Why Does It Hurt When I Poop — and What Can I Do About It?
Figuring out what's causing your painful poops can help you find relief.
You're not drinking enough water
Bowel movements, as you know, are made up of waste products that are being excreted from your body. And the waste comes from both food and water.
“The body requires a certain amount of water to be absorbed before it eliminates excess in stool, so if you do not drink enough water — or you need more water because of water loss for other reasons like sweating while you have a fever—bowel movements can become very hard and brittle,” Carolyn Newberry, MD, a gastroenterologist at NewYork-Presbyterian and Weill Cornell Medical Center, tells Health. “This lack of water leads to difficulty with stool passage and common symptoms of constipation including straining, cramping, abdominal pain, and bloating,” she says.
What you can do about it: Drinking enough water (or eating foods with high water content, like cucumbers) can help you stay hydrated and ensure your bowel movements are easy to pass.
“Aim for six to eight cups of water per day, and make sure to limit beverages that can cause excessive water loss like alcohol, coffee, and sugary beverages (which act as diuretics),” says Dr. Newberry.
You have a food intolerance
“Sometimes abdominal discomfort and painful pooping may be caused by food intolerances such as lactose, fructose, or gluten,” Christian Stevoff, MD, gastroenterologist at the Digestive Health Center at Northwestern Medicine. “They can lead to abdominal distension and discomfort.”
What you can do about it: Some of these intolerances can be tested for, which can help you avoid problematic foods and therefore prevent the pain. “Others require trial-and-error elimination diets to determine the offending agents,” says Dr. Stevoff.
You're not eating enough fiber
Fiber is indigestible plant matter that’s an important part of a healthy diet — and healthy bowel movements.
“There are two types, soluble — the kind that dissolves in water — and insoluble — the kind that doesn't dissolve in water,” Dr. Newberry says. “Soluble fiber helps stool retain water and keeps stools soft. Insoluble fiber helps bulk stool and makes it easier to pass. Both are important for your gut health and should be consumed daily.”
What you can do about it: If pooping is painful, try increasing your intake of fruits, vegetables, and whole grains, Dr. Newberry suggests.
Most adults don’t meet the recommended daily fiber goals of 25 to 29 grams a day, Dr. Newberry says. While the healthiest way to add fiber to your diet is from eating fiber-rich foods, she says, “if you have trouble getting all your fiber from food, try adding a daily supplement in the form of a powder, capsule, or bar.”
You're not getting enough exercise
“Getting moving not only stimulates your muscles, it also can make your gut move, change the way your stool absorbs water, and beneficially alter important hormone signals that regulate gut health,” Dr. Newberry says.
What you can do about it: “Incorporating aerobic exercise into your daily routine may alleviate the uncomfortable side effects of constipation (and keep your body and heart healthy in the process),” she says. “Any activity that gets your heart rate up counts, so even if you don't have time to get to the gym, you should still try to take a brisk walk or climb a flight of stairs.”
You're taking meds that cause constipation
“Some commonly prescribed medications can alter the way your bowel movements are passed by changing water absorption, hormone secretion, and/or motility of the gut itself,” says Dr. Newberry.
Culprits can include antacids, narcotic pain medications, iron tablets, certain blood pressure medications, and antidepressants.
What you can do about it: Understand the common side effects of your medications, and if there is a concern they may be causing your constipation, talk to your doctor about trying something else (or even using a stool softener).
You have IBS
Irritable bowel syndrome commonly causes abdominal pain and bloating, “but there are many different ways for IBS to present,” says Dr. Stevoff. Some people with IBS may have bowel spasms and diarrhea while others have constipation.
What you can do about it: “Treatment is based on the symptoms you exhibit,” Dr. Stevoff says. Besides lifestyle changes like diet, stress management, and exercise, there are also some medications approved for IBS treatment.
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You have a more serious medical problem
If none of these other scenarios sounds familiar, it’s possible you could have an underlying medical problem that’s decreasing your ability to pass bowel movements easily and effectively.
“These include blockages in your intestines from twisting or masses, damage to the muscles in your gut from surgery or childbirth, damage to the nerves in your gut from nervous system diseases like Parkinson's, or inflammation in the colon from a number of causes,” says Dr. Newberry.
What you can do about it: Talk with your doctor about your symptoms. “Any gastrointestinal bleeding (in the stool, in the toilet, or on the paper) should be evaluated by your physician,” Dr. Stevoff says. “Likewise, other alarming features — such as unintentional weight loss, fevers or chills, nausea or vomiting, and abdominal pain that is severe and unremitting — should be evaluated right away.”