Common Causes of Rectal Pain

The Possible Causes and Home Treatments for Rectal Pain

Mature Adult Consultation with Doctor. Credit: BSIP / Contributor

Pain in the rectum is a common experience and is not, in general, due to any serious medical condition. However the pain can be intense and worrying. Here are the main causes of rectal pain, plus advice to calm the pain caused by each.

Anal Fissure

An anal fissure is a small tear in the skin at the opening of the rectum. It is usually caused as a result of straining and stretching the rectum when passing a hard stool.

Anal fissures can also occur if the anal sphincter (the muscle that controls the anal opening) is too tight to pass stools. The pain is a sharp knifelike pain that returns during the times when the anal opening is irritated. It can be very very painful during bowel movements especially if you get constipated or dehydrated. A dull throbbing pain may then take over and it may last for hours.​

Helpful home treatments: Eating a high fiber diet softens the stool, making bowel movement less painful. It also reduces the strain put on the anus. Soak in a hot tub three times a day for 20 minutes. It reduces the pain and helps heal the fissure. A hydrocortisone cream will reduce swelling and promote healing.


Hemorrhoids are swollen veins in the anus that affect over 25 percent of American adults. They are caused by straining during bowel movements and are common in pregnant women or following heavy lifting.

They are also a common cause of fresh blood in bowel movements. Hemorrhoids are very painful if bowel movements are hard, but it is usually a general discomfort. If the hemorrhoids burst, the pain may be very intense, beginning suddenly and lasting for several days. Medical intervention is required as a matter of urgency.

Helpful home treatments: Soak in a hot tub for 20 minutes three times a day. Eat a high fiber diet to soften bowel movements so using the bathroom will be less painful, and apply a hemorrhoid cream to decrease pain.

Levator Ani Syndrome

Although more prevalent in women, levator ani syndrome is characterized by apparent spasms in the group of muscles that surround and support the anus. It is not known why it occurs, but it can be very painful and can last up to 20 minutes. The pain is often worse when sitting and is felt high up inside the rectum.

Helpful home treatments: Soaking in a hot tub can help. Massaging the levator ani muscles to help stop the spasm. Anti-inflammatory painkillers such as ibuprofen can also help.

Proctalgia Fugax

The cause of proctalgia fugax pain is unknown but often experienced in clusters. It can then go away and return weeks or months later. It is a sudden, brief and intense pain at the anal opening that usually only lasts for a minute or so, but can wake you up.

Less Common Causes of Anal Pain

There are medical conditions that have associated rectal pain, cancer, foreign bodies in the rectum, rectal prolapse, infections and inflammatory diseases such as Crohn's disease and ulcerative colitis​, and thrombosed hemorrhoids.

All of these diseases are accompanied by different symptoms and a doctor will have to provide diagnosis and treatment.

Seek urgent medical intervention if:

  • Your pain becomes more severe and regular
  • You have a fever
  • You have an infectious rectal discharge
  • The pain spreads to other areas of your body
  • You have a large bleed or increasing amount of blood loss
  • You have suffered a recent physical trauma

If you are concerned by any physical symptoms then you should always see your doctor. Cancer is rarely the cause of anal pain, but it tends to be the thing first worried about. Still, it is better not to be complacent and get a diagnosis so that you know what you are dealing with and so you can then get the best treatments to relieve the problem.