Pressure in Your Rectum? What does it mean and how can you reduce it.

Feeling pressure in your rectum? You're not alone—many people experience this discomfort, but few talk about it. Let’s be real, it’s not exactly dinner-table conversation! But ignoring that pressure won’t make it go away. Whether it's a dull ache or a more intense cramping sensation, rectal pressure can signal a range of issues, from minor annoyances to conditions that need immediate attention.

Before you dismiss it as just something that will pass, it’s crucial to understand what might be causing it. Rectal pressure is often described as the sensation of needing to “go,” even when there’s nothing there. Other times, it can feel like something is stuck or like you are sitting on a golfball. The causes? Everything from common conditions like constipation to more severe issues like a hypertonic pelvic floor, tailbone pain, or pudendal neuralgia.

So, what’s going on down there, and when should you be concerned? In this blog post, we'll explore the common—and not-so-common—reasons behind rectal pressure. Plus, we’ll dive into actionable solutions you can try today, along with when it’s time to call your healthcare provider. Let’s get into it.

Common Causes of Rectal Pressure

1. Constipation: The Usual Suspect

Constipation is one of the most frequent culprits behind rectal pressure. If you’re having fewer than three bowel movements a week, if you feel like not everything is coming out, or straining to pass stool, you’re likely dealing with constipation. The pressure builds up, causing discomfort that can range from mild to severe.

What to do: Increase your fiber intake, drink more water, and get moving. If lifestyle changes don’t help, over-the-counter (OTC) supplements or possible prescription medications might be necessary. Chronic cases? It’s time to consult a healthcare provider and pelvic floor physical therapist, as it could be due to tight pelvic muscles.

2. Hemorrhoids: The Swollen Veins

Hemorrhoids are another frequent cause of rectal pressure. These swollen veins around the anus or inside the rectum can cause discomfort, itching, and sometimes bleeding.

Quick Fixes:

  • Eat high-fiber foods

  • Use OTC pain relievers

  • Try sitz baths

  • Avoid straining during bowel movements

Severe hemorrhoids may require treatments like rubber band ligation or even surgery.

When Things Get Serious

3. Rectal Prolapse

Rectal prolapse happens when part of the rectum protrudes through the anus. You might feel a bulging sensation or notice a reddish mass. This typically happens with pushing or straining.

Treatment: Pelvic floor PT can help with constipation. They can also provide exercises and techniques to strengthen your pelvic floor muscles to address the rectal prolapse. Surgery is sometimes necessary if the prolapse is more severe.

4. Coccydynia aka Tailbone pain

Coccydynia can occur either from a direct injury, stress, or tightness in the pelvic floor muscles. When the pelvic floor muscles are tight, they can create a sensation of something being in the rectum.

Treatment Options:

  • Stretching exercises to the back and hips

  • Donut pillow when sitting

  • Breathing exercises to help relax the pelvic floor muscles

5. Pudendal neuralgia

Pudendal neuralgia occurs when the pudendal nerve located in the pelvis is irritated. This causes the pelvic floor muscles to often tighten up and guard to protect the nerve, thus leading to a possible symptom of pressure in the rectum.

What to Do: Similar to tailbone pain, breathing and stretching exercises can be helpful to get the pelvic floor muscles to relax. However, proper evaluation from a pelvic floor therapist to determine where the nerve is getting irritated can be more effective and efficient at getting your pain to go away.

6. Prostatitis: Inflammation in Men

For men, prostatitis (inflammation of the prostate) can cause a range of uncomfortable symptoms, including rectal pressure. Other symptoms may include urinary problems, erectile or sexual health concerns, and lower back pain.

Treatment: If there is not an infection present, usually in the cases of chronic prostatitis learning to relax the pelvic floor muscles is once again key. This can be done through hip and back stretches. Internal soft tissue work to the pelvic floor muscles can also be greatly beneficial.

When to See a Healthcare Provider or Pelvic Floor PT

If rectal pressure persists for more than a few days or is accompanied by other symptoms—like changes in your bowel habits, bladder function, or sexual health—it’s time to see a doctor. Don’t wait for the situation to worsen; early treatment can prevent more serious complications down the road.

Conclusion

Feeling pressure in your rectum can be uncomfortable and even alarming. But the good news is, most causes are treatable and often temporary. Whether it’s a simple case of constipation or a more complex issue like chronic prostatitis, there are solutions available. Listen to your body, try some at-home remedies, but don’t hesitate to seek medical advice when necessary. You don’t have to live with the discomfort—relief is just a few steps away.

Written By,

Dr. Jana Richardson, PT, DPT, WCS, PRPC, CIDN
Dual Board Certified Pelvic Floor Therapist and Owner of Chicago Pelvic Health

Dr. Jana Richardson is a highly accomplished pelvic floor therapist with dual board certifications and extensive experience in treating complex pelvic floor dysfunctions. As the owner of Chicago Pelvic Health, Dr. Richardson is dedicated to providing personalized and effective care for her patients. With a Doctorate in Physical Therapy, and specialized certifications in Women’s Health and Pelvic Rehabilitation, Dr. Richardson is a leading expert in her field. She is also certified in Integrative Dry Needling, further enhancing her ability to offer comprehensive treatment plans. Dr. Richardson’s commitment to patient-centered care and her passion for helping individuals achieve optimal pelvic health make her an invaluable asset to the community.

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