Sharp Pain During Bowel Movements: Is It Hemorrhoids?

There is a sharp, cutting sensation in the anus?

Hello, doctor.
Sometimes when I have a bowel movement, it feels like I'm being cut with a knife as the stool comes out.
Last week, it was like that, and the first part of the stool was harder.
However, today the stool seemed fine and not very hard.
After I finish, I feel a pulsing sensation in my anus, like there's a wound.
Two years ago, during a colonoscopy, the doctor said I had mild internal hemorrhoids.
Could this be caused by the internal hemorrhoids?

Xiao Wang, 40~49 year old female. Ask Date: 2017/09/11

Dr. Ke Fangxu reply Surgery

Based on your description, it seems more like the typical symptoms of an anal fissure, which include pain during bowel movements accompanied by slight bleeding.
The common causes are often constipation or diarrhea.
The fundamental treatment is to improve bowel habits, along with warm sitz baths.
You can also purchase hemorrhoid suppositories at the pharmacy for relief.
If symptoms persist without improvement, it is advisable to consult a physician for further evaluation.

Reply Date: 2017/09/11

More Info

Experiencing sharp pain during bowel movements can indeed be concerning, and your description suggests that it could be related to hemorrhoids, particularly given your history of mild internal hemorrhoids. However, there are several factors to consider when evaluating the cause of your symptoms.

Firstly, hemorrhoids are swollen veins in the lower rectum or anus that can cause discomfort, especially during bowel movements. They can be classified as internal or external. Internal hemorrhoids are typically not visible and can cause bleeding or a sensation of fullness, while external hemorrhoids can be painful and may cause itching or swelling around the anus. The sharp, knife-like pain you describe could be indicative of irritation or inflammation associated with hemorrhoids, especially if the stool is hard or if there is straining involved during bowel movements.

The fact that you experienced this pain even when your stool was not particularly hard suggests that other factors might be at play. For instance, anal fissures, which are small tears in the lining of the anus, can also cause severe pain during bowel movements. These fissures can occur due to passing hard stools, but they can also develop from other causes, such as prolonged diarrhea or even excessive wiping. The pulsing sensation you feel after a bowel movement could be related to increased blood flow to the area due to irritation or inflammation.

Additionally, it is important to consider other potential causes of anal pain, such as infections, abscesses, or other gastrointestinal issues. If you have any accompanying symptoms such as bleeding, changes in bowel habits, or persistent pain, it would be prudent to seek medical evaluation.

Given your previous colonoscopy, it is reassuring that no significant issues were found at that time. However, if your symptoms persist or worsen, it may be advisable to consult with a gastroenterologist or a colorectal surgeon for further evaluation. They may recommend a repeat examination or additional diagnostic tests to rule out any other underlying conditions.

In the meantime, there are several self-care measures you can take to alleviate your symptoms. Increasing your fiber intake through fruits, vegetables, and whole grains can help soften your stool and reduce straining during bowel movements. Staying well-hydrated is also crucial. Over-the-counter topical treatments, such as hydrocortisone creams or witch hazel pads, can provide relief from itching and discomfort. Warm sitz baths can also soothe the area and promote healing.

In summary, while your symptoms may be related to your history of internal hemorrhoids, other conditions such as anal fissures or infections should also be considered. Monitoring your symptoms and seeking medical advice if they persist or worsen is essential for proper diagnosis and treatment.

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