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Home » Pregnancy » Rectal Pain during Pregnancy (It Really is a Pain in the Butt)

Rectal Pain during Pregnancy (It Really is a Pain in the Butt)

  Written by Feature Editor
   Medically reviewed by Kimberly Langdon MD Ob/Gyn
  Updated on June 22nd, 2023
Rectal Pain during Pregnancy (It Really is a Pain in the Butt)

What Causes Rectal Pain During Pregnancy?

The reason is pretty simple—the uterus expands in size, the baby keeps growing, the placenta weighs another pound or so, the amniotic fluid increases throughout. Before you know it, there is an extra 10-20 pounds of downward force or pressure on the blood vessels in the rectum, pelvis, and legs.

Constipation and Pressure

Constant pressure and constipation are common throughout pregnancy – even early on – which results in blood vessels in the rectal walls that swell, causing rectal throbbing, itching, and pain.

Before you know it, the wall of the rectum pushes out into a little sac called a hemorrhoid.

They can bleed after bowel movements or even in between.

They aren’t serious, but they sure hurt.

Stabbing and Shooting Rectum Pain During Pregnancy

If you notice stabbing or shooting rectal pain, that may mean that a blood clot has formed in the hemorrhoid sac.

Blood clots may need to be removed with a small incision which definitely isn’t fun.

You won’t be able to sit for long periods after the blood clot is extracted unless you are sitting on an ice pack that is soft and malleable.

There is a thing called a ‘donut’ which looks like a small life preserver that is filled with air and has an opening in the middle to prevent additional pressure on the damaged hemorrhoid when you sit.

Related Content: Huge Poops in Pregnancy

Prevention of Pain in the Rectum and Anus

The best way to prevent rectal pain and hemorrhoids is to keep very well-hydrated because of the water demands of pregnancy increase by over 50%–due to the increased blood volume.

That means that you must drink twice as much during pregnancy.

Another key behavior is to increase your fiber intake which keeps the bowels moving by preventing constipation.

If your prenatal vitamin has iron in it, you may want to add a stool softener because iron binds up your stool and makes it hard. Talk to your doctor about the best choice.

Prolonged standing, sitting, and straining on the toilet are additional reasons for increased rectal pressure and pain.

One of the best ways to stop or prevent constipation is with activity like a brisk walk. Keep on moving throughout pregnancy (unless your doctor prescribes bed rest for some other reason) because that will strengthen your abdominal muscles or core—all essential for the labor and delivery process.

You want strong abs when you are pushing out your bowling ball of joy.

The longer time it takes to push the baby out, the more your hemorrhoids will swell, and it takes weeks even months for them to shrink.

It’s not uncommon for the pushing stage to last 2-3 hours if you are a first-time mom.

More Types of Pain in the Rectum, Groin and Lower Back

Besides rectal pain and pressure, low back pain and round ligament pain adds to your misery during pregnancy.

Round ligament pain is groin and abdominal pain that tends to start around 20 weeks and is due to a sudden movement of direction such as twisting or getting out of a chair.

Back pain can be from the strain on the lower back as the uterus and baby protrude forward, outward, and backward.

Or, back pain can be due to pressure in the rectum and tailbone.

The hormones of pregnancy make the joints looser which can make you prone to excessive stretch that causes nerves of the vertebra (spine) and hip joint to become inflamed, causing pain.

And one final source of butt pain is a condition known as sciatica which is due to swelling and stretching of the largest nerve in the body called the sciatic nerve which supplies all the nerves to the legs.

The additional pressure on this nerve is near an opening in the pelvis and results in:

  • Throbbing
  • Burning
  • Pain in the butt 
  • Pain in the back of the upper thigh

Bending over or curling up in a ball make this pain worse.

Treatment Options for Rectal Pain in Pregnancy

Practically the only medication that you can take for the pain of any sort in pregnancy is acetaminophen orally, topical lidocaine, and topical nitroglycerin; the last two are Category C in pregnancy so you will need doctor approval for those.

Will the Pain Go Away?

Don’t worry about all of these changes because the body has an amazing ability to heal and return to normal after childbirth.

As you know, prevention is easier than dealing with the consequences of constipation.

Drink, drink, drink, and then drink some more.

It might seem counter-intuitive, but the swelling is reduced, not increased by proper hydration because the salt content is equalized.

That prevents fluid from pooling in the tissues of the rectum, butt cheeks, and lower legs—all of which can lead to hemorrhoids, sciatica, and swollen veins or varicose veins in the legs and that’s rectum pain during pregnancy.

Final Thoughts and Tips on Managing Pregnancy Rectal Pain

Rectal pain during pregnancy is primarily attributed to the expansion of the uterus and the growing baby. As the uterus increases in size, it exerts downward pressure on the blood vessels in the rectum, pelvis, and legs. This additional pressure, coupled with common occurrences like constipation, can lead to swollen blood vessels in the rectal walls, resulting in rectal throbbing, itching, and pain. Hemorrhoids, the most common source of rectal pain during pregnancy, occur when the rectal wall bulges outward into little sacs.

  1. Hydration: Adequate hydration is crucial during pregnancy as the body’s water demands increase significantly. Drinking plenty of fluids, such as water, helps prevent fluid retention and swelling, including in the rectal area. Well-hydrated tissues are less prone to hemorrhoids and other sources of rectal pain.
  2. Fiber-Rich Diet: Increasing fiber intake can help regulate bowel movements and prevent constipation. Fiber-rich foods, including whole grains, fruits, and vegetables, add bulk to the stool and promote regularity. If your prenatal vitamin contains iron, which can contribute to constipation, your doctor may recommend adding a stool softener to your routine.
  3. Physical Activity: Engaging in regular, moderate exercise, with your healthcare provider’s approval, can help stimulate bowel function and prevent constipation. Activities like brisk walking strengthen the abdominal muscles, which are crucial during labor and delivery.
  4. Avoid Prolonged Sitting or Straining: Prolonged sitting and straining on the toilet can increase rectal pressure and contribute to pain. It is advisable to take breaks from prolonged sitting and to avoid straining during bowel movements.
  5. Pain Management Options: Acetaminophen, when taken orally, is generally considered safe for pain relief during pregnancy. Topical lidocaine and topical nitroglycerin may also be used with doctor approval. These options can help alleviate discomfort associated with rectal pain.

Healing and Recovery

The body has an incredible ability to heal and return to normal after childbirth. It’s important to remember that the discomfort experienced during pregnancy is often temporary. By focusing on prevention, such as maintaining proper hydration and a fiber-rich diet, expectant mothers can alleviate rectal pain and support their body’s natural healing processes.

Rectal pain during pregnancy is a common occurrence caused by the expanding uterus and other factors like constipation. By understanding the underlying causes and implementing preventive measures, such as staying hydrated, consuming a fiber-rich diet, and engaging in regular physical activity, expectant mothers can manage and alleviate rectal pain. It is important to consult with a healthcare provider for personalized advice and to ensure the safe use of any medication or treatment options. Remember, the discomfort experienced during pregnancy is temporary, and the body has an incredible ability to heal and recover postpartum.

 

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