The symptom of pain on going to the toilet can be very variable in terms of the location of the pain and also the character of the pain. It is important to try and differentiate between lower abdominal or stomach pain which comes on with an urgency to go to the toilet and is relieved by going to the toilet and pain lower down in the pelvis or anal canal which is usually made worse by going to the toilet.

Conditions that cause pain when using the toilet tend to relate to the skin around the anal canal or anus, and the pain typically continues after using the toilet and lasts for minutes to hours. The pain may be associated with a lump and also on occasions bleeding. This sort of pain is commonly caused by conditions such as fissure in ano, or a tear and a thrombosed pile.

In addition, abscesses and fistulas (connections between the anal canal and the skin of the buttock) can also be associated with pain on going to the toilet. Typically there will be an area of tenderness where the abscess is developing and may be general symptoms such as fever or temperature.

Sometimes pain occurs further up in the pelvis, lower abdomen or stomach, comes on prior to going to the toilet, and is relieved by going to the toilet. This often relates to conditions of the colon. They include diverticular disease (a wear and tear condition of the colon), colitis (inflammation of the colon), irritable bowel syndrome and sometimes polyps or cancer. Once again any symptoms such as the warrant a referral for discussion and investigation if needed.