One possible explanation is proctalgia fugax, which causes sudden episodes of rectal pain believed to involve muscle spasms. Pelvic-floor muscle spasms can produce similar symptoms. Depending on the cause, approaches such as warm baths, relaxation techniques or pelvic-floor physiotherapy may sometimes help, particularly when muscle tension contributes to the problem.

Other conditions can also cause pain around the rectum or pelvis. Endometriosis may produce bowel or rectal pain, particularly around menstruation. Digestive disorders such as irritable bowel syndrome (IBS) can cause abdominal discomfort and bowel changes, although sudden rectal pain shouldn’t automatically be blamed on IBS. Irritated or compressed pelvic nerves may also produce sharp, shooting sensations.

Infections are another consideration. Some sexually transmitted infections can involve the rectum and cause pain, inflammation, discharge, sores or bleeding. This is why persistent symptoms shouldn’t be self-diagnosed from the sensation alone. A clinician may need to consider the timing of the pain, bowel symptoms, menstrual or pelvic symptoms, medications and other health information to identify the cause.

The most important detail is when the pain needs medical attention. Seek medical advice when episodes are frequent, persistent, increasingly severe, or accompanied by rectal bleeding, fever, unexplained weight loss, significant changes in bowel habits, persistent abdominal or pelvic pain, discharge, or a new lump. Severe pain with heavy bleeding or feeling seriously unwell warrants urgent medical assessment. “Lightning bum” itself isn’t a medical diagnosis, and although brief episodes can be harmless, recurring symptoms deserve proper evaluation rather than simply being ignored.