Most cases are not serious, though some can be.
Technically, the rectum is the last few inches of thelarge intestinethat terminates at the anus.
Fortunately, many conditions that cause rectal pain can be managed at home.
Verywell / Nusha Ashjaee
Its still important to know when to see a healthcare professional for rectal pain.
Other, more urgent treatment may be required.
Hemorrhoids
Hemorrhoidsare swollen veins in the rectum.
They affect over half of American adults over 50 years.
Hemorrhoids are one of the most common causes of anal pain when sitting.
This can cause sudden, severe rectal or anal pain.
Anal Fissure
Ananal fissureis a small tear in the skin at the opening of the anus.
It is usually because of straining and stretching of the anal canal when passing a large orhard stool.
When an anal fissure develops, the internalanalsphincterthe muscle that controls the anal openingmay spasm.
If it does, it may become even harder to pass stools.
Fecal Impaction
Fecal impactionoccurs when hard, dry stool gets lodged in the rectum.
This causes pain and other symptoms like:
Fecal impaction is resulting from chronic constipation.
It often happens in older people who may not feel the urge to have a bowel movement.
Limited fluid intake, a low-fiber diet, and an inactive lifestyle can also contribute.
These episodes of aching or pressure-like pain high up in the rectum may last 30 minutes or longer.
This syndrome is more common in females.
It tends to occur between 30 and 60 years of age.
The cause is unknown.
Muscles in the rectum or the anal sphincter may also be affected.
Spasms in the rectum come on suddenly.
The pain may feel like cramping or produce a gnawing sensation.
The pain is not related to bowel movements.
On average, attacks last around 15 minutes.
They may be triggered by stress or anxiety.
Proctalgia fugax may occur at any age in males or females.
It is rare before puberty.
It is sparked by trauma or an injury that makes the veins in your anal area suddenly break open.
Both cause chronic inflammation leading to pain and ulcers (sores) in the digestive system.
Crohns disease affects your digestive tract.
It can occur anywhere between your mouth and your anus.
Symptoms may include:
Ulcerative colitis nearly always involves the rectum and lower colon.
Sometimes the entire colon may be affected.
Symptoms may include:
Proctitis
Proctitisis an inflammation of the lining of the rectum.
Solitary Rectal Ulcer Syndrome
This is an uncommon and poorly understood disorder.
People with this condition have redness or sores in the lining of the rectum.
Symptoms include:
The precise cause of this condition is unknown.
Experts suspect it may stem from chronic constipation.
Other possible causes include:
Cancer
Rectal cancercan cause rectal pain, as can anal cancer.
These cancers can also cause a feeling of fullness around the anus.
Bleeding is often the firstsign of anal cancer.
The cause also factors into other symptoms that may be present.
They will ask about your medical history and do a physical exam.
However, certain conditions require medications or procedures.
Pain Relievers
Oral and topical pain relievers can help reduce rectal pain.
In severe cases, hard stool may need to bemanually removedby a practitioner.
Other medical therapies or office-based procedures may be used for various conditions.
For example,Botox injectionsmay help relax the anal sphincter and levator ani muscles.
Rubber-band ligationcan be used for some hemorrhoids.
Cancer is also a potential cause, but its much less common.
Rectal pain is often easily diagnosed and managed.
National Institute of Diabetes and Digestive and Kidney Diseases.Definition & facts of hemorrhoids.
Lohsiriwat V.Treatment of hemorrhoids: a coloproctologist’s view.World J Gastroenterol.
2014;9(8):e105281.
doi:10.1371/journal.pone.0105281
Bharucha AE, Lee TH.Anorectal and pelvic pain.Mayo Clin Proc.
2017;38(2):73-77. doi:10.13048/jkm.17019
American Society of Colon and Rectal Surgeons.Abscess and fistula expanded information.
National Institute of Diabetes and Digestive and Kidney Diseases.Colonic & anorectal fistulas.
Hardy A, Cohen C.The acute management of haemorrhoids.Ann R Coll Surg Engl.
2015;11(3 Suppl 1):1-16
MedlinePlus.Proctitis.
Centers for Disease Control and Prevention.Proctitis, proctocolitis, and enteritis.
A case-control study.J Clin Med.
2021;10(19):4401. doi:10.3390/jcm10194401
Endometriosis Foundation of America.Endometriosis symptoms: painful sex (dyspareunia).
Forootan M, Darvishi M.Solitary rectal ulcer syndrome: a systematic review and meta-analysis study protocol.Medicine (Baltimore).
2018;97:e10565.
doi:10.1097/MD.0000000000010565
American Cancer Society.Signs and symptoms of anal cancer.
UCSF Health.Medical tests - rectal bleeding.
UpToDate.Patient education: hemorrhoids (Beyond the Basics).
Docherty MJ, Jones RCW, Wallace MS.Managing pain in inflammatory bowel disease.Gastroenterol Hepatol (N Y).
2011;7(9):592-601.
Dykstra MA, Buie WD.Anal fissures.CMAJ.
2019;191(26):E737.
doi:10.1503/cmaj.190074
National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for constipation.
Centers for Disease Control and Prevention.Inflammatory bowel disease (IBD) basics.
2018;61(3):284292. doi:10.1097/DCR.0000000000001030
