If It Hurts When You Poop, Here’s What It Means According to Gastroenterologists

Why does it hurt to poop at times? Expert doctors’ reasons

Painful bowel movements can happen for many different reasons—some are temporary and harmless, while others may signal an underlying health issue. Sometimes the explanation can be straightforward, such as not eating enough fiber, not being very physically active, or taking medications that slow down the digestive system. These medications can include certain blood pressure drugs, GLP-1 medications prescribed for diabetes and weight loss, and narcotic pain relievers.

The key is paying attention to what your body is telling you, since causes can range from constipation to more serious conditions. And before you reach for over-the-counter treatments, it’s always best to check in with your doctor to make sure you’re addressing the root cause. Here are some of the most common reasons pooping can hurt, along with what doctors recommend you do about them:

You’re constipated

One of the most common reasons for bowel movements discomfort is constipation. When stools are dry and hard, “the more difficult and painful it is to pass them, which can cause mucosal injury and pain as it passes through the anal canal,” says Dr. Jirik.

If you’re constipated, you’re likely straining—and that strain can add to the problem. “Straining can cause small tears or swollen veins around the anus, both of which can make bowel movements painful,” adds Dr. Chiang.

The good news: simple lifestyle changes can help. Drinking enough water, eating fiber-rich foods like fruits, vegetables, and whole grains, and staying physically active can keep your digestive system moving. Over-the-counter stool softeners or laxatives may offer short-term relief, but if constipation lasts more than a week, consult your doctor.

And again: drink plenty of water daily.

You have hemorrhoids

“Another common reason [it hurts to poop] are external hemorrhoids, which are veins from the anal canal that can protrude and cause pain and bleeding,” explains Dr. Jirik, who adds that straining during a bowel movement often makes the problem worse. Symptoms may include sharp or burning pain, itching, swelling, and bright red blood on the toilet paper after wiping.

Fortunately, many hemorrhoid symptoms can be managed at home. Sitz baths (described by the Cleveland Clinic as “a warm water bath you sit in to relieve discomfort in your perineal region”), topical creams, and a diet with enough fiber can reduce irritation and make stools easier to pass.

If discomfort doesn’t improve—or if bleeding is persistent—your doctor may recommend medical procedures to shrink or remove hemorrhoids.

You have an anal fissure

A sharp, cutting pain during a bowel movement is often a sign of an anal fissure, which is a small tear in the lining of the anal canal. This is another common culprit behind painful bathroom trips, says Dr. Chiang.

Anal fissures are most often linked to chronic constipation and straining, but “they can also be caused by Crohn’s disease, malignancy, and STDs (sexually transmitted diseases),” says Dr. Jirik. In addition to pain, anal fissures may cause blood in the stool and a lingering stinging sensation afterward.

Treatment usually starts with warm sitz baths, topical ointments, and stool softeners to keep bowel movements gentle. For chronic fissures that don’t heal, doctors may prescribe stronger creams—or, in rare cases, recommend surgery.

You’re dealing with an infection or inflammation

Sometimes painful bowel movements are the result of an underlying infection or inflammatory condition, notes Dr. Chiang. Although less common, sexually transmitted infections (STIs), rectal abscesses, or inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis can all cause pain when passing stool. These conditions may also bring additional symptoms like fever, pus, or ongoing abdominal discomfort.

Because these issues are more complex, home remedies typically aren’t enough. Diagnosis and treatment often require medical care, which may include antibiotics, anti-inflammatory medications, or other targeted therapies depending on the underlying cause.

You have IBS (irritable bowel syndrome)

Irritable bowel syndrome (IBS) is a chronic condition that disrupts how the digestive system functions—and it may also be a cause of painful bowel movements. For some people, IBS alternates between diarrhea and constipation, both of which can make pooping uncomfortable. And just like constipation, excessive diarrhea can cause painful poops, notes Dr. Jirik. Other common symptoms include abdominal cramping, bloating, and an urgent need to go.

Treatment often requires a combination of strategies. Managing stress, adjusting your diet to avoid trigger foods, and working with a gastroenterologist on prescription medications can make a big difference. A tailored plan is usually the best approach, since IBS looks different for everyone.

You might have endometriosis

“There may also be other pelvic disorders and illnesses like endometriosis that could lead to painful pooping,” says Dr. Chiang. Endometriosis is a chronic condition where tissue similar to the uterine lining grows outside of the uterus. When this tissue builds up around the bowel or rectum, bowel movements can become painful—especially during menstruation.

Symptoms often go beyond painful pooping and may include severe period cramps, pelvic pain between cycles, bloating, and pain during sex. Because these signs overlap with other conditions, endometriosis is sometimes difficult to diagnose.

Treatment varies depending on severity. Pain relievers, hormonal therapies, and lifestyle changes can help manage symptoms, while more advanced cases may require surgery to remove endometrial growths. If you suspect you may have endometriosis, talk with your gynecologist or a specialist, since early diagnosis can make treatment more effective.

You’re experiencing proctitis or a rectal condition

Inflammation of the rectum—known as proctitis—can cause significant pain during bowel movements. This condition may result from infections, radiation therapy, or chronic illnesses. Other rectal issues, such as rectal prolapse (when the rectum slips out of place), can also make pooping painful.

Dr. Chiang also highlights that, “Sometimes it has nothing to do with the bowels, but rather the skin around the anus that could be the culprit.” Skin irritation, rashes, or dermatitis in the anal area may mimic or worsen rectal pain.

Because these conditions vary widely, diagnosis usually requires a doctor’s exam and sometimes imaging or a scope. Treatment depends on the cause—options may include antibiotics, anti-inflammatory medication, or minor procedures to correct structural problems.

Cancer concerns

Dr. Chiang notes that while less common, colorectal cancer can sometimes present with painful bowel movements. Other red flags to watch for include unexplained bleeding, unintentional weight loss, fatigue, or a persistent change in bowel habits.

Because symptoms of colorectal cancer can overlap with more common conditions like hemorrhoids, it’s important not to ignore them. Early detection makes a significant difference in treatment outcomes. If you notice any concerning symptoms, talk to your doctor about appropriate screening tests, such as a colonoscopy, to investigate potentially serious causes.

When to see a doctor

Occasional discomfort when pooping isn’t usually a cause for alarm, but both Dr. Chiang and Dr. Jirik stress that there are times when you should seek medical care right away. Make an appointment with your doctor if you experience:

• Pain that persists or gets worse
• Abdominal pain or rectal bleeding
• Changes in bowel habits or the shape/size of stool
• Unexplained weight loss
• Fever, chills, or signs of infection
• A family history of colorectal or anal cancer

These symptoms may point to more serious conditions, including colorectal or anal masses, infections or perianal abscesses, and inflammatory bowel disease.

At your visit, your doctor may start with an in-office anorectal exam to check for hemorrhoids, abscesses, or fissures. This can also include a digital rectal exam, where the doctor feels for any obvious masses in the lower rectum or anal canal. Depending on what they find, you may also need a colonoscopy or imaging tests—such as a CT scan or MRI of the abdomen, pelvis, or perineum—for a clearer diagnosis.

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