Pelvic Floor Symptom
Pain with Bowel Movements
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
Going to the bathroom hurts. The pain may come as you pass stool, or build afterward as a deep ache or spasm that lasts for minutes or hours. Your colorectal exam may be normal. The muscles that surround the rectum have to stretch and relax for every bowel movement, and when they are tight or tender, that becomes painful.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
Understanding Pain with Bowel Movements
Painful bowel movements, called dyschezia, have several possible causes. Fissures, hemorrhoids, abscesses, inflammatory bowel disease and endometriosis involving the bowel should all be checked by your physician.
When those are ruled out, the pelvic floor is a common source. The puborectalis and other pelvic floor muscles wrap around the rectum and must relax and stretch for stool to pass. When they are tight or hold trigger points, that stretch is painful, and they may spasm afterward, causing a lingering ache. Pain then leads to more guarding and straining, which keeps the cycle going.
Dr. Gordon assesses and treats the pelvic floor around the rectum, and coordinates with your colorectal specialist or gynecologist.
Pain with Bowel Movements at a Glance
Also called
Painful defecation, dyschezia
Causes to rule out
Fissures, hemorrhoids, abscess, IBD, endometriosis on the bowel
Common pelvic floor patterns
Pain as stool passes, spasm or ache afterward
Often seen with
Constipation, straining, rectal pain, pain with sex
Main drivers
Puborectalis tension, trigger points, post-bowel movement spasm, straining
The Gap in Care
What Tests Check, and What They Can Miss
Colorectal exams look for fissures, hemorrhoids and disease. When they are clear, the muscles around the rectum are the next place to look.
What routine testing is looking for
- Anal fissures
- Hemorrhoids
- Abscess or fistula
- Inflammatory bowel disease
What often keeps symptoms going
- Puborectalis tension that resists stretch
- Pelvic floor spasm after bowel movements
- Trigger points that refer pain to the rectum
- Straining that increases guarding
- Endometriosis-related pelvic floor guarding
These are assessed with a pelvic floor exam.
Signs & Symptoms
Does This Sound Like You?
Symptoms vary from person to person. These are the patterns Dr. Gordon sees most often.
Pain as stool passes
Sharp or aching pain during the bowel movement.
Lingering ache afterward
Deep rectal or pelvic pain that lasts after you finish.
Spasm after going
A cramping or clenching sensation after a bowel movement.
Fear of going
Delaying bowel movements because of pain.
Straining
Pushing harder, which increases pain.
Pain with sitting afterward
Discomfort sitting after a bowel movement.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Finding which one leads makes treatment more efficient.
Puborectalis tension
This muscle wraps around the rectum and must relax. Tension makes the stretch painful.
Post-bowel movement spasm
Tight muscles can spasm after being stretched, causing a lingering ache.
Trigger points
Trigger points in the pelvic floor refer pain into the rectum.
Avoidance and straining
Delaying and straining harden stool and increase guarding.
Your First Visit
How Dr. Gordon Evaluates Pain with Bowel Movements
The initial evaluation runs 60 to 75 minutes. You leave with a clear picture of what is driving your symptoms, a written plan, a realistic timeline, and in most cases your first treatment.
Records and history review
Dr. Gordon reviews your colorectal or GI findings, bowel history and any endometriosis or surgical history.
Abdominal and tailbone assessment
External assessment of the abdomen, tailbone, sacrum and hips.
External pelvic floor assessment
The pelvic floor muscles are examined from the outside, with no internal exam. With you draped for comfort, gentle pressure around the perineum, sit bones, tailbone and inner thighs checks tone, tenderness and trigger points.
Bowel habits review
Dr. Gordon reviews stool consistency, timing, straining and posture.
Plan and coordination
A clear plan, plus communication with your physician or pelvic floor PT when that helps your care.
When to see a physician first
- Blood in the stool or black, tarry stools
- A lasting change in bowel habits, especially after age 45
- Unexplained weight loss
- Severe abdominal pain with fever or vomiting
- Fever with a painful lump or swelling near the anus
- New numbness in the saddle area or loss of bladder or bowel control
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for pain with bowel movements, chosen from your exam findings.
Primary approach
Intrapelvic & Extrapelvic Dry Needling
Dr. Gordon holds ASE certification in both intrapelvic and extrapelvic dry needling. Treatment releases the puborectalis and pelvic floor muscles that resist stretch and spasm after bowel movements. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum.
Learn about pelvic floor treatmentNerve focus
Neuro-Functional Acupuncture
Electro-acupuncture along sacral nerve pathways to calm pain and support bowel regulation.
See servicesBetween visits
Bowel Plan & Team Coordination
Stool consistency, posture and breathing guidance, coordinated with your GI or colorectal specialist.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Visits 1 to 3
Find the main driver
Dr. Gordon confirms which muscles and nerves are behind your symptoms and starts calming the most reactive areas. Many people notice early changes between visits.
Visits 4 to 8
Lower the baseline
Day-to-day symptoms ease, flares become shorter and less frequent, and normal routines start to feel more manageable.
Visits 9 to 12 and beyond
Build resilience
Visits are spaced out as improvement holds. You leave with a maintenance and early-flare plan.
Most patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
"Dr. Gordon is a master of his craft...always listening to our symptoms and concerns and developing a customized and comprehensive plan to address the symptoms and the body as a whole so that it can work toward healing itself. Dr. Gordon is caring, compassionate and knowledgeable and truly has the best interest of his clients at heart."
Mo Dee, Google Review
Pain with Bowel Movements Questions
Answers About Pain with Bowel Movements
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
Fissures are a common cause and should be checked by your physician. Pelvic floor tension can contribute to fissures too.
Tight pelvic floor muscles can spasm after being stretched.
Yes. Endometriosis on or near the bowel can cause painful bowel movements, often with pelvic floor guarding.
No. Delaying makes stool harder and pain worse. Dr. Gordon helps you make it easier.
Many people improve within six to ten sessions.
No. The pelvic floor is examined and treated from the outside. When the deep pelvic floor needs needling, the needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum.
Before You Book
General Questions
The clinic is an out-of-network practice. The initial evaluation is $300 and follow-up visits are $250. After each visit you receive a detailed superbill to submit to your PPO plan for possible reimbursement. FSA and HSA cards are accepted, and the clinic can run a complimentary benefits check before your first appointment. The check is a courtesy, so please confirm your coverage with your plan. See Insurance & Fees for details.
The first evaluation is 60 to 75 minutes and usually includes treatment. Follow-up visits run 45 to 60 minutes.
Yes. Call (516) 597-5400 or send a message through the contact page. This is especially helpful if your case is complex and you want to understand the approach before committing to a full evaluation.
1508 Union Turnpike, Suite 133, North New Hyde Park, NY 11040, with free parking on site. The clinic is an easy drive from Manhasset, Great Neck, Garden City, Lake Success, Floral Park and Mineola. Early morning, evening and weekend hours are available.
Most people feel a quick muscle twitch or a deep ache that lasts a few seconds. That twitch is a normal sign the trigger point is releasing. Mild soreness for 24 to 48 hours afterward, similar to a hard workout, is common. Depth, angle and stimulation are adjusted to your comfort.
Both use the same fine, sterile, single-use needles. Dry needling targets specific trigger points and tight bands in muscle based on your exam. Neuro-functional acupuncture targets nerve pathways, often with gentle electrical stimulation, to calm nerve sensitivity. For pain with bowel movements, Dr. Gordon commonly uses both.
When performed by a trained, licensed provider with detailed knowledge of anatomy, it has a strong safety record. Tell Dr. Gordon if you take blood thinners, have a bleeding disorder, are pregnant or have a weakened immune system so he can plan accordingly.
It is a technique that reaches the internal pelvic floor muscles, including the levator ani, obturator internus and coccygeus, to release trigger points and restore normal muscle function. Dr. Gordon holds ASE certification in this technique, which few practitioners in New York have.
Yes. Your privacy and comfort come first. When undressing is needed for the area being treated, you are fully draped, and nothing internal is done without your clear consent. You can pause or stop at any time.
Yes. Pain with bowel movements can affect people of every gender, and Dr. Gordon treats adults of all genders and identities.
It helps to have had a medical workup so serious causes have been checked. If you have not seen a physician for your pelvic symptoms yet, call the clinic to talk through the best order of steps.
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioBook an Evaluation for Pain with Bowel Movements
Book a full evaluation with Dr. Gordon and find out whether the muscles around your rectum are behind your pain.
Early morning, evening and weekend appointments available. Free on-site parking.
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