The Uncomfortable GI Problem That No One Talks About

Photographed By Ashley Armitage.
While we're arguably more aware of female pain than ever, there are still some unchartered health topics that have yet to be explored: like bowel movement pain. Although this is a reality many of us have experienced at one point or another, we don't talk about poop pain nearly enough. Shit happens, and it's nothing to be ashamed of. In fact, being aware of your gastrointestinal issues is important to your health long-term, so it's important to speak up.
Painful poop is actually a very common topic, even among young women, according to Rita Knotts, MD, gastroenterologist and assistant professor of medicine at NYU Langone Health. The most common causes of painful poops can be traced back to constipation, defined as having fewer than three bowel movements a week, she says.
When you're constipated and pooping less frequently, your stool is often very hard because there's less water in it, Dr. Knotts says. "So, when you do have a bowel movement, it's hard, and it can cause significant pain," she says. If you strain too hard, it can actually cause something called an anal fissure, which is a small split or tear in the tissue lining the rectum. (You might recall Tom Schwartz suffered from this on Summer House.) Symptoms include painful bowels and sometimes blood.
Another common cause of painful poop is hemorrhoids, or swollen, inflamed veins inside the anus, Dr. Knotts adds. "Those can be painful, and even hard for you to sit," she says. The brutal Catch-22 about hemorrhoids is that they're usually caused by straining to pass a bowel movement. Beyond that, people who are pregnant also tend to get hemorrhoids because there's more pressure than usual on the lower body. Pregnant people might feel more constipated than usual because of the increased hormones as well.
With these two causes of painful poop, treatment typically entails getting your bowels back to normal. Drinking plenty of water, exercising, and adding fiber to your diet are wise ways to get regular, Dr. Knotts says. But sometimes poop that hurts can be a sign of a more serious health condition, such as the sexually transmitted infection gonorrhea. Inflammatory conditions such as irritable bowel disorder may also cause a significant amount of rectal pain, she says.
If you're experiencing blood in your stool in addition to pain, then that's a red flag that something is up. "If you see a little bit of blood on the toilet paper, especially after you’ve been straining, that could be just an anal fissure," Dr. Knotts says. "But large amounts of blood in your stool, or ongoing blood in your stool, is a warning sign." You should be seen by a doctor — either your primary care physician, Ob/Gyn, or a gastroenterologist — who can rule out anything more serious, such as rectal or anal cancer.
Above all, it's wise to let your doctor or healthcare provider know if it hurts to poop, so they can take a look and double check that everything is going smoothly. "Even just a brief exam, just to get a lay of the land, and make sure that everything is okay," Dr. Knotts says. Because, honestly, everyone poops — and sometimes it hurts.

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