Rectal pain is common and almost always treatable. However, the solutions depend on whether the pain is being caused by hemorrhoids, tears in the anal canal, or skin irritation. Rectal pain may also be a result of a clotted hemorrhoid under the skin or a spasm in the muscle of the floor of the pelvis, or a possible infection or abscess.
If you’re experiencing rectal pain, especially if it’s persistent, worsening, or interfering with daily activities, a medical evaluation can help identify the cause and guide appropriate treatment.
What Rectal Pain Feels Like
- Itching and sharp ‘glass-like’ pains during or after defecation
- Burning or itchy sensations that persist
- Pressure, throbbing, or a tender mass at the anal edge
- A feeling that you still have to ‘Go.’
- Bright red blood on tissue or in the bowl
If the bleeding is heavy or is recurring, or if the pain is bad, get help. A person does not always bleed because of hemorrhoids.
Common Causes Of Rectal Pain
Hemorrhoids
Engorged veins in the rectum or anal canal. Internal hemorrhoids: May bleed with little pain. External hemorrhoids: May itch, burn, and may form a tender, hard lump called a thrombosed external hemorrhoid, especially if a blood clot has formed.
Anal fissures
A very small tear in the lining of the anus, commonly from very hard stool or straining during a bowel movement. Painful during bowel movements, accompanied by some bright red blood. Many can be treated effectively with home remedies, while some may require medication or a medical procedure.
Thrombosed external hemorrhoids
Sudden onset of a large, very tender bulge along the edge of the anus due to a blood clot underneath the skin. The pain will often reach its peak in 48-72 hours, improving; the hard bulge might take weeks to resolve as the body resolves the clot.
Pelvic floor muscle spasms
Levator ani syndrome and proctalgia fugax are examples of other conditions that may give the patient rectal pressure and cramping that is not related to bowel movements.
Abscesses or infections
A swollen and painful spot on the body that could have a warm feeling or fever.
Everyday Habits That Impact Rectal Pain
- Constipation or diarrhea
- Low fiber or Low fluids
- A lot of sitting (at a desk, in a car, or loitering on the toilet
- Lifting, straining, or otherwise
- Holding toilet visits
- Pregnancy or Postpartum Changes
- Harsh wipes and fragrant soaps on sensitive skin
Small changes, such as more fiber and fluid, shorter bathroom visits, and gentle skin care, are often effective in controlling flare-ups.
When To Be Seen for Rectal Pain
- Severe or repetitive rectal bleeding
- Painful swelling in the genital area of the lower abdomen
- A painful swelling that could be an abscess
- Unintentional weight loss, Anemia, or Alterations in bowel habits
- Pain that is not improving even with consistent home care for a week
How We Figure It Out
1. Conversation & History to understand your symptoms, objectives, and processes.
2. Gentle exam to establish cause – speedy and discreet.
3. Clear plan based on what we’ve found, whether that’s home steps, something that can be done in the office, or a referral if there’s another issue at play.”
Easy Ways to Treat Rectal Pain
- Fiber: 25-35g/day, added incrementally (produce, grains, beans, or a fiber supplement).
- Fluids: Adequate so that urine is light yellow.
- Bathroom habits: Go when you need to, don’t push, and don’t linger (no doom scrolling on reels! ).
- Sitz baths: Warm water, 10-15 minutes, and 2-3 times daily to relax the area
- Sensitive skin care: Gently pat skin dry and use barrier ointment if skin is irritated
- Light Exercise: Taking short walks after each meal can help maintain regularity.
In-Office Hemorrhoid Treatment for Rectal Pain
At The Hemorrhoid Institute, our focus is on non-surgical and in-office treatment. Our key procedure for treating hemorrhoids is Infrared Coagulation (IRC), where infrared pulses are used to seal a blood vessel so that the internal hemorrhoid reduces in size.
- No incisions and general anesthesia
- About 10 minutes in the office
- Most people return to normal activity the same day
- The relief builds over several days into a period of a couple of weeks; a short sequence of treatments may be scheduled if several areas require treatment
When dealing with cases of anal fissures, abscesses, or spasm of the pelvic floor, the course of treatment varies (for instance, medicated creams for the fissures, drainage for the abscesses, and stress techniques or pelvic floor therapy for spasm). Your healthcare professional will provide the care that corresponds to the precise diagnosis, not a guess, but not a “one size fits all” approach.
Rectal Pain vs. Hemorrhoids: What’s the Difference?
Rectal pain is a symptom. One of many possible causes of that symptom, frequently in combination with other findings, such as fissures, abscesses, or pelvic floor spasm, is hemorrhoids. Here’s how to differentiate them at a glance:
Internal hemorrhoids are usually painless and characterized by bleeding at the end of bowel movements. Bleeding is bright red on the tissue or in the bowl. Fullness and pressure are present, and it may also be accompanied by prolapse. Pain is infrequent, and that is, unless irritation arises.
- External hemorrhoids: Painful itching or burning at the anal margin; a thrombosis will present as a sudden painful lump, usually accompanied by sharp pain, which peaks within 48–72 hours.
- Anal fissure (not hemorrhoids): Sharp, “glass-like” pain with bowel movements and a small streak of bright-red blood. Pain often lingers after the BM.
- Pelvic floor spasm (not hemorrhoids) Deep ache or cramp not related to bowel movements Episodes that come and go.
- Proctitis/other inflammation (not hemorrhoids): Mucus, urgency, and bleeding with diffuse irritation.
If you are not sure, a quick examination sorts out which one you are dealing with-so you may choose the right fix, rather than guess.
Ready to Start Hemorrhoid Treatment for Rectal Pain?
We keep visits to discuss hemorrhoids confidential, brief, and compassionate. The Hemorrhoid Institute has offices in nearby Milford, Fairfield, Newtown, and Shelton. Reach out to us today, and we will figure out what is happening, outline your choices clearly, and if possible, treatment can be started on the initial visit.