Pain in your rectum or anus can stop you in your tracks, and it’s always distressing when you don’t know exactly what’s going on. The good news is that most rectal pain comes from common, treatable conditions, not anything scary.
The fastest way to figure out what’s going on is to pay attention to how and where it hurts. Use the sections below to match your symptoms, then click through for the full guide.
Not sure which one sounds like you? Take our 2-minute quiz and a Bummed clinician can help sort it out.
Sudden, sharp pain that’s gone in seconds
A stabbing or cramping pain deep in your rectum that comes out of nowhere, often at night, and disappears within seconds to minutes is most likely proctalgia fugax, a spasm of the muscles around your anus. It’s painful but harmless, and it’s often linked to bowel habits like straining or holding it in.
→ Proctalgia fugax: causes and symptoms · How to treat proctalgia fugax
Tearing or burning pain when you poop
Sharp, tearing pain during a bowel movement, followed by an ache that can last for hours, plus bright red blood on the toilet paper, points to an anal fissure, a small tear in the lining of your anus. Fissures are very treatable with prescription creams that relax the sphincter.
→ How to heal an anal fissure · Anal fissure cream · Hemorrhoids vs. fissures
Swelling, a lump, itching or bleeding
A tender lump near your anus, itching, swelling or blood when you wipe usually means hemorrhoids. External hemorrhoids, especially if a clot forms, can be quite painful. Internal hemorrhoids are usually painless but may bleed.
→ Hemorrhoid treatment · Internal vs. external hemorrhoids
A dull ache or pressure that gets worse when you sit
A deep ache or feeling of fullness high in your rectum, like you’re sitting on a ball, that builds the longer you sit and lasts for hours may be levator ani syndrome, a type of pelvic floor muscle spasm (Cleveland Clinic).
→ Levator ani syndrome: symptoms and treatment
Itching and burning around the anus
Itching that won’t quit, sometimes with burning or soreness from scratching, is called pruritus ani. It has many possible causes, from moisture and irritating products to skin conditions.
Pain with hard stools and straining
If going to the bathroom means pushing hard, constipation may be behind your pain. Straining irritates the area and can lead to fissures, hemorrhoids and muscle spasms.
→ Best fiber supplement for constipation
Pain during cancer treatment
Radiation and chemotherapy for colorectal or anal cancer can cause significant rectal pain and irritation.
→ Anorectal pain during cancer treatment
Quick relief while you figure it out
Whatever the cause, a few things soothe most types of rectal pain:
- A warm sitz bath in a bathtub for 10 to 15 minutes
- Keeping stools soft with fiber and fluids, and not straining
- A numbing cream like lidocaine for short-term relief
- Sitting on a wrapped ice pack for 5 minutes
- Gentle cleaning with water instead of rough, dry toilet paper
When rectal pain is urgent
Most rectal pain can wait for a regular appointment. Get medical care right away if you have:
- Severe pain that’s getting worse, especially with fever or chills
- A hot, swollen, very tender lump near your anus (possible abscess)
- Heavy rectal bleeding, or bleeding with dizziness or weakness
- Black, tarry stools
- Severe belly pain or an inability to pass stool or gas
See a provider if you notice ongoing bleeding, pain that keeps coming back, a change in your bowel habits lasting more than a few weeks, or unexplained weight loss.
Rectal pain FAQs
What’s the most common cause of rectal pain?
Hemorrhoids and anal fissures are among the most common causes. Fissures in particular cause sharp pain with bowel movements.
How do I stop rectal pain fast?
A warm sitz bath is one of the quickest ways to relax the area. For sudden spasms, slow belly breathing and letting your pelvic floor relax can help the muscle release.
Can stress cause rectal pain?
Stress is a common trigger for muscle-related rectal pain like proctalgia fugax and levator ani syndrome.
What kind of doctor treats rectal pain?
A primary care doctor is a good first stop. For ongoing problems, a colorectal surgeon is the specialist.
Explore more
- Proctalgia fugax: causes and symptoms
- Proctalgia fugax treatment
- Levator ani syndrome
- How to heal an anal fissure
- Best treatment for anal fissure
- Hemorrhoid treatment
- Anal itching causes
- Sitz bath benefits
Bummed about your bottom?
We get it, and we’re right behind you. Answer a few quick questions and a Bummed clinician can help figure out what’s causing your pain and prescribe a treatment made for you, delivered discreetly to your door. Find My Treatment
This article is for informational purposes only and isn’t a substitute for professional medical advice. Consult with a medical provider before starting any medications. If you’re pregnant or breastfeeding, talk to your OB first.
References
- Cleveland Clinic, Proctalgia fugax.
- Cleveland Clinic. Levator ani syndrome.
- Davids JS, Hawkins AT, Bhama AR, et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of anal fissures. Dis Colon Rectum. 2023;66(2):190-199.
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Symptoms & causes of hemorrhoids.