I experience pain going to the toilet

Sometimes I feel pain after bleeding. It's like I can't walk or sit, I am in too much discomfort. My GP referred me to hospital and they did a camera test which came back normal. But two days ago I felt pain without bleeding after passing stools. This has continued for the last three years. Please advise me.

13 April 2014

Pain in your bottom is a common problem, and it can be very distressing. There are several possible causes that spring to mind. Very rarely, a tumour can cause pain and bleeding, but since you’ve had camera tests to examine the inside of your bowel I’m pleased to say that this is not the case for you.

A much more common cause is piles, or a fissure (a crack in the skin) at the margin of the anus. Piles, or haemorrhoids, are fleshy lumps usually found just inside the bottom, caused by swelling in the network of veins in this area. They are most often caused by constipation, although pregnancy is another common cause and they can run in families. They affect about 1 in 2 people in Britain at some time. The most common symptom is bright bleeding on the paper or pan when you go to the toilet. Pain on opening your bowels and itching can also be a problem.

The fact that you are having bleeding as well as pain makes piles more likely as a cause. However, there are also two conditions which cause pain in your bottom which don’t show any abnormality on camera testing. They are called proctalgia fugax and levator ani syndrome. They are thought to be caused by spasms in the muscles in this area, and while constipation may be at the root of these problems too, in some people there is no obvious reason for the symptoms coming on.

Answered by Dr Sarah Jarvis.


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