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Colorectal Diseases

Extreme pain when emptying bowels



For the past few years I have been experiencing extreme pain when empyting my bowels. It has got worse over time, and at first I thought it was due to large/hard stools but even after taking laxatives, the pain is the same if not worse. It sometimes feels like a spasm and I have had blood on the toilet paper in the past. I have also had black faeces aswell. I don`t have any pain in my abdomen- only around my anus.

I am an 18 year old female and generally healthy. I told my doctor about the problem and he said I have a fissure, but surely it would have healed over 2 years? Also, wouldn`t it have healed after taking laxatives for a while?

Thank you for reading this email and I hope you get back to me soon.


It sounds like you do have a fissure. Most fissures heal over time with maintenance of soft bowel movements; even one hard BM can re-open the tear in the anal canal.

Best for you to see a colorectal surgeon who can examine you to see if this is indeed the diagnosis. You may have other treatment options that would be more effective, including suppositories, topical ointments, and even surgery.

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Response by:

Janice Frederick Rafferty, MD Janice Frederick Rafferty, MD
Professor of Surgery
Chief of Colorectal Surgery Division
College of Medicine
University of Cincinnati