Painful Bowel Movement: What Could it Mean?

There are various disorders that can cause painful bowel movement. In certain functional disorders, the problem is restricted to bowel movements only. This means that the feces remain unaffected in terms of their color, size, and texture.

Medical conditions that cause painful bowel movements

Most functional disorders of the rectum and colon affect bowel movements and do not affect the quality of feces. In other cases, a painful bowel movement is accompanied by various other symptoms.

In both these instances, the underlying cause of the symptoms is often unknown.

Constipation

Constipation causes hard and small poop that is difficult to pass. Often, it requires the individual to exert excessive pressure to ensure the passage of hard stool, thus, leading to painful bowel movement.

Passing hard stool over a long span of time may cause other disorders like anal fissures or hemorrhoids. This can occur due to various factors. Some of the most common reasons are:

• Lack of sufficient intake of water and healthy fluids, like fresh fruit juices, lemonade, etc.
• Inadequate consumption of high-fibre food products. These are valuable sources of roughage that reduce the risk of painful bowel movements.
• Postponing visiting the washroom
• Lack of co-ordination in bowel movements, leading to slow passage of poop

Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS) is one of the most common medical conditions that cause painful bowel movement. In normal conditions, the colon absorbs undigested food, nutrients, and water from the partially digested food that gets passed into it by the small intestine.

Whatever cannot be absorbed is gradually turned into waste and excreted from the body through the anus. The process of bowel movement here may become ‘irritable’ or one may experience muscle spasms of the colon due to lack of coordination or interruption in the smooth passage of the waste.

This occurs when the muscles of the colon are not aligned with those of the rest of the body. In such cases, the bowel is sensitive, which causes pain while pooping.

Abdominal pain and cramping is mostly experienced soon after having a meal. A painful bowel movement usually relieves the pain. As Dr. John Inadomi, MD, Gastroenterologist practising at the University of Washington Medical Center and Harborview Medical Center, mentions, “If the pain doesn’t go away after a bowel movement, that’s out of the ordinary and we’d want to evaluate that”. However, if the painful bowel movement prolongs beyond 24 hours to 48 hours, a doctor needs to be consulted. In case, the pain is accompanied by fever, visiting a doctor immediately is of utmost importance.

The other symptoms of IBS are as below:

• Diarrhoea/constipation – Some people with IBS experience constipation, while others suffer from diarrhoea. Some others may experience a combination of both. There is an urgent need for frequent bathroom visits. 
• Flatulence and bloating – Swelling of the abdominal area accompanied by bloating are common symptoms of IBS.
• Mucus in stool – Small amounts of mucus is common for all. But, people with IBS will have a substantially increased quantity of it in their faeces.

Inflammatory Bowel Disease (IBD)

Unlike IBS, wherein the abdominal pain and cramps stop after relieving oneself, the symptoms of IBD continue even after a painful bowel movement. IBD, which is inflammatory bowel disease, refers to a group of functional disorders of the colon and rectum like Crohn’s disease and ulcerative colitis. IBD is usually accompanied by several complications that require treatment. It may also be a sign of colorectal cancer in rare cases. This type of cancer usually occurs amongst the elderly. However, recent research shows that it is gradually becoming more common amongst people in their 50s as well. 

Thrombosed external haemorrhoid

In this health condition, blood clots develop in the outer haemorrhoid in the anal skin. When these clots are large, they can cause difficulty in sitting and walking, and also painful bowel movement.

A painful anal mass may also develop. If this worsens in the next 48 hours and is accompanied by bleeding, the doctor may recommend surgical or non-surgical treatment. Non-surgical treatments include sitz baths, stool softeners, and medications. Most experts recommend that the blood clots be removed surgically.

Anal fissure

An anal fissure, also referred to as fissure-in-ano, is a minor tear that may occur in the anal canal lining. Often misdiagnosed as hemorrhoids, it may cause painful bowel movements amongst other symptoms.

However, doctors usually treat anal fissures in a similar way as hemorrhoids – non-surgical treatment like medications, sitz bath, high-fiber diet, and fibre supplements, etc. Surgery may be recommended only for chronic anal fissures.

Anal abscess

Another functional disorder that may lead to painful bowel movements is an anal abscess, a cavity filled with pus. This pus is generally drained through surgery. 

Anal fistula

A tunnel that connects the anal abscess to the skin near the anus via the infected glands is called anal fistula. It is generally treated with surgery, varying from a simple to a complicated one, depending on the severity of the fistula. Severe cases may also need multiple surgeries.

Infections

Pain in the rectum, caused by infections due to STDs or fungal infections, can lead to painful bowel movement. The pain varies on the basis of the severity of the infection.

Sexually Transmitted Diseases include herpes, gonorrhoea, chlamydia, syphilis, etc. The pain is accompanied by various other symptoms like itching and minor bleeding from the anus. Drugs like topical or oral antibiotics and anti-fungal medications can help treat this.

Now that you know that these medical conditions could be the cause of your painful bowel movement, it will be easier for you to keep a check on your gastrointestinal health. Consult your doctor immediately in case the symptoms worsen and cause you more discomfort.

Learn more about digestive health, here.

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