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Rectal Symptoms

Is this your symptom?

Itching or soreness around the rectum (anus)
Pus or mucus from the rectum
Rectal pain or pain when having a bowel movement (BM)
Rectal bleeding is covered in the Rectal Bleeding care guide

Causes of Rectal Symptoms

Anal Fissure or Tear is a common cause of rectal pain and blood in the stools. It causes blood on the surface of a stool. Blood may also be found on toilet tissue after wiping. The blood is always bright red and usually only a few streaks are seen. The tear is often caused by passing a large or hard stool. It can also be due to Crohn's disease, anal sex or happen with childbirth. It is less common with anal cancer or HIV. It can become long-term and make passing stools painful. You may have pain for several hours after passing a BM. Seek care if the fissure does not get better with the care advice.
Hemorrhoid is a swollen vein in or near the anus. Around 75% of adults will have hemorrhoids at some time in their life. They cause bleeding, pain, and itching. Sometimes swelling or a lump at the anus occur. Bleeding is usually painless and happens with a BM. It is seen as a streak of blood on the toilet paper. Causes include constipation and straining to pass stools, sitting for long periods on the toilet, pregnancy, chronic diarrhea, obesity, regular heavy lifting and anal sex.
Anal Fistula is a small tunnel which forms between the bowel and the skin near the opening of the anus. It can occur due to an infection and usually will not get better on its own. It causes pain and irritation. If the infection flares up, there may be a painful lump and fever. You may have trouble controlling bowel movements, which may contain pus and or blood. Surgery is often needed to clean the area and remove the tunnel that has been created. See your doctor if you think you could have an anal fistula.
Rectal Itching can be caused by:
- Threadworms. Itching is usually worse at night when the person is warm in bed. The worms look like tiny threads on the stool.
- Hemorrhoids
- Leakage of stools which you cannot control may lead to irritation of the skin around the anus and itching.
- Sores, swelling or irritation from other causes (skin rashes, fungal infection, genital warts or other STIs).
- Side effects of creams or ointments used long-term to treat a problem like anal fissure.
Proctitis is inflammation of the lining of the rectum. It often occurs with inflammation in other parts of the bowel (Crohn's disease or ulcerative colitis). It causes pain, discharge and bleeding. It can also happen with radiation treatment for cancer in a different part of the body.
Bowel Polyps may be a small single polyp or groups of polyps that develop in the bowel. Many are harmless and do not cause symptoms, but they can cause bleeding that is seen in the stools or in the toilet bowl . Some polyps can become cancer. A bowel exam with an endoscope (a camera that is passed into the rectum to examine the bowel lining) will help find polyps. The polyps can then be removed and tested for cancer.
Colo-Rectal Cancer tends to occur in older adults, but can occur at any age. Often starts as a polyp in the colon (large bowel) or in the rectum. The main symptoms to watch for are:
- Blood in the stools
- Change in your bowel habits, such as constipation or diarrhea which is new for you
- Abdominal pain, cramps or gas
- Feeling like your bowel does not empty fully
- Feeling tired and lacking energy
- Anemia
- Weight loss for no clear reason (you have not been trying to lose weight)
- Caution: you may have less serious rectal problems, but if bleeding is severe or there are many episodes, do not assume it is due to that problem. Your doctor can examine you and order tests . If you have a family history of colon cancer, you may be get screening tests to detect any polyps at an early stage.
Inflammatory Bowel Diseases such as Crohn's Disease and ulcerative colitis are from inflammation in the bowel. They are long-term problems that can be hard to diagnose without a bowel exam. Both can cause bleeding from the bowel, abdominal pain, weight loss and diarrhea. Symptoms can be mild to severe.
Peptic and Duodenal Ulcers are open sores or ulcers that happen in the stomach or bowel. The main symptom is often pain in the upper part of the abdomen or the back. Sometimes the ulcer can bleed. With a bleeding stomach ulcer there may be vomiting of blood. The amount of blood can be slight (blood might look brown) or a large amount of blood (which is bright red). If you vomit bright red blood, Call 911 Now. Bleeding from an ulcer can be painless and you only know it is happening because of blood in your stools. Stool blood may look black or purple. It often will smell bad. If your stools look black, purple or are tarry, call you doctor or seek help now.

When to Call for Rectal Symptoms

When to Call for Rectal Symptoms
Call Doctor or Seek Care Now Severe rectal pain You have a fever and rectal pain Tarry or black-colored stool High-risk patient, such as bleeding disorder or Crohn's disease Fever and a painful lump in the rectum (anus) You feel weak or very sick You think you need to be seen, and the problem is urgent	Contact Doctor Within 24 Hours Painful lump or lumps at the anus Rectal area looks infected (redness or a draining sore) Rash of small water blisters You think your could have a sexually transmitted infection (STI) Rectal pain keeps you from working or other activities Rectal itching does not get better with washing or rectal ointment (such as Anusol) Hard to pass a stool due to pain, swelling or painful rash You think you need to be seen, but the problem is not urgent Contact Doctor During Office Hours Feeling weak or tired Rectal pain lasts more than 3 days A change in bowel habits for no clear reason in the last 4 weeks Family history of bowel cancer Rectal itching or rash lasts more than 7 days Mucus discharge from the rectum (anus) You have other questions or concerns	Self Care at Home None of these Mild rectal pain Mild rectal itching

Call Doctor or Seek Care Now

Severe rectal pain
You have a fever and rectal pain
Tarry or black-colored stool
High-risk patient, such as bleeding disorder or Crohn's disease
Fever and a painful lump in the rectum (anus)
You feel weak or very sick
You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

Painful lump or lumps at the anus
Rectal area looks infected (redness or a draining sore)
Rash of small water blisters
You think your could have a sexually transmitted infection (STI)
Rectal pain keeps you from working or other activities
Rectal itching does not get better with washing or rectal ointment (such as Anusol)
Hard to pass a stool due to pain, swelling or painful rash
You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

Feeling weak or tired
Rectal pain lasts more than 3 days
A change in bowel habits for no clear reason in the last 4 weeks
Family history of bowel cancer
Rectal itching or rash lasts more than 7 days
Mucus discharge from the rectum (anus)
You have other questions or concerns

Self Care at Home

None of these
Mild rectal pain
Mild rectal itching

Care Advice

Care Advice for Hemorrhoids

What You Should Know about Hemorrhoids:

Hemorrhoids are a common cause of rectal pain. They can often be treated at home.
Symptoms include swelling or lumps at the anus, pain and rectal bleeding. There may also be itching with a mucus discharge.
These symptoms can also occur with more serious bowel problems. Contact your doctor if they do not get better using this care advice.
Here is some care advice that should help until you talk to your doctor.

High-Fiber Diet:

Change your diet to avoid constipation.
Increase fruits, vegetables and grains (fiber).
If constipation is the cause, see the Constipation care guide and advice.

Drink More Fluids:

Drink 6-8 glasses per day (but not alcohol) to keep stools soft.

Bowel Habits:

Do not strain to pass a stool.
Don't delay passing a stool. If you feel the urge, go to the toilet and pass the stool now. Holding it in can make it harder to pass later.
Do not sit for long periods. This includes sitting on the toilet.

Exercise:

Staying active can help prevent constipation.

Warm Sitz Baths:

Sitz baths can relieve mild pain, itching or swelling. Also, this helps with lumps around the anus which make the area hard to clean after a bowel movement.
Sit in warm bath water for 20 minutes. This helps heal the rectal area.
Add 2 ounces (60 grams) of table salt or baking soda to each tub of warm water. Stir the water until it dissolves.
Do 2 times per day or each time you pass a stool to clean the area.

Ointments for Hemorrhoid Pain and Itching:

You can use 1% hydrocortisone ointment (such as Anusol HC) to help with hemorrhoid pain and itching.
Hydrocortisone is an over-the-counter treatment (no prescription needed) you can buy at the drug store. If you are not sure what to use, ask a pharmacist for advice.

Call Your Doctor If:

Bleeding occurs and gets worse
Small bleeding happens more than 2 times
You develop a painful lump at the anus
You think you need to be seen
Your symptoms get worse

Care Advice for Rectal Itching

What You Should Know about Rectal Itching:

Rectal itching is a common symptom. There are many causes and each will need specific treatment. The itching is rarely a serious problem, but if it does not get better quickly, contact your doctor.
Here is some care advice that should help until you talk with your doctor.

Clean the Rectal Area:

Gently wash and dry the rectal area with warm water after each bowel movement and before going to bed.
Avoid rubbing the area with toilet paper.
Avoid scented soaps and bath salts.