Pressure in the Rectum: 11 Causes

Many conditions may cause pressure in your rectum, including constipation, diarrhea, anal fissure, and hemorrhoids. Serious causes of rectal pressure are less common and include diverticulitis, rectal prolapse, and anal cancer.

Pressure in the rectum can feel like a need to move your bowels. It can also feel like stool (poop) is stuck in the lower digestive tract or that something is falling out of your anus. Rectal pressure can range in intensity from a dull aching sensation to pain and cramping.

This article discusses the conditions that may cause the feeling of pressure in the rectum. It explains the different symptoms that may accompany rectal pressure, how they’re treated, and when to see your healthcare provider.

Anal Fissure

An anal fissure is a tear or crack in the tissue lining the anus that can cause pain and pressure in the rectum. Other symptoms of anal fissures include rectal bleeding and pain that lasts for hours after a bowel movement.

An anal fissure is usually acute and heals on its own with at-home treatments, such as a high-fiber diet and warm baths. If the anal fissure is chronic and a lingering problem, surgery may be needed.

Constipation

Constipation is defined as bowel movements that occur fewer than three times per week. Symptoms may include abdominal discomfort; stools that are hard, dry, or lumpy; stools that are difficult or painful to pass; or a feeling that not all stool has passed, which can cause rectal pressure.

Lifestyle changes, such as adding fiber to your diet, drinking more water, and being active. Other treatments may include over-the-counter (OTC) or prescription medicines, biofeedback, or surgery.

Diarrhea

Diarrhea is described as loose, watery stools three or more times a day and can be acute (lasting one or two days), persistent (lasting two to four weeks), or chronic (lasting four or more weeks and can be continual or come and go).

For diarrhea, slowing bowel movements down may help with the pressure. This could include taking antidiarrheal medications and eating the BRAT (bananas, rice, applesauce, tea, and toast) diet temporarily. For diarrhea that is persistent or chronic, or if you see blood in the stool, check with a doctor before using these drugs.

Hemorrhoids

Hemorrhoids are swollen and inflamed veins around the rectum or anus that can be internal or external. This condition can result in anal discomfort or pressure, pain, itchiness, and bleeding. At-home treatments may include:

• Eating high-fiber foods
• Taking a stool softener or a fiber supplement such as psyllium 
• Drinking enough water
• Not straining during bowel movements
• Not sitting on the toilet for long periods of time
• Taking OTC pain relievers such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), naproxen (Aleve), or aspirin
• Sitting in a tub of warm water, called a sitz bath, several times a day to help relieve pain

In some cases, procedures or surgery such as rubber band ligation, sclerotherapy, or hemorrhoidectomy are done to treat hemorrhoids.

Coccydynia (Bruised Tailbone)

An injury to the coccyx (end of the spine) is called coccydynia, or bruised tailbone. Coccydynia is often related to an injury when falling on the tailbone or during childbirth, or from sitting for prolonged periods on hard surfaces.

Coccydynia will usually heal slowly with time and the following treatments:

• OTC pain relievers and anti-inflammatory medications to reduce swelling and relieve discomfort
• Ice and heat therapy after a fall or other trauma
• Special pillows to reduce pressure on the tailbone
• Physical therapy, massage, and stretching exercises to reduce muscle tension and tightness

Fistula

A fistula is an abnormal tunnel or connection between two body parts that is usually the result of an injury, surgery, infection, or inflammation. If the fistula occurs between the rectum and the vagina or the intestine and the skin, it may cause pressure in the rectum.

Symptoms may include:

• Pain
• Fever
• Diarrhea
• Weight loss
• Pus, blood, stool, or other foul-smelling discharge

Additional symptoms can occur depending on the location of the fistula. Some fistulas will heal on their own without surgery to close them. Other treatments may include fluids, electrolytes, antibiotics, and nutrition support.

Diverticulitis

Diverticulitis is inflammation or infection of diverticula (outpouchings) in the lining of the colon. Bloating and gas may put pressure on the rectum. Symptoms can include:

• Tenderness, usually in the left lower part of the abdomen
• Bloating or gas
• Fever and chills
• Nausea and vomiting
• Not feeling hungry and not eating
• Severe abdominal pain

Depending on the severity and frequency of developing diverticulitis, treatment may include:

• Rest
• Heating pad on your stomach
• Pain medicines (ask your healthcare provider which ones you should use)
• Drink only fluids for a day or two, and then slowly begin drinking thicker liquids and then eating foods
• Colectomy (surgery to remove part of the colon) in severe cases

Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease (IBD, which includes Crohn’s disease, ulcerative colitis, or indeterminate colitis) causes inflammation in the digestive tract.

The pressure associated with IBD may be from diarrhea or constipation caused by the disease. It could also be from a complication such as a fistula or perianal disease. Controlling the inflammation caused by IBD is a big part of the treatment.

Treatments for IBD can include oral medications, biologic medications, enemas, suppositories, and lifestyle modifications.

Rectal Prolapse

Rectal prolapse occurs when the lining or the wall of the rectum drops down through the anus. Symptoms may include:

• A feeling like something is coming out of the anus
• A visible reddish-colored mass sticking out of the anus
• Constipation, diarrhea, or both
• Feeling that the rectum is not empty after a bowel movement
• Inability to control bowel movements (fecal incontinence)
• Passing blood or mucus from the rectum

A rectal prolapse that stays on the outside of your body can be serious and requires prompt medical treatment. The prolapsed tissue can become strangulated, start to lose circulation, become necrotic, and die.

Seek emergency medical care if rectal prolapse is accompanied by pain, fever, or a lot of bleeding. If the prolapse isn’t causing symptoms, make an appointment with your healthcare provider.

Treatment usually involves surgery. Reducing or avoiding constipation is recommended to lower the chance of recurrence.

Prostatitis

Prostatitis is inflammation of the prostate—a walnut-shaped gland responsible for producing the fluid portion of semen. Symptoms will differ depending on the cause of inflammation but may include:

• Pain or discomfort in the abdomen, penis, scrotum, lower back, or between the scrotum and anus
• Pain in the urethra or penis during or after urination
• Urinary urgency or frequency—urinating eight or more times a day
• A weak or interrupted urine stream
• Urinary retention—the inability to empty the bladder completely
• Trouble starting a urine stream
• Urinary blockage—the complete inability to urinate
• Urinary tract infection (UTI)
• Fever or chills
• Nausea or vomiting
• Body aches

Treatment depends on the type of prostatitis and may include antibiotics or other medications to decrease pain, discomfort, and inflammation. Other treatments may include sitz baths, heat therapy, physical therapy, biofeedback, and acupuncture.

Anal Cancer

Cancer of the anus is considered rare when compared to other forms of cancer. However, the rate has been increasing by about 2% each year. A bulge or a bump (a mass) in the anal area could cause pressure in the rectum area.

Surgery, radiation, and chemotherapy are all treatments used for cancer. It’s important to remember, however, that cancer is not a common cause of rectal pressure.

When to See a Healthcare Provider

Constant pressure in the bowel is not a normal part of the digestive process. See your healthcare provider if symptoms last longer than a few days or are accompanied by the following symptoms:

• A mass or lump or bump in the anal area
• Bleeding from the rectum
• Chills
• Fever
• Signs of an infection
• Tissue protruding from the anus
• Unusual discharge from the rectum

Talking with a healthcare provider about symptoms in the digestive tract can be difficult. There are some key things to remember when bringing up anal or rectal pressure with your healthcare provider.

• Many of the common causes of rectal pressure are not serious and can get better with treatment.
• Bringing symptoms to a healthcare provider can help in getting a diagnosis and treatment faster.
• Healthcare professionals hear about bowel problems all of the time. They’re trained in how to take a list of symptoms and determine what to do next.

Summary

Pressure in the rectum may come from a variety of causes, but most of them are temporary and treatable. Seeing a healthcare provider for this symptom will help in understanding what is causing it and how to treat it.