Pain When You Poop? Here’s What Your Body Is Trying to Tell You

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If pooping is painful, find the root cause to get relief.
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This might be a little personal, but does it hurt when you poop? If you have trouble on the toilet, you shouldn't just grin and bear it.

We spoke to Niket Sonpal, MD, a New York-based internist and gastroenterologist, to understand the most common causes for an achy anus when you go number two, plus ways to prevent painful poops and soothe your sore butt.

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If your anal pain does not subside within 24 to 48 hours, you experience ongoing rectal bleeding, you have a mass that does not improve or you’re running a fever along with anal pain, you should see a doctor, according to the American Society of Colon and Rectal Surgeons (ASCRS).

1. You're Constipated

It's probably no surprise that constipation is a common culprit for painful poops.

"Constipation is painful for two reasons: the strain of pushing and how hard the stool is," Dr. Sonpal says. "Stool that is too hard or large to pass will cause pain during a bowel movement because the muscles are stretching."

To make matters worse, when you strain regularly or sit on the toilet too long, you increase pressure in the lower rectum, which may result in painful hemorrhoids (more on this later), according to the Mayo Clinic.

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The fix:​ To help prevent constipation (and hemorrhoids), consume high-fiber foods, drink six to eight glasses of water daily and exercise regularly, per the Mayo Clinic. Also, avoid straining and sitting for extended periods, and hit the bathroom as soon as you feel the urge to go.

If you're already constipated, try a stool softener like MiraLAX or Colace.

2. You've Got Diarrhea

Conversely, diarrhea could be the source of your discomfort on the toilet.

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"Because diarrhea speeds up the digestion process, food is oftentimes not broken down fully," Dr. Sonpal says. This means that stomach acids, digestive enzymes and bile may be present, which can cause a burning sensation in the rectum during a bowel movement.

And if you ate spicy food, you might also have to contend with capsaicin (the active ingredient in hot peppers) passing in your stool, Dr. Sonpal says. This chemical compound can irritate digestive tissue and trigger a burning feeling with diarrhea.

What's more, "food that hasn't been processed entirely may cause physical trauma to the rectum, leading to pain," Dr. Sonpal says. "Large, rough foods and those with seeds, shells or pods can rub against or cut the rectum's delicate tissue."

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Adding insult to injury, wiping — which, let's be honest, you do more of when your poops are runny — can irritate your butt too. "Wiping too hard can also cause small tears," Dr. Sonpal says.

The fix:​ "To treat diarrhea, eat a diet high in fiber to make stools more solid and increase liquid intake," Dr. Sonpal recommends.

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3. You Have Hemorrhoids

Hemorrhoids can cause a world of hurt when you're trying to take care of business in the bathroom. But what are they, exactly?

"Hemorrhoids are swollen veins in the lower part of the rectum and anus," Dr. Sonpal says. "The blood vessels' walls are often stretched so thin, the veins bulge and become irritated, even more during a bowel movement."

The fix:​ Mild cases of hemorrhoids only cause pain when you poop (because the blood vessels stretch) and usually go away on their own, Dr. Sonpal says.

However, more severe hemorrhoids might hurt throughout the day and may need an over-the-counter cream like Preparation H, he says.

4. You've Got an Anal Fissure

If your butt bothers you when you have a bowel movement, you might be experiencing an anal fissure.

"An anal fissure is a tear in the anus, exposing the delicate lining of the anal sphincter," Dr. Sonpal says. "This tear may cause the muscle to spasm, which pulls the edges of the fissure."

Sometimes caused by physical trauma, childbirth or a sexually transmitted infection, anal fissures can be very painful during poop sessions when the tear stretches, Dr. Sonpal explains.

The fix:​ But they can be easily treated with a multipronged approach. For starters, Dr. Sonpal suggests upping your fiber and liquid intake to soften stool, which will make it easier to pass and cause less pain (and stretching).

Plus, soaking in warm water and applying a nitroglycerin cream like Fissure Control from Forces of Nature (to increase blood flow to the fissure) helps the sphincter to relax and promotes healing, he says.

"You can also try an anesthetic cream like lidocaine hydrochloride to reduce pain," Dr. Sonpal adds. "However, if the anal fissure is unresponsive to these treatments, a doctor may recommend surgery to remove it."

5. You Have Pelvic Floor Issues

Pelvic floor problems can produce pain while you poop, too.

"When there is dysfunction in the pelvic floor, one is unable to control muscles that help you complete a bowel movement," Dr. Sonpal says.

In addition to uncomfortable bowel movements, you might also experience unexplained lower back and pelvic pain and constipation.

The fix:​ "Treatment usually involves behavioral changes (like avoiding pushing or straining during a bowel movement), learning how to relax the pelvic floor muscles, warm baths, yoga, relaxants like diazepam and physical therapy," Dr. Sonpal says.

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6. You Have a Sexually Transmitted Infection

"Any sexually transmitted disease can also affect the anal area and cause pain when going to the bathroom," Dr. Sonpal says.

For example, chlamydia in the rectum can cause discharge and discomfort during bowel movements.

The fix:​ While symptoms are usually manageable, you'll likely need to see a doctor, who can prescribe an antibiotic medication, Dr. Sonpal says.

7. You've Got a Skin Condition

Surprisingly, skin conditions like psoriasis, eczema and warts can affect the anal area too, Dr. Sonpal says.

"Pain, itching and bleeding can occur before, after and during a bowel movement in the area around the anus."

The fix:​ For a proper diagnosis and treatment options, you should consult with a dermatologist.

8. You Have Anal Cancer

While less common, anal cancer can trigger painful pooping.

Tumors can cause bleeding, a mass and changes in bowel habits, as well as pain that gets worse over time, according to the ASCRS.

The fix:​ If you have anal pain or bleeding that doesn't decrease (or worsens), see a medical professional immediately.

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Is This an Emergency?

If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911. If you think you may have COVID-19, use the CDC’s Coronavirus Self-Checker.
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