Common GI Symptoms

Common GI Symptoms > Pain on Passing Bowel Motions (Painful Defecation)

Pain on Defaecation

What is the pain on defecation? 

This means that passing motions (stools) is painful and difficult, causing discomfort either when initiating the motion, during the actual passage and after the motion has passed.

What causes pain on defecation?

This can be caused by the passage of hard stools, which may cause trauma (tears) to the lining of the skin around the anus, known as an anal fissure. Other causes can include infections, piles and prolapse (when part of the anus and rectum comes down and out of the body).

For some people there can be other disorders involving the muscles of the pelvis and anus. It is also important to rule out cancer. A small number of people get the pain for no reason – known as proctalgia fugax – but this should only be considered after all other causes have been ruled out.

What symptoms should I worry about?

Watch out for a lump around the anus that doesn’t go away. This may be tender to touch. If you are experiencing fevers, this may indicate an infection that needs urgent medical treatment. Pain that is constant and not relieved by any activity should also be urgently investigated. Bleeding is also a very important sign.

Should I see my doctor?

Yes. See your doctor if you are concerned about the pain, particularly if it is not getting better. Don’t put it off if you are worried!

Are there tests I should have?

Your doctor can check you over by gently spreading your buttocks apart and looking at your anus. Sometimes it is necessary to place a special camera into the anus to look inside. This is known as proctoscopy and is not painful.

If you have had bleeding, your doctor might send you for a test called a “colonoscopy”. For these tests, the doctor puts a flexible tube into your anus and advances it into your colon. The tube has a camera attached to it, so the doctor can look inside your colon and check for problems. If necessary, the doctor may also arrange special scans for you.

What can I do on my own to help the pain?

You can:

  • Drink more water – this helps to soften the contents of your stool by increasing the water content within your bowel.
  • Eat more fiber – Eating more fiber can help keep your bowel movements soft. Fiber is found in most fruits, vegetables, and whole grains.
  • Take a stool softener – Stool softeners are medicines that help make your bowel movements easier to pass. These can be bought without prescription. Lactulose is a good example of this, and helps to ‘trap’ water within your bowel, making the motions softer.
  • Relax: soak your buttocks in warm water. This is known as a ‘sitz bath’ Do this 2 to 3 times a day for 10 to 15 minutes. Do not add soap, bubble bath, or anything else to the water. Sitz baths help relieve pain and relax the sphincter.

Remember: If the pain doesn’t go away after simple measures, it’s time to find a doctor to speak to. This can be your local doctor/GP or a specialist. Don’t worry; we’re here to help!