movement
How to treat it: Anal fissures will typically heal on their own within a few weeks. In the meantime, you should avoid excessive straining during a bowel movement and treat diarrhea and constipation when appropriate, Stein says.
You can also try remedies for anal fissures like:
- Soaking in a warm bath several times a day for 10 to 20 minutes
- Lubricating the area with petroleum jelly
For persistent anal fissures, you may need hydrocortizone suppositories or medicated creams.
4. Diarrhea
Diarrhea is a condition where you pass loose, watery stools at least three times a day.
Liquid stool tends to be more acidic than normal stool, which can sometimes cause burning during a bowel movement, Yen says.
There are numerous conditions and dietary habits that may cause diarrhea but some of the most common are:
- Consuming alcohol
- Food allergies
- Digestive conditions
Aside from loose, watery stools, other symptoms of diarrhea include the following:
- Bloating
- Abdominal cramps
- Urgent need to have a bowel movement
- Nausea
How to treat it: Diarrhea goes away on its own in a few days, Yen says.
If you've had diarrhea for several weeks, your healthcare provider might prescribe antibiotics, probiotics, or other medications depending on the cause or specific health condition.
5. Inflammatory bowel disease (IBD)
IBD is a term that describes two conditions that involve the chronic inflammation of the gastrointestinal tract: ulcerative colitis and Crohn's disease.
People with IBD sometimes get tears and infections around the anal region, which can cause pain during a bowel movement, Yen says.
There are several common symptoms of IBD, such as:
- Fatigue
- Diarrhea
- Weight loss
- Bloody stools
- Abdominal pain
How to treat it: You can use oral medications like biologics, corticosteroids, and 5-aminosalicylic acids to treat the inflammation.
Early and rapid treatment of IBD is necessary to improve IBD symptoms, Stein says.
6. Anal cancer
Having cancer in the anal canal causes pain in the area of the anus, which can make bowel movements hurt.
Other symptoms include the following:
- Bleeding from the anus
- Anal itching
- A mass or growth in the anal canal
- Dark spots or changes in coloration in the anal area
Anal cancer comes in several forms, whether it's a bump, a small lump, or even little dark spots or changes in coloration, that's why you should never ignore any symptoms in the anal area, Stein says. It's best to get examined right away.
How to treat it: The treatment generally depends on the stage of your anal cancer as well as your own preferences.
Combined chemotherapy and radiation therapy, surgery, and immunotherapy are some of the treatment options for anal cancer you may have.
Insider's takeaway
It's difficult to determine the cause of painful bowel movements since the reasons can range from a mild benign issue to something as dangerous as cancer, Yen says.
If passing stool is always painful for you, see a healthcare provider to determine the cause and receive appropriate treatment.