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The Facts About Rectal Pain

Colitis and Other Causes


Updated June 19, 2014

The causes of rectal pain are too numerous to list all of them here. Let's continue to highlight some of the ones that are common in HIV positive and HIV negative people.

  • Colitis (Ulcerative Colitis or Crohn's Disease) - Colitis is an inflammation of the intestinal tract. Ulcerative colitis is limited to the large intestine while Crohn's can involve the entire digestive system. Both cause inflammation that causes rectal pain.

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    • rectal pain
    • bowel urgency
    • nausea
    • bloody diarrhea
    • fatigue
    • weight loss
    • mucus and pus in stool

    Causes - Ulcerative Colitis

      The cause or causes of ulcerative colitis are not entirely understood. Most believe it's an abnormal autoimmune response in the large intestine, possibly associated with food or the GI bacteria Escherichia coli (E-coli)

    Causes - Crohn's

      Blockages within the intestinal mucosa causes swelling, inflammation, ulcerations, and abscesses that are common to Crohn's. Like ulcerative colitis, the cause of Crohn's is not well understood but is thought to be autoimmune in nature.


      The treatment of ulcerative colitis and Crohn's is aimed at minimizing inflammation which causes the symptoms common to these conditions. Treatments can include steroids that slow the inflammation process. Medications can be taken orally or in some cases in the form of enemas in order to apply the medication directly to the areas of the intestinal tract involved. In extreme cases or in cases of intestinal tract damage, surgical interventions are done to reduce symptoms and eliminate severely damaged lengths of bowel. Unfortunately, there is no cure for ulcerative colitis and Crohn's.

    • Trauma Related To Anal Sex - While men and women practice a variety of voluntary sexual activities, few put the participants at risk for serious physical injury. The most common injuries are related to anal sex. While most of these injuries are minor and can resolve with little intervention, they can be uncomfortable and frightening for the injured.

      Types of Injuries

      • anal fissure or tearing
      • rectal perforation (more common if foreign objects are used during anal sex)
      • mucousal tears in and around the rectum and anus
      • sphincter injuries (can again be related to foreign objects or aggressive anal sex)
      • rectal prolapse (part of rectum protruding from anus


      • rectal pain during and after sex
      • bleeding during and after sex
      • pain when moving the bowels
      • palpable mass or lump near anus


      • pain relief
      • refrain from anal sexual activity until fully healed
      • stool softener to decrease the potential of a hard bowel movement
      • no straining, bearing down, or heavy lifting while healing
      • in extreme cases surgical repair may be required.

    • Anal and Rectal Lesions - Lesions or growths in and around the anus can cause rectal pain. Two of the most common anal lesions are genital warts and herpes simplex.

        Genital Warts - smooth, flesh-colored round lesions that are caused by human papilloma virus (HPV). Genital warts are sexually transmitted and caused by Human papillomavirus (HPV). HPV can also lead to anal cancer.

      • Genital Herpes - one of many types of herpes. This one is caused by the herpes simplex virus. They are painful, fluid filled blisters around the anus. These lesions break, drain, and sometimes form ulcers of the rectum and anus.


      • Genital Warts
        • clusters of flesh-colored lumps that some say resemble cauliflower
        • the clusters themselves are painless but often interfere with bodily functions such as moving the bowels, making that process painful

      • Genital Herpes
        • painful, fluid-filled lesions that break and heal
        • flu-like symptoms
        • fever
        • swollen glands


      • Genital Warts - whether or not to treat genital warts is up to the patient. Treatment can be in the form of topical creams or surgical removal. The virus that causes genital warts can't be cured even if the warts are removed or treated.

        What You Need To Know About HPV

      • Genital Herpes - the lesions that are characteristic of genital herpes come and go but there is no cure. Topical medications such as Zovirax Cream and oral medications such as acyclovir and valtrex can shorten outbreaks and decrease their frequency.

      The Facts About Genital Herpes

    The important thing to remember is that rectal pain signals that there is a problem. The problem can be something simple and easy to remedy like like hemorrhoids or something very serious and potentially fatal like anal cancer. If you remember one thing from this article understand that if you do experience anal or rectal pain, regardless of severity, you should make an appointment with your doctor and get an evaluation. That evaluation can save your life.

    Finding the Right Doctor


    1. American Academy of Dermatology Brochure; "Genital Warts"; 2006.

    2. Geist, R.; "Sexually Related Trauma"; Emergency Medicine Clinics of North America; 6 Aug 1988; 439-66.

    3. Myers, D.; "Anus"; About.com: Colon Cancer; 8 Aug 2007.

    4. Myers, D.; "What is the Rectum?"; About.com: Colon Cancer; 12 Jan 2008.

    5. USA Today Health Encyclopedia - Diseases and Conditions; "Hemorrhoids"; USA Today 4 Apr 2007.

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