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Rectal Pain at night
Every so often (undefineable), I get awoken with pain and pressure in my rectal area.  It starts out weak and then if left unmedicated with three advil, will get so intense that it feels like my insides are falling out from the pain and pressure.  I've had a hysterectomy so it can't be pressure from a uterus.  Please help me diagnose this situation.  It only happens at night.
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Your symptoms sound very like a problem I have had for many years. I was told that it is called Fugax Proctitis. It is a very painful problem and although I was told that it usually leaves one around the age of 50, I still have the pain mostly at night like you do. I am 72 years old. Sitting in a (tolerable)  bath of hot water has been recommended, and has helped me most times. Apparently it is from muscle spasms in that area.
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