Why it hurts when you poop, and when to get help
Pooping should never be painful.
Health experts say it’s quite common for people to feel pain in their anal area when passing a stool. But besides feeling pain, irregular pooping should also be considered a red flag, said gastroenterologist Dr. Talia Zenlea of Women’s College Hospital in Toronto.
“Regularity doesn’t matter… you don’t get a gold star of having one form of poop,” she told Global News. “Some people say, ‘What is normal?’ It doesn’t matter how often you go or don’t go, as long as it isn’t bothersome.”
She said “normal poop” can be considered going two times a day or once a week — it all depends on the individual. “If you went from one stool a week to one stool a day, I would be more worried about that,” she continued, adding that people’s pooping routine comes down to a variety of factors including genetics, diets or even how much they exercise.
Experts have also said “normal poop” may come down to looking at the smell, type and colour.
General internal medicine specialist Dr. Seema Marwaha of Toronto added that although we all poop, it’s still quite taboo to talk about pooping patterns or even pain to your doctor.
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“In the past people had long-term relationships with their doctors and were more willing to to talk about their personal issues,” she explained. “But now we have a culture in younger people where they don’t have regular medical followups and when they see a doctor, it’s in an emergency setting or walk-in.”
She also added we rely too much on what we find online, often diagnosing ourselves before we even see a doctor. A quick search on “pain while pooping” can lead to articles about irritable bowel syndrome or cancer, which are rarer.
Below, both experts help us determine the most common reasons why pooping can be a painful experience.
Constipation is common across all age groups and something that causes many symptoms. Marwaha said doctors often define it two ways. “One is that it’s a decrease in frequency in bowel movements, going less than three times a week,” she explained. “But we also use the second definition of passing a stool that is hard, even though that is not the medical definition.”
Often the terms are used interchangeably, but any type of irregularity from your unique pattern can be a cause of pain when you poop.
Zenlea added constipation can also become chronic, where people shift back and forth between constant diarrhea to normal stools. “I would speak to an expert if there are bothersome symptoms like pain, bloating and definitely if there is blood.”
Diet can also play a role in making your poop irregular, and while it may not cause pain, it could lead to constipation or frequent bowel movements, which could eventually be painful to pass gas or stools.
“Certain [things] high in fibre, caffeine and alcohol can make stool looser, as well as greasy food,” Zenlea said. She adds people with food intolerance like dairy or gluten may also experience irregular bowel movements.
Hemorrhoids are also very common and some research suggests three in four adults will experience hemorrhoids at some point in their lifetime, Marwaha added.
“You have blood vessels that supply and drain blood from the anus and rectum and they are kind of exposed,” she explained. adding they are sensitive to pressure or strain.
“When the walls of the blood vessels are stretched, they become painful… you can probably see it or feel it when you wipe.”
A rectal exam can help determine whether or not you have hemorrhoids, but Marwaha said it is often the result of passing blood when you poop. “People that do activities that cause increased pressure in that area, like heavy weightlifters who squat or pregnant women [are at higher risk].”
Trauma or anal fissure
An anal fissure is a small tear in the lining of the anus and it is very common in young children and adults. “This is also pressure based, after a long period of time you can get hemorrhoids,” she continued.
During childbirth, anal fissures are common or even after anal intercourse, which is considered trauma. And while they can be mild and go away on their own, if they are causing pain when you poop, talk to a doctor.
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