Why Does my Stomach Hurt when I Poop? How to get Rid the Pain

At times you experience stomach pains when you poop that extends to the abdomen and at times in form of a tense pressure. It is hard to fathom its source unless a thorough investigation is conducted to identify the underlying cause. It is usually important to address this with a doctor. More particularly, gastroenterologists are involved with such specificity.

Why does my stomach hurt when I poop? Abdominal Pain & Pressure during Pooping Causes

This pain could be caused by a number of reasons. These underlying conditions are discussed in their relation to pain when you poop.

Irritable Bowel Syndrome

IBS is associated with bloating, abdominal discomforts and abdominal pains but these symptoms can vary from one person to another with some having constipation. In this case, constipation is the difficulty in passing stool.

Most of the people who have constipation strain during bowel movements and they do it with a lot of agony and cramping pain to the anal sphincter muscles. You can also have diarrhea and frequent looseness of stool.

In other words, IBS can be associated with either constipation or diarrhea. According to a renowned gastroenterologist Dr. David S. Shields, M.D and other researchers, there is a co-relation between food intolerance, stress and the occurrence of IBS. The pain felt can be related to the following:

1. Spasmodic episodes that occur with IBS occur with sudden strong muscle contractions and this may be the reason for the pain felt.
2. Too much fluid buildup when the colonic motility is reduced and its ability to absorb fluids is tampered with. This may cause pain due to distension.
3. Inflammation may occur due to food intolerances that lead to IBS and this is associated with swelling and pain. This includes celiac disease that is an allergic reaction to gluten.
4. There is increased sensitivity to pain receptors in the GI tract owing to the reduced receptor activity of serotonin in the gut. Normally, this serotonin, 95% of the total in the body, prevents problems associated with bowel movement, sensation (pain) and motility.
5. Post-infectious IBS after an infection with gastroenteritis which is associated with pain.

Anorectal Trauma

Pain during pooping may also be caused by an injury to the anus or rectum. This could be caused by anal intercourse, constipation, physical trauma or conditions that are associated with impaired anal sphincter muscles’ ability to relax such as internal sphincter syndrome.

At times people insert foreign bodies into the anus such as weaponry ad this could lead to trauma. The pain in the rectum could be associated with the ‘stomach’ pains you feel.

Abscess and Fistula

When there is a cavity between the anus and the pelvis, an abscess may be formed and this may cause painful defecation. Abscesses that have been identified include pelvic abscess, prostate abscess, perianal abscess and ovarian abscess.

Sometimes there is a shooting pain between the uterus in ovarian abscess and the anus. A fistula occurs when there is a passage between the two cavities or hollow organs and may occur as a complication to an abscess. All types of fistulas cause abdominal pain regardless of whether it is a rectovaginal, anorectal or vesicorectal

Infection and Inflammation

All inflammations are associated with pain especially if it is an infection. Pathogenic bacteria may overpower the probiotic bacteria that reside in the colon and lead to infections. You may also get an infection from ingestion of contaminated food and fluids.

Proctatitis is an inflammation of the rectum that is associated with abdominal pain and may lead to pain during defecation. Other infections that do the same include colitis, prostatitis, cystitis and enteritis.

Other organs that may be adjacent to the gut but not directly related to pain during pooping include the bladder which if inflamed, may lead to increased perineal pressure and irritation.

Anal Fissures

Pain in the abdomen may be caused by a tear in the anal epithelium. It is caused by constipation or diarrhea but injury to the anus may also cause it among others such as sexually transmitted diseases. In this case, the pain is localized to the anus but may be felt as a referred pain to the abdomen.

Tumors and Growths

Polyps of adenomas in the colon may present with pain when pooping. The colon spans the lower abdomen as the transverse and the sigmoidal colon and growths may occur anywhere along this lumen.

Fortunately, polyps are benign meaning that they are not cancerous but are however known as precancers. Malignant tumors such as colorectal carcinoma are also responsible for painful defecation and is associated with unexplained weight loss, rectal pleading, proctatitis and altered bowel movements.

Tenesmus

Ever gone to the loo only to strain hard and have no bowel movements? Well, it could be tenesmus a condition that gives you the feeling that you need to defecate even if you have had one recently. It is a result of other conditions such as inflammatory bowel disease which is a general term for Crohn’s disease and ulcerative colitis.

Crohn’s disease leads to ulcerations anywhere in the gut and if you were to have it along the GIT, then you would have abdominal pain during defecation. Ulcerative colitis affects the colon only and the pain is felt in one area of the abdomen rather than multiple localized pains.

Pelvic Lower Abdominal Pain before Bowel Movement Causes

Infections

Even without bowel movements, some pains are existent. Bowel infections such as gastroenteritis are the most common causes of pain in the abdomen. The pain occurs like an ache present for a few days to a week or more if not treated.

Some infections such as viral gastroenteritis are self-limiting and antibiotics are not taken to treat them but only management of the diarrhea and pain with analgesics.  However, bacterial or fungal infections have to be treated and are very painful if not managed. Here is a list of infections for your own consumption:

• Gastroenteritis
• Pseudomembranous colitis
• Intestinal worms
• Diverticulitis
• Procatatitis

Pelvic floor muscle dysfunction

According to Rush university Medical Center[1], this condition is one that has forced some patients to manually remove stool or splint the rectum to ‘defecate’.

Since the pelvic muscles or the levator ani muscles are responsible for proper bowel movements, dysfunction of these muscles could lead to pain when passing stool. Therefore, different positions need to be assumed to be able to defecate.

Inflammation

Inflammation could be caused by auto-immune, traumatic or allergic reasons. Injury may further be mechanical, allergic or chemical in nature and leads to inflammation and pain before a bowel movement.

Chemical trauma could be due to ingestion of foods that are contaminated or drugs that are poisonous. Allergy-associated and autoimmune inflammation could be caused by celiac disease and other food intolerances.

Other auto-immune conditions may cause inflammation and still lead to pain even before bowel movements. A malfunctioned immune system could be observed in inflammatory bowel disease (IBD).

Circulatory factors

These factors could emanate from conditions such as ischemic bowel disease and volvulus. The former is related to an occlusion of the mesenteric arteries that disrupts the delivery of oxygen and nutrients to the tissues.

A volvulus occurs when a part of the large intestines twists around itself on its mesentry. This may lead to colonic obstruction and ischemia. In chronic ischemic bowel disease or mesenteric ischemia, you may experience severe pain, mesenteric angina. Atherosclerosis and thrombosis are causes of this ischemia and pain in the abdomen.

Drugs & Toxins

Some drugs can result in excessive bowel contractions before bowel movements or defecation. Such include laxative abuse and parasympathomimetics. Anticholinergics may also lead to pain before pooping as they lead to decreased GI tract secretions and therefore indigestion.

Why Sharp Pain during Bowel Movement

Bowel movement should be a smooth process and pain is unfortunately common. It is advised that you see a doctor when such happens as conditions that are associated with painful bowel movements are serious. They may complicate to other conditions that are much worse.

People describe pain during bowel movements as like that of ‘pooping glasses. Here are some reasons to explain why you are pooping glass.

1. Infection around the anus or in the rectum. This includes anorectal abscess or pilonidal cyst. The latter is a sac of pus that collects around a hair follicle along the intergluteal cleft but may occur deeper in the anal canal.
2. Anal fissure which is a small tear in the rectum. This could lead to an inflammation of the rectum, proctatitis.
3. Proctatitis in which the anal opening and the lining of your rectum are inflamed. It is associated with pain during bowel movement and soreness in the anal and rectal area. Spasms that occur during defecation are also reason for the pain.
4. Internal sphincter syndrome or anismus in which there is a ‘paradoxical’ contraction of the anal sphincter muscle when it is supposed to relax such as during defecation.
5. Hemorrhoids more particularly when they are thrombosed as happens in external hemorrhoids. This can be painful when passing stool.

How to get rid of Poop Cramps & Bowel Movement Pain

Management of cramps of pain during bowel movement requires an interplay of different medications and non-pharmacological interventions. This interplay speeds up the process of healing while preventing the worsening of the condition and other complications that may arise.

There are home remedies that you may use but if the condition persists, do not insist. See a doctor or a gastroenterologist. Pregnancy could also lead to pregnancy-related constipation which leads to pain during bowel movements and therefore, this needs to be corrected.

Anti-cholinergic and antispasmodics:

Hysocine-S-butylbromide, hyoscyamine, dicyclomine, drotaverine and dicyloverine are good medications that treat colonic spasms that lead to cramping pain.

Laxatives

There are different types of laxatives including emollient and lubricant laxatives. Emollient laxatives such as docusate sodium help wet and soften the stool while lubricant laxatives such as mineral oil coat the stool to prevent loss of water and frictional trauma to the walls of the intestines.

They are indicated for constipation but while emollient laxatives are good for chronic and long term constipation, the latter is meant for short-term constipation as it is linked with malabsorption of fat soluble vitamins, A, D, E and K.

Antidiarrheals:

If the pain is due to a diarrhea, then your doctor could administer antidiarrheals such as loperamide. However, diarrhea in children below two years of age is treated with zinc sulphate.

Analgesics:

While treating the underlying condition, it would be good to manage the pain so as to increase the quality of life of the patient. Pain medications could be administered depending on the scale of pain and while you may take paracetamol or ibuprofen for less severe pain, someone else might be put on opioids. Opioids such as morphine are also anti-diarrheals.

Anti-inflammatory medications:

If the pain is due to an inflammation, non-steroidal anti-inflammatory drugs (NSAIDs) may be used such as ibuprofen. Corticosteroids are however commonly used in the management of inflammatory bowel disease such as budesonide. Another inflammatory agent is mesalamine which is prescribed for mild to moderate ulcerative colitis.

Antibiotics and antiprotozoals:

Particularly for gastroenteritis. Antibiotics that could be used include metronidazole, erythromycin, cefuroxime or amoxicillin.

The WASH regimen is recommended for anal fissures.

• W arm water; sitz bath after bowel movement
• A nalgesics
• S tool softener
• H igh-fiber diet

In other cases, surgical interventions need to instituted such as in management of fistulas. Though operative interventions are associated with complications such as incontinence, they are effective. This applies to removal of polyps and cancerous tumors.

Fistulotomy ligation of the intersphincteric fistula tract (LIFT), or the use of mucosal advancement flaps, plugs, or fibrin glue should be considered only if there is no luminal inflammation (Gecse KB, Bemelman W, Kamm MA, et al, 2014).

[1] https://www.rush.edu/services-treatments/abdominal-and-pelvic-health/pelvic-health-faqs-rush-university-medical-center#four