Why does the anus hurt when having a bowel movement during the postpartum confinement period?

In general, "defecation" refers to bowel movements, and "postpartum month" refers to the puerperium (the period of recovery after childbirth). Pain in the anus during defecation in the puerperal period may be caused by postpartum recovery issues, poor diet, internal hemorrhoids, anal fissures, perianal abscesses, or other reasons. If discomfort occurs, timely medical consultation is recommended. The specific analysis is as follows:

1. Postpartum Recovery

After childbirth, women may experience pain during defecation due to increased pressure on the tissues around the anus during delivery, which can lead to tension or injury of the anal sphincter muscle. It is recommended to perform pelvic floor muscle exercises to strengthen control of the anal sphincter and promote recovery. At the same time, maintaining smooth bowel movements by drinking plenty of water and consuming fiber-rich foods is beneficial.

2. Poor Diet

During the puerperium, if the diet is excessively greasy or lacks sufficient water and dietary fiber, stools may become dry and hard, leading to anal pain during defecation. It's important to maintain healthy eating habits—reduce intake of spicy and hard-to-digest foods, increase consumption of vegetables and fruits, keep stools soft, avoid straining during bowel movements, and thereby reduce anal pain.

3. Internal Hemorrhoids

Internal hemorrhoids are often caused by prolonged sitting or standing, or poor bowel habits, resulting in congestion and dilation of the hemorrhoidal venous plexus. When hemorrhoids become inflamed or the veins rupture, they can cause anal pain, along with symptoms such as bleeding and itching. Patients may use medications such as Ma Yinglong Musk Hemorrhoid Ointment, Zi Hua Hemorrhoid Ointment, or Chlorhexidine Acetate Hemorrhoid Suppositories under medical guidance.

4. Anal Fissure

Anal fissures are usually caused by chronic constipation or hard stools, leading to mechanical damage of the anal canal skin. This may tear the mucosa of the anal canal, forming a fissure that causes severe pain during defecation, possibly accompanied by bleeding. Treatment may include medications such as lincomycin-lidocaine gel, ibuprofen cream, or Shengji Yuhong ointment, as directed by a physician.

5. Perianal Abscess

A perianal abscess is typically caused by infection and blockage of anal glands, with bacterial proliferation leading to pus-forming inflammation in the surrounding tissues. Postpartum women, whose immunity is reduced, are more susceptible to infections, which may result in local tissue swelling and anal pain during bowel movements. Symptoms may also include redness, swelling, and fever around the anus. Under a doctor’s advice, patients may take medications such as cefixime dispersible tablets, metronidazole tablets, or levofloxacin tablets for treatment.

During the puerperium, it is important to maintain a balanced diet, avoid oily and spicy foods, prevent excessive fatigue, and maintain regular作息 (daily routines), all of which support postpartum recovery and help prevent anal pain during defecation.