Pain in the rectum


Pain in the rectum can occur when there is irritation from an injury, inflammation, or indigestion. Of the multitude of possible causes, the most common are the harmless. If pain persists for a long time, and especially if accompanying symptoms such as blood in the stool occur, a doctor should be consulted. In most cases, temporary treatment can relieve the pain.


The possible causes of pain in the rectum are diverse and can often only be determined by a doctor. Often times it is a symptom of constipation.
Too hard stool creates a painful feeling of pressure, which occurs particularly when defecating. Diseases of the rectum itself, such as inflammation or injuries such as an anal fissure, are also possible. These are tears in the rectal lining.
Another common cause of pain in or on the rectum is hemorrhoids. These are plexuses of blood vessels that normally lie in the rectum, but can also emerge from it. This then often leads to pain and possibly also to light bleeding.
Please also read our article on this Symptoms of hemorrhoids.

The pain in the rectum can also be the first sign of cancer in the rectum. Even if more harmless causes are much more common, it is imperative to get a medical examination promptly in order to rule out cancer. If cancer should be diagnosed, the earlier therapy is started, the greater the chances of recovery.
Please also read our article on this Signs of colon cancer.


When diagnosing pain in the rectum, the doctor-patient conversation comes first.

The basis for diagnosing pain in the rectum is initially a medical consultation (so-called "anamnesis"). Detailed questions are asked, including when the pain occurs, what causes or intensifies it, and how long it has existed. In addition, the doctor asks about other symptoms or complaints such as fever, shivering red and in particular whether blood has been found in the stool. The frequency and nature of bowel movements are also important information for establishing a diagnosis.
In addition to this medical interview, the physical examination is very important in the next step. The doctor must first look at the area of ​​the intestinal anus and examine it for a possible disease. In addition, it is often necessary for the doctor to penetrate the intestine with a finger and feel it. This examination is an important part of the diagnosis, even if it can be perceived as unpleasant.
In most cases, the doctor can already make a diagnosis based on the findings obtained in the patient interview and during the examination and initiate appropriate therapy. In some cases, further diagnostics, such as a colonoscopy, are necessary. The doctor will refer you to an appropriate specialist for gastrointestinal diseases or to a hospital.


If there is pain in the rectum, there are often accompanying symptoms that can provide an indication of the cause of the pain.
If there is also a fever or chills, this can be an indication of an inflammatory disease of the rectum. Difficult bowel movements can result in a digestive disorder with constipation.
One should be particularly careful if bloody stool is an accompanying symptom of pain in the rectum. Often a harmless condition, such as hemorrhoids, is the cause. Often there is also an excruciating itchiness. However, it can also be the signs of colon cancer. In the case of bloody stools, a doctor should therefore be consulted and a colonoscopy should be carried out promptly. This also applies if there is only a small amount of blood in the stool.
Please also read our article on this Blood in the stool and Burning in the intestines


Treatment for rectal pain varies widely and is always based on the cause.
In the event of indigestion or constipation, steps should be taken to regulate the stool and make bowel movements easier. This primarily includes ensuring that there is an adequate supply of water or tea (1.5 to 2 liters per day). In addition, the diet should contain enough fiber, for example from whole grain products, vegetables and fruits. The meat intake should be rather low. In addition, natural stool softeners such as psyllium husks can be used (e.g. Mucofalk®). A spoon of these is dissolved in a glass of water and drunk one to three times a day. When using psyllium husks, a high fluid intake is particularly important, as otherwise the symptoms can even worsen.
If the cause of the pain in the rectum is a disease of the bowel itself, further measures are often necessary. For example, if you have an abscess (an encapsulated purulent inflammation) in the rectum, minor surgery is necessary to remove it.
Please also read our article on this Therapy of an anal abscess.

Even with advanced hemorrhoids, pain relief can often only be successfully achieved with a small operation. (see treatment of hemorrhoids)
If colon cancer is the cause of the pain, different measures can be considered depending on the size of the tumor. This includes surgical removal and, if necessary, local radiation and / or chemotherapy. As a rule, the earlier the disease is diagnosed and treated, the lower the level of therapy required.
Please also read our article on this Colon cancer therapy


How long the pain in the rectum lasts varies and depends largely on the cause of the pain.
In the case of constipation, the pain is usually strongest, especially during and after a bowel movement, and then usually subsides and can also go away completely.
In the case of inflammation or an injury to the intestinal mucosa, the pain is more likely to be permanent and only subsides after appropriate medical treatment.
With a hemorrhoidal disease, there are different courses with regard to the duration of the pain. In some cases, pain only occurs in certain circumstances, such as after defecating or cycling. In other cases, however, the pain can be permanent and independent of the situation. In any case, if pain in the rectum lasts for several days, you should see your family doctor as soon as possible so that the doctor can determine the cause of the pain and, if necessary, initiate appropriate therapy.


The prognosis for rectal pain is good in most cases, provided that the cause of the pain is treated appropriately in a timely manner. If the cause is constipation due to malnutrition, the pain often subsides after a few days with a change in diet.
If there is an illness that should be treated by a doctor, such as an infection or injury, the pain after the procedure and a phase of wound healing can also be relieved well in most cases.
Even if a cancer of the rectum is responsible for the pain, in many cases a cure and freedom from pain can be achieved through optimal therapy. It is important to start treatment as early as possible. It is therefore important for the prognosis of pain in the rectum to see a doctor as soon as possible.

Pain in the rectum when sitting

Pain in the rectum, which occurs particularly when sitting, indicates a cause of pain that is particularly exacerbated by the pressure of the body weight when sitting. These include in particular diseases that are in the area of ​​the intestinal outlet or anus, such as hemorrhoids. An encapsulated purulent inflammation (abscess) at the anus is also painful, especially when sitting. The cause of the pain in the rectum, which occurs especially when sitting, can often be identified by a medical examination.

Pain in the rectum and abdomen

Quite often, pain in the rectum is accompanied by pain in the abdomen. The cause can be the increased pressure in this area in the case of blockages.

Pain in the rectum area can often also radiate to the abdomen and be felt there. In addition to the various possible diseases in the intestine as a cause of pain, constipation can also lead to pain in the rectum and abdominal pain.
In women, the uterus is in close proximity directly in front of the rectum. For example, when there is constipation, the increased pressure in the bowel can also exert pressure on the uterus, causing pain.Different causes of pain in the rectum and in the abdomen are also possible. For the latter, for example, menstrual symptoms are often responsible.
Please also read our article on this Pain during menstruation

Nocturnal pain in the rectum

Pain in the rectum that only occurs at night or in the early morning hours should also suggest a so-called "Proctalgia fugax". This leads to cramp-like, severe pain that lasts for up to 30 minutes and then disappears. In the event of these symptoms, the family doctor should be consulted, who can prescribe certain medications and prevent the symptoms from occurring.

Pain in the rectum when defecating

If pain in the rectum occurs mainly during bowel movements, constipation is often the cause. The stool is very hard and it is usually difficult to empty it. In turn, constipation can be caused by various factors.
These often include inadequate fluid intake and a low-fiber diet, that is, if you eat too little fruit, vegetables or whole grain products. However, there are numerous other possible causes that could be responsible for the pain. When defecating, the rectum is exposed to great stress and pressure, so that diseases or injuries in this area cause pain in particular. This also includes hemorrhoids, inflammation, but also benign and malignant space-consuming processes in the rectum. Therefore, if you experience frequent pain in your rectum during bowel movements, you should definitely consult a doctor.
Please also read our article on this Constipation pain.

Pain in the rectum from hemorrhoids

Hemorrhoids are a common cause of pain in the rectum. These are protruding blood vessel cushions that usually remain within the rectum. Various risk factors such as obesity, lack of exercise and congenital influences can promote hemorrhoidal disease and, in addition to pain, itching, stool smear and bleeding often occur.
The doctor can determine whether hemorrhoids are present and if so, at what stage, by looking at and examining the anus. In the early stages, treatment with ointments can provide relief. In advanced stages, a small surgical procedure is usually necessary to remove the protruding hemorrhoids. As a rule, this also eliminates pain in the rectum, provided the hemorrhoids were the cause.
Please also read our article on this Symptoms of Hemorrhoids.

Pain in the rectum with constipation

Pain in the rectum is often associated with constipation. The stool is particularly hard and firm, so that the rectum has to withstand a lot of pressure when defecating and is heavily stressed. So in order to relieve the pain, it is necessary to do something about constipation. At first glance, you should ensure that you drink a sufficiently high amount of around 1.5 to 2 liters per day (ideally water or tea). In addition, high-fiber products such as vegetables, fruit and whole grain products should make up a large proportion of the diet. Larger amounts of meat and sausage products, on the other hand, should be avoided, as they encourage constipation. Natural supplements such as psyllium husks can also be taken as they regulate stool. However, if the pain in the rectum and the constipation persist despite the above measures, a doctor should be consulted as soon as possible.