Rectal problems are common. Almost
everyone will experience some rectal itching, pain, or bleeding at some time
during his or her life. These problems are often minor and may go away on their
own or with home treatment.
Rectal itching (pruritus) is usually
not a sign of a serious disease. At first, the skin of the
anal area may appear red. Itching and scratching may
make the skin become thickened and white. Common causes of rectal itching
- Poor cleaning of the area after a bowel
movement. Itching and discomfort may occur when pieces of stool become trapped
in skin folds around the
- Medicines, especially medicines that
cause diarrhea or constipation, such as
- Cleaning of the anus with
very hot water and strong soaps. The anal area is normally oily, and this
barrier protects against the irritation of bowel movements. Repeated cleaning
or showering will remove these oils and can lead to a cycle of itching and
scratching that can be hard to stop.
- The use of scented toilet
paper, scented soap, or ointments (such as those that contain
- A generalized dry skin condition that affects the
entire body. This condition is more common in older adults. For more
information, see the topic
Dry Skin and Itching.
- Hemorrhoids. Hemorrhoids are enlarged veins near the
lower end of the
rectum or outside the anus. For more information, see
- An infection of the anus or
rectum, which may be caused by viruses (such as
scabies, fungus, yeast, or parasites. Pinworms are the
most common cause of anal itching in children. For more information, see the
Genital Warts (Human Papillomavirus).
- Certain foods, such as coffee, tea, cola,
alcoholic beverages, chocolate, tomatoes, spicy foods, and large amounts of
Rectal pain may be caused by diarrhea,
constipation, or anal itching and scratching. Rectal pain caused by these
conditions usually goes away when the problem clears up.
common causes of rectal pain include:
- Enlarged, swollen veins in the anus
- Structural problems, such as
anal fissures and fistulas or
- Infection, such as a
sexually transmitted infection,
prostate infection, an
abscess, or a
- Injury from foreign body
insertion, anal intercourse, or
- Diseases, such as
cirrhosis of the liver,
Crohn's disease, or
- Cancer of the rectum
or the prostate or skin cancers, such as
squamous cell cancer and
- Previous treatment, such
as surgery or radiation therapy to the rectum or pelvis.
- Rectal spasms (proctalgia fugax).
Many people have small amounts of
rectal bleeding. Irritation of the rectum from diarrhea or constipation, a
small hemorrhoid, or an anal fissure can cause a small amount of bright red
blood on the surface of the stool or on the toilet paper. Hemorrhoids and anal
fissures usually occur after straining during a bowel movement because of
constipation. This type of bleeding can cause pain during a bowel movement and
does not make the toilet water bloody. It is not serious if there is only a
small amount of blood and the bleeding stops when the diarrhea or constipation
stops. Home treatment is usually all that is needed.
occur anywhere in the digestive tract. The blood is digested as it moves
through the digestive tract. The longer it takes the blood to move through the
digestive tract, the less it will look like blood. Often blood that is caused
by bleeding in the stomach will look black and
tarry. A tarry stool has a black, shiny, sticky appearance and looks like
tar on a road. Blood that has moved quickly through the
digestive tract or that begins near the rectum may appear red or dark red.
Check your symptoms to decide if and when
you should see a doctor.
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
April 14, 2011
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