What Is Constipation

Researchers estimate that 3.8% to 37% of endometriosis cases affect the bowel. Symptoms of this condition include:

What can make passing stool painful?

Painful bowel movements can cause a great deal of discomfort. There are many possible causes ranging from constipation to anal cancer.

It is normal to occasionally experience mild pain during bowel movements. However, when this happens regularly, it could indicate an underlying medical condition.

In this article, we cover 10 possible causes of painful bowel movements and how to treat them. We also explain when it is necessary to see a doctor.

A person may experience a painful bowel movement for a number of reasons, including:

1. Constipation

Share on Pinterest Painful bowel movements is a common symptom of constipation.

A person can become constipated for multiple reasons, such as:

a hardening of stool due to a lack of fiber or water
a slowing of intestinal movements
as a side effect of a medication
emotional issues

Healthcare providers may use the Rome IV criteria to diagnose constipation. To receive a diagnosis of constipation, two or more of the following symptoms must be present for at least 1 month in infants and children up to 4 years old:

passing two or fewer bowel movements in a week
if they usually have complete control of their bowels, having at least one accidental bowel movement per week
a history of fecal withholding, or not using the bathroom despite having an urge
passing hard and painful stools

A doctor may diagnose chronic constipation in a child over 4 years old if these symptoms persist for at least 2 months.

Health professionals tend to recommend increasing water and fiber intake or taking fiber supplements as the first steps in treating constipation.

If symptoms persist despite making these dietary changes, taking over-the-counter (OTC) laxatives is also a good treatment option. A pharmacist can advise on the best product in each case.

If there is no movement within 2–3 days, or if pain develops or worsens, it is important to seek medical attention immediately.

2. Anal fissures

An anal fissure is a tear in the skin around the anus. Anal fissures can occur as a result of constipation or passing hard stools. Anal penetration can also cause a fissure.

Other possible causes include:

sexually transmitted infections (STIs)
chronic diarrhea
inflammatory bowel disease
human papillomavirus
anal cancer
vaginal delivery
surgery

If constipation has caused an anal fissure, a healthcare provider may recommend taking stool softeners to help it heal.

Lidocaine jelly is also helpful for reducing the pain of an anal fissure. A doctor may also suggest nitroglycerin or nifedipine ointments. Both drugs will increase blood flow to the anus, which helps the body heal the injury.

People with chronic anal fissures may need surgery. Another treatment option for more severe cases is to inject botulinum toxin A (Botox).

3. Hemorrhoids

Hemorrhoids are swollen veins under or on top of the skin in the anus. Both can make passing a bowel movement painful.

Sometimes, people will also see blood on the toilet paper or in the toilet bowl.

Several OTC treatments are available for hemorrhoids, such as hydrocortisone. More severe hemorrhoids may require surgery, however.

Doctors and pharmacists will recommend that people with hemorrhoids keep their stools as soft as possible. This will help ease the pain of passing a bowel movement over a hemorrhoid.

4. Diarrhea

Share on Pinterest Antibiotics can help treat an infection that is causing diarrhea.

Passing three or more loose or watery bowel movements per day may indicate diarrhea . Chronic cases of diarrhea can last for longer than 4 weeks.

To treat diarrhea, a health professional may recommend loperamide (Imodium). If an infection is causing the diarrhea, a person will need to take antibiotics.

Chronic or bloody diarrhea requires prompt medical attention.

5. Food intolerances and sensitivities

People with food intolerances or sensitivities may experience painful bowel movements or diarrhea if they eat certain foods. Common examples include lactose and glucose intolerances.

The best form of treatment is to avoid eating any foods that the person knows can trigger a reaction.

6. Inflammatory bowel disease

The two types of inflammatory bowel disease are ulcerative colitis and Crohn’s disease.

People with ulcerative colitis may experience bloody diarrhea with or without mucus. Episodes of diarrhea can cause pain during bowel movements. Other symptoms of ulcerative colitis may include:

urgently needing to pass stools
abdominal pain
weight loss

7. Proctitis and anusitis

Proctitis refers to inflammation in the rectum. Anusitis, meanwhile, is inflammation in the anus. These conditions share many symptoms with hemorrhoids.

To treat proctitis and anusitis, it is necessary for a doctor to first understand the cause. Several factors can lead to proctitis or anusitis, including:

ulcerative colitis
STIs
colon infections
certain medications
consuming a diet too rich in citrus, coffee, cola, beer, garlic, spices, or sauces

8. Anal cancer

Anal cancer can cause tumors to develop around the anus that make bowel movements painful. Other symptoms of anal cancer include:

bleeding from the anus
pain or irritation in the anus or pelvis
weight loss
feeling a weight in the anus or rectum
incontinence
severe constipation

It is important to consult a doctor immediately if these symptoms occur.

9. Endometriosis

Share on Pinterest Endometriosis can cause painful bowel movements.

In endometriosis, tissue that normally lines the uterus develops in other areas of the body, such as the ovaries.

Researchers estimate that 3.8% to 37% of endometriosis cases affect the bowel. Symptoms of this condition include:

pain during bowel movements
mucus in the stool
bleeding from the rectum
diarrhea or constipation
bloating

Health professionals tend to treat bowel endometriosis using hormonal therapy or surgery.

10. Skin conditions

Some chronic skin conditions, including eczema and psoriasis, can cause rashes to develop on the anus. Passing a bowel movement over an irritated area of skin can be painful.

Sometimes, painful genital warts can also develop on or near the anus.

Painful bowel movements have many potential causes. Some — including constipation, diarrhea, and hemorrhoids — are treatable at home. However, other causes may require medical attention.

People who find blood in their stools or feel severe pain during bowel movements should see a doctor for advice and treatment.

People experiencing diarrhea should drink plenty of water to avoid dehydration. Doctors recommend also following the BRAT diet, which focuses on:

Following a diet rich in fiber is essential for preventing constipation and keeping good bowel health. Getting regular physical activity also helps prevent constipation.

Keeping the bowel healthy requires daily care. It is important to eat fiber rich foods and drink enough water. Many causes of painful bowel movements are preventable.

Some people have conditions or infections that cause painful bowel movements. These are not always treatable with OTC remedies, so it may be necessary to see a doctor.

Last medically reviewed on September 25, 2019

Food Allergy
Crohn’s / IBD
GastroIntestinal / Gastroenterology
Nutrition / Diet

How we reviewed this article:

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What Is Constipation?

Being constipated means your bowel movements are tough or happen less often than normal. Almost everyone goes through it at some point.

Although it’s not usually serious, you’ll feel much better when your body is back on track.

The normal length of time between bowel movements varies widely from person to person. Some people have them three times a day. Others have them just a few times a week.

Going longer than 3 or more days without one, though, is usually too long. After 3 days, your stool gets harder and more difficult to pass.

Constipation Symptoms

Few bowel movements
Trouble having a bowel movement (straining to go)
Hard or small stools
A feeling that everything didn’t come out
Belly bloating

You also may feel like you need help to empty your bowels, such as pressing on your belly or using a finger to remove stool from your bottom.

Constipation Causes

Some causes of constipation include:

Changes to what you eat or your activities
Not enough water or fiber in your diet
Eating a lot of dairy products
Not being active
Resisting the urge to poop
Stress
Overuse of laxatives
Some medications (especially strong pain drugs such as narcotics, antidepressants , and iron pills)
Antacid medicines that have calcium or aluminum
Eating disorders
Irritable bowel syndrome
Pregnancy
Problems with the nerves and muscles in your digestive system
Colon cancer
Neurological conditions such as Parkinson’s disease or multiple sclerosis
An underactive thyroid (called hypothyroidism )
Excess calcium in your blood (hypercalcemia) due to overactive parathyroid glands, medications, cancer (lung, breast, multiple myeloma), or other causes

Constipation Remedies

Take these steps:

Drink two to four extra glasses of water a day, unless your doctor told you to limit fluids for another reason.
Try warm liquids, especially in the morning.
Add fruits and vegetables to your diet.
Eat prunes and bran cereal.
Exercise most days of the week. When you move your body, the muscles in your intestines are more active, too.
Don’t ignore the urge to poop.

You can try taking a laxative, too. There are several types of laxatives, and you can buy many of them over the counter. Each of them works in a different way to ease constipation. Ask your doctor or pharmacist which kind might work for you and how long you should take it.

How Long Does Constipation Last?

When constipation lingers for 3 weeks or more, get a checkup just to make sure a medical condition isn’t causing the problem. Also see your doctor if:

You’ve never been constipated before now.
You have stomach pain .
You notice blood in your stools.
You’re losing weight without trying.

Don’t let constipation go unchecked for too long. When untreated, constipation can lead to unpleasant complications such as hemorrhoids and rectal prolapse, a condition in which part of the intestine pushes out through the anus from too much straining.

When Should I Call My Doctor?

Call your doctor right away if you have sudden constipation with belly pain or cramping and you aren’t able to poop or pass gas at all.

Also, make the call if:

Constipation is a new problem for you and lifestyle changes haven’t helped.
You have blood in your stool.
You’re losing weight even though you’re not trying to.
You have severe pain with bowel movements.
Your constipation has lasted more than 2 weeks.
The size, shape, and consistency of your stool has changed dramatically.

Your doctor may recommend some tests to find the cause of your constipation:

Blood tests to check on hormone levels
Tests that check the muscles in your anus
Tests that show how waste moves through and out of your colon
Colonoscopy to look for blockages in your colon

Show Sources

National Digestive Diseases Information Clearinghouse.

National Institutes of Health.

American Academy of Family Physicians.

Mayo Clinic: “Hypercalcemia.’

UpToDate: “Hypercalcemia of malignancy: Mechanisms.”