Recurring Lower Abdominal Pain and Burning Sensation After Bowel Movements

Recurrent lower abdominal pain with persistent burning sensation in the anus after bowel movements?

Hello, doctor.
I have a long-standing issue with irregular bowel movements; sometimes I go once a day, and other times it can be two to three days before I go again.
Over the past month or two, I've frequently experienced bloating and excessive gas.
Recently, the gas has decreased, but I've noticed more frequent abdominal rumbling (even when I'm not hungry, and it can occur with changes in position or movement).
This past week, I've had recurring lower abdominal pain (near the uterus and pelvic area).
I consulted a gynecologist, but no issues were found.
The abdominal pain lasts for several hours and is often relieved after a bowel movement, but the stools are not well-formed; they are either mushy or watery.
After a bowel movement, the abdominal pain does not immediately resolve; it gradually eases over a few hours.
Additionally, I have a persistent burning sensation in the anal area after bowel movements that lasts until the next day (I have hemorrhoids, but there is no blood in the stool or swelling.
Based on my past experiences with hemorrhoids, this burning sensation is unlikely to be caused by a hemorrhoid flare-up).
Therefore, I would like to know if this could possibly be rectal inflammation?

iris, 40~49 year old female. Ask Date: 2024/03/21

Dr. Lin Minghui reply Gastroenterology and Hepatology

Abdominal pain with persistent burning sensation after bowel movements may be due to difficulty in passing stools, which can cause pelvic muscle coordination issues leading to abdominal pain.
It could also be caused by colitis or proctitis resulting in abdominal pain.
The presence of unformed, bulky stools or watery stools can irritate the skin around the anus, sometimes causing a burning sensation.
If there is difficulty in bowel movements and abdominal pain accompanied by blood or mucus in the stool, urgency, weight loss, or anemia, further examination is necessary.
Wishing you good health.

Reply Date: 2024/03/21

More Info

Based on your description, it sounds like you are experiencing a complex set of symptoms that could be related to several gastrointestinal issues. The recurring lower abdominal pain, burning sensation after bowel movements, and changes in your bowel habits suggest that there may be underlying conditions that need to be addressed.

Firstly, the irregular bowel movements you mentioned—sometimes having a bowel movement once a day and other times going several days without one—can lead to a condition known as constipation. This can cause abdominal discomfort, bloating, and increased gas production, which may explain the frequent flatulence and abdominal rumbling you are experiencing. When stool becomes hard or difficult to pass, it can also lead to straining during bowel movements, which may exacerbate any existing issues with hemorrhoids (or "痔瘡" as you mentioned) and contribute to the burning sensation you feel after defecation.

The burning sensation you describe after bowel movements could indeed be related to your hemorrhoids, especially if they are inflamed or irritated. However, since you have noted that there is no bleeding or swelling, it is also possible that you could be experiencing anal fissures, which are small tears in the lining of the anus that can cause pain and a burning sensation during and after bowel movements. These fissures can occur due to passing hard stools or straining.

Another possibility is that you may be experiencing rectal inflammation, which could be due to a variety of causes, including infections, inflammatory bowel disease (IBD), or even dietary factors. Given that you have a history of irregular bowel habits, it might be beneficial to consider whether certain foods or stressors are contributing to your symptoms. Foods that are high in fiber can help regulate bowel movements, while spicy foods, caffeine, and alcohol can sometimes exacerbate gastrointestinal discomfort.

Since you have already consulted with a gynecologist and no issues were found in that area, it may be worthwhile to follow up with a gastroenterologist. They can perform further evaluations, such as a colonoscopy or other imaging studies, to rule out conditions like IBD or other gastrointestinal disorders. Additionally, they may recommend dietary changes, such as increasing fiber intake, staying hydrated, and possibly using stool softeners or laxatives if necessary.

In the meantime, managing your hemorrhoids and any potential anal fissures is important. Over-the-counter treatments, such as topical creams or ointments, can provide relief from burning and discomfort. Warm sitz baths can also help soothe the area and promote healing.

In summary, while your symptoms could be related to hemorrhoids, anal fissures, or even rectal inflammation, it is essential to consult with a healthcare professional who can provide a thorough evaluation and appropriate treatment plan. Keeping a symptom diary, noting what you eat, your bowel habits, and any other relevant factors, can also be helpful for your healthcare provider in diagnosing and managing your condition effectively.

Similar Q&A

Understanding Persistent Abdominal Pain: Is It a Gastrointestinal Issue?

I have been experiencing lower abdominal pain and back pain for over a year, along with frequent, unpredictable pain and numbness throughout my body, a burning sensation all over, skin twitching, a sensation of something crawling on my skin, and a burning feeling on my skin. Init...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: Based on the symptoms of irritable bowel syndrome, the symptoms you described, such as generalized intermittent pain, generalized intermittent numbness, a burning sensation throughout the body, skin twitching, a sensation of something crawling on the skin, a burning sensat...

Understanding Gastrointestinal Issues: Symptoms and Concerns Explained

Hello Dr. Chang, thank you for taking the time to respond to my lengthy question. To save your time, I will directly describe my situation: I have been experiencing gastrointestinal and bowel issues for over a year. Recently, I have had more noticeable symptoms, including intermi...

Dr. Zhang Siyuan reply Gastroenterology and Hepatology
To Xiao Qi: You have described your symptoms very clearly, which are evidently related to issues around the anal area. An anoscopy should be the starting point for examination. There may be inflammation and swelling in your anal tissue, which could be causing the frequent urge to...

Understanding Abdominal Bloating and Pain: Causes and Solutions

Since July 3rd, I have been experiencing persistent abdominal bloating and pain, along with alternating constipation and diarrhea. I have seen a doctor and initially felt better, but after finishing the medication, the pain returned. I feel bloated and unable to have a bowel move...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello: You frequently experience abdominal pain, alternating between constipation and diarrhea, with a burning sensation when hungry. Common causes include gastroenteritis. It is recommended to pay attention to dietary hygiene and maintain a mild diet. Continue with outpatient fo...

Persistent Left Abdominal Pain: Possible Causes and When to Seek Help

Hello Doctor: Since Saturday morning two weeks ago, I experienced pain after eating spicy food the night before. During the night, I woke up due to pain, which was localized on the left side of my lower back, about 5 to 10 centimeters above the lumbar region. The pain lasted for ...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Abdominal pain accompanied by bowel irregularities, considering your age, common causes include gastroenteritis and irritable bowel syndrome. It is recommended to pay attention to your diet, eat at regular intervals, chew food thoroughly, and avoid irritating foods, caffeine, car...