Internal Medicine

Painful bowel movements

definition

Many people experience painful bowel movements. This affects both women and men and can have various causes, ranging from poor nutrition to pregnancy and anal disorders.

The feces, also called faeces, should normally have a soft to medium-hard consistency and when bowel movement come off easily without causing discomfort. Is the Feces too hard or exist Injuries in the anal area, this can lead to painful bowel movements.
The feces consist of indigestible food residues, intestinal bacteria, rejected intestinal mucosa and, to a large extent, water. The water content is responsible for the consistency of the stool, which is why diet plays an important role in the texture of the faeces.

Pain when defecating is medically a part of the rectal discomfort, the so-called proctalgia, which includes anal and anus discomfort.

causes

https://www./?id=12385 The causes of pain when defecating are very diverse. Often people also complain chronic constipation (constipation) about these complaints. In these people, the feces are very hard and dry and a relatively high level of force is required to press the feces out. Pressing is often associated with severe pain.

Chronic constipation also promotes the development of hemorrhoidswhich can also lead to problems with bowel movements. If hemorrhoids exist, then regardless of the constipation, painful bowel movements may occur. Also one Anal vein thrombosisThat causes symptoms similar to hemorrhoids can be the cause of the pain.

Little ones Cracks in the mucous membrane of the anus or in the lining of the rectum can lead to sharp pain during bowel movements. One speaks of so-called Anal fissures.

Also can Anal fistulas, so Inflammationthat run like a tunnel under the skin in the area of the anus, or Anal eczemawhich are a rash in that area, cause pain. Also encapsulated purulent inflammation in the area of the anus, so-called Anal abscesses, can cause pain during bowel movements.

In addition, can also STDs, how syphilis or Genital warts Cause pain when defecating.

In addition to harmless causes, such as spicy food or long-lasting diarrhea, which irritates the mucous membrane of the anus, in rare cases malignant diseases how Anal cancer (anal cancer) or Rectal cancer (Rectal cancer) be responsible for the pain.

Concomitant symptoms

In addition to the painful bowel movements, various can Concomitant symptoms occur. These are especially important in determining the cause.

itching in the area of the anus (see also: Anus itch) indicates a Hemorrhoid disease down. In addition, symptoms that are less specific, such as persistent symptoms, may appear Bloating, convulsive stomach pain or slimy secretion or. bloodthat is mixed in with the chair.

It definitely should be one Consulted a doctor and the cause of the pain and accompanying symptoms are clarified. This also applies if, in addition to the pain, general tiredness that has persisted for a long time or unexplained weight loss occurs.

Blood in the stool

If blood is mixed in with the stool and there is additional pain when defecating, in most cases it is an anal fissure. This is a more or less small crack in the lining of the anus. The pain that persists when defecating is sharp and burning, and the blood is usually fresh and bright red. However, the anal fissure can also make itself felt as itching. The pain can be relieved by using ointments with anesthetic agents. If no fissure is visible from the outside, a doctor should be consulted.

Blood in your stool can also be caused by serious medical conditions, especially if it is dark blood. These include chronic inflammatory bowel diseases such as Crohn's disease or ulcerative colitis or tumors in the large intestine.

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therapy

For chronic constipation, changing your diet can help normalize stool consistency. Sufficient amounts of water to drink, fruit, legumes and vegetables are particularly helpful.

Depending on the underlying cause of the pain, there are different ways to do something about it. Especially in the case of constipation, it helps to keep the bowel movements soft through proper nutrition so that there is as little pain as possible when emptying. This also helps reduce the pain associated with hemorrhoids or anal fissures.

Read more on the subject at: Diet for constipation.

Above all, it is important to drink enough, as a large part of the feces consists of water. In addition, a high-fiber diet with whole grains, legumes, fruits, vegetables and nuts in conjunction with adequate exercise is helpful.

More information is available here: Constipation - What Can You Do About It?

In addition, bowel movements should not be suppressed, as this can lead to additional discomfort. By using soft toilet paper, the risk of skin irritation and cracks in the anal mucosa is minimized.
If these measures don't help relieve constipation and relieve pain, laxatives may be needed.
If inflammation is the cause of the pain, ointments, suppositories or enemas with pain relievers often help. Sitz baths with chamomile or tea tree oil can also provide relief.
If hemorrhoids are present, they must be removed in most cases. This can be done in a number of ways and does not necessarily require surgery. (see also hemorrhoid therapy)
Anal vein thromboses, tumors and abscesses must, however, be surgically removed in any case to avoid further complications.

Which doctor should I see if I have painful bowel movements?

The specialist in diseases of the rectum is the proctologist. If the symptoms are severe, a colonoscopy may be necessary to rule out a possible internal disease.

If there is pain during bowel movements, the Family doctor visited. This is also the right way, as this can decide, depending on the accompanying symptoms, whether a visit to a specialist and further diagnostics are necessary. It is especially important to see a doctor if blood is mixed in with the chair.
The specialist in diseases of the rectum is the Proctologist. Depending on what is suspected, however, it may be necessary to call in internists, gastroenterologists, surgeons, urologists, gynecologists or oncologists for diagnoses and examinations.
In addition to viewing the anal region from the outside, depending on the suspected diagnosis, palpation, a rectal or Colonoscopy or compromises may be necessary.

Pain when defecating in the child

If children have pain when defecating, it is usually due to one of them constipation (Constipation). If the complaints last longer than two months, one speaks of one chronic Constipation. The pain is usually accompanied by a stomach ache, loss of appetite, and gas, and when you pass stool, the stool appears very hard or as large lumps.
Constipation occurs in around 95% of cases no underlying organic cause and the trigger is one Gastrointestinal infection or stress. Diet can also make the stool very hard, causing pain when emptying. After a fairly short period of time, constipation in children leads them to associate going to the toilet with pain and trying to avoid defecation. However, this makes the situation worse, because the feces continue to harden and if at some point it can no longer be held back, the subsequent transactions become more and more painful. Often only a visit to the pediatrician who does an enema helps laxative prescribed which lead to bowel movements.
If the constipation is already chronic, the children should be given stool-softening medication for the next few months. As a result, the children notice that the stool does not have to hurt and they trust themselves to go to the toilet again. This Learning process however, it can take a long time.

Certain lifestyle and eating habits can ensure that the stool is and remains a soft consistency. Sufficient Drinking quantities and Move are an important foundation. A glass of juice in the morning can be good for your intestines. In addition, pears, pumpkin and dried fruit are helpful in loosening up the poop. Bananas and chocolate, on the other hand, tend to have the opposite effect and should not be served in huge quantities to children.

If there is blood in the faeces in addition to the pain when defecating, this is in most cases also due to a harmless cause. If the blood is bright red, it is fresh blood, which is probably due to a tear in the anal mucosa.
Dark red blood indicates bleeding upstream in the digestive tract. Often times are Colon polyps the reason. These are also harmless and do not actually cause any problems for an otherwise healthy child.
However, if it is a diarrheal disease that is associated with blood, this is often an indication of one bacterial Infection with Salmonella or Shigella or chronic bowel inflammation. These include Crohn's disease and ulcerative colitis. A pediatrician should be consulted urgently.

But also so-called Mock bleeding can worry parents. Blood in the stool can be faked by beetroot or tomatoes.

Pain when defecating in women

During the period

If you experience increased pain when defecating during your period, this is usually due to a so-called Endometriosis traced back. This is a benign condition in which the lining of the uterus spreads to deeper layers or even to other organs. All in all, all symptoms of endometriosis occur more frequently during menstruation, with abdominal pain in particular. In this context, pain can also occur during bowel movements, as the pressure when going to the toilet also compresses the uterus.

During pregnancy

During pregnancy, many women complain of painful bowel movements. On the one hand, this may be due to the digestive system during pregnancy slowed down is. The body keeps food in the gastrointestinal tract for as long as possible in order to extract sufficient nutrients for mother and child. This creates the chair very hard and strong pressure during bowel movements can cause pain.
Due to the increased pressure in the pelvic area that can be traced back to the growing baby, pregnant women have an increased risk of hemorrhoids to develop. This is usually not dangerous, but if the hemorrhoids are large enough, it can cause pain during bowel movements. After pregnancy, the hemorrhoids usually resolve on their own.

After a caesarean section

That the intestines after one Caesarean section is messed up is normal in the vast majority of cases. This manifests itself differently from woman to woman. Pain during bowel movements can be a possible symptom, as can diarrhea, constipation, or indefinable pain.
The hormones produced during pregnancy slow down digestion. This can lead to constipation. Constipation can persist even a short time after delivery. Pain can result from increased pressure during bowel movements. If these do not go away after a few days, a doctor should be contacted.

Please also read our article on this Pain after caesarean section

After a scraping

After a Scraping of the uterus symptoms can occur up to a few days after the procedure. These can express themselves in different ways. From pulling pains in the lower abdomen to slight bleeding to problems with bowel movements, everything is harmless to a certain extent.
Since the uterus is a well-perfused organ and scraping is a not inconsiderable procedure, the area is very sensitive in the days after the procedure. If strong during bowel movements pressed this can become a Applying pressure to the uterus come what causes pain. After about a week, however, the symptoms should subside on their own, otherwise the gynecologist should be visited again.