Anal (rectal) pain: Causes, Symptoms, Treatment

Anal (rectal) pain: Causes, Symptoms, Treatment
Photo source: Getty images

This symptom is common in less serious diseases, for example, hemorrhoids, constipation and diarrhea. The opposite is true for more serious diseases such as chronic fissure, cancer or others requiring surgical intervention. Pain also occurs after an accident. In diabetes, also as a consequence of a sexually transmitted disease.

Rectal pain can take different forms, from itching, regular pain, to an unpleasant burning sensation or other symptoms. Painfulness itself, in various forms, can be a serious problem if it lasts for a long time and is constantly recurring. But many people tend to rather underestimate this problem.

In this case, however, it is advisable to seek professional medical treatment and examination early. Because pain can signal several serious problems. Neglect can mean serious complications.

Rectal pain = anal pain = proctalgia.

Haemorrhoids and pain

Hemorrhoids are frequently associated with rectal pain. These are dilated veins in the rectal area. They can become inflamed. Inflammation occurs, which is painful, especially when passing stools.

The pain is felt during bowel movements, i.e. when passing stool. 

Sometimes there are light and darker blood stains appear on the toilet paper, which is also a sign, along with soreness, that this is the health problem. A certain amount of blood may not only be on the paper, but also in the stool. 

Although hemorrhoids are not a serious disease, but they are very unpleasant, and therefore there is no need to postpone medical treatment.

Fissura ani

Anal fissure is the second possible problem associated with rectal soreness. It is a tear in the wall of the rectum. This arises when very hard stool is passed and the problem is manifested with sharp pain and bleeding on passing stool.

Sometimes it is possible for the problem to resolve itself. However, in most cases, this is not the case and the anal tear becomes chronic. Regular and intermittent pain as well as stretching of the rectum occurs. The solution is surgery, when it gets even more difficult.

Anal fistula

Even, the pain can also be associated with the formation of ducts between the anus and other tissues or the surface of the body, that is, the skin. These canals are very easily infected with bacteria, which aggravate the inflammation and make treatment more difficult. The technical name is anal fistula.

Abcess and pain

An abscess in the rectal area is also manifested by pain. It is a well-defined, but purulent inflammation with a necrotizing tendency.

An abscess is formed when the lining of the rectum is damaged and bacteria enter this lining in the deeper tissues and cause inflammation in the form of an abscess.

Rectal prolapse

It is a condition when the anus slips out of its position and gets out of the body through the anus. It is manifested by pain, but also by bleeding. Lighter forms can be pushed back. In this case, recurrence of prolapse is common. More severe forms are operated on.

Woman, pain in gluteal muscles, holding hands, constipated or diarrhea, holding toilet paper
Pain can be present during constipation and diarrhea. Source.

Constipation and diarrhoea

Pain in the rectum can also occur with constipation when hard stool is pushed out as a result of stool accumulation. The opposite is diarrhea. When the stool is thin and there is frequent defecation. The frequency of stools irritates the rectum, i.e. the anus, which can result in pain in the area, before, during and even after defecation.


Cancer is one of the most dangerous diseases manifested by rectal pain. If the tumor is directly inside the rectum, the lower part of the colon, other symptoms may also be present, e.g. diarrhea or constipation. A complication is an obstruction of the bowel if the tumour narrows it too much.

Pain in the anal area in infectious diseases

Also various venereal infectious diseases are manifested by pain in the anus. Common modes of transmission include sexual intercourse. Another example is parasitic infections. Sexually transmitted diseases that can cause pain in that area include:

  • gonorrhoea
  • syphilis
  • genital warts
  • herpes genitalis
  • yeasts
  • chlamydia

Other diseases and pain

A painful rectum, especially during bowel movement, is also associated with various idiopathic bowel diseases, e.g. ulcerative colitis or Crohn's disease.

Some such immune-mediated intestinal inflammations are very complicated to treat.

Question mark, unknown cause
If the cause is unknown, examination is better than self-medication. Source: Getty Images

Similarly, discomfort and pain can also be caused by inflammation of the skin in the anal area, eczema.

Inflammation in babies in diapers is common because aggressive properties of the stool and moisture adversely affect the skin.

Other causes of itching or other discomfort:

  • diabetes
  • liver disease
  • kidney disease
  • prostate enlargement, prostatitis
  • increased thyroid activity, i.e. hyperthyroidism
  • faecal incontinence
  • atopic, allergic dermatitis
  • dry skin due to excessive or insufficient anal hygiene
  • psoriasis
  • mycosis

Gynaecological problems

Gynecological problems can also manifest in rectal pain, especially in cases of inflammations of the ovaries and their supporting structures, vagina and uterus. Pain may also occur during ectopic pregnancy.

A difficult childbirth may also cause pain in the rectal area.

Injury and overexertion

A painful symptom in the rectal area can also be an injury to the coccyx due to a fall or an accident. However, here it is a secondary pain. That is, the problem is not directly in the rectum. Injury and pain can also be caused by a foreign body in the rectum. This also happens during various sexual practices.

Pain in the rectum can also be caused by coccygodynia.

This tailbone pain arises after the above mentioned injury, but also due to prolonged sitting. Other causes include neuralgia or pain after a difficult childbirth.

What is Anal Itching (Causes, Treatment & Home Remedies)

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Interesting resources

    • "Differential Diagnosis for Rectal pain Rectalgia". 
    • Janicke DM, Pundt MR (November 1996). "Anorectal disorders". Emerg. Med. Clin. North Am14 (4): 757–88. 
    • Metcalf A (November 1995). "Anorectal disorders. Five common causes of pain, itching, and bleeding". Postgrad Med98 (5): 81–4, 87–9, 92–4.
    • Giulio Aniello Santoro; Andrzej Paweł Wieczorek; Clive I. Bartram (27 October 2010). Pelvic Floor Disorders: Imaging and Multidisciplinary Approach to Management. Springer. pp. 601–603. ISBN 978-88-470-1542-5.
    • Chronic anal pain: A review of causes, diagnosis, and treatment
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