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
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.
Certain medicines and foods can affect the color of the stool. Diarrhea medicines (such as Pepto-Bismol) and iron tablets can make the stool black. Eating lots of beets may turn the stool red. Eating foods with black or dark blue food coloring can turn the stool black.
Blood in the stool can come from
anywhere in the digestive tract, such as the stomach or intestines. Depending
on where the blood is coming from and how fast it is moving, it may be bright
red, reddish brown, or black like tar.
A little bit of bright red
blood on the stool or on the toilet paper is often caused by mild irritation of
the rectum. For example, this can happen if you have to strain hard to pass a
stool or if you have a hemorrhoid.
Certain medicines and foods can affect the color of stool. Diarrhea
medicines (such as Pepto-Bismol) and iron tablets can make the stool black.
Eating lots of beets may turn the stool red. Eating foods with black or dark
blue food coloring can turn the stool black.
If you take a medicine that affects the blood's ability to clot, such as aspirin, warfarin (Coumadin), enoxaparin (Lovenox), or clopidogrel (Plavix), it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms.
Shock is a life-threatening condition that may occur quickly
after a sudden illness or injury.
Symptoms of shock in a child may include:
Being very sleepy or hard
to wake up.
Not responding when being touched or talked to.
Breathing much faster than usual.
The child may not know where he or she is.
Seek Care Today
Based on your answers, you may need care soon. The
problem probably will not get better without medical care.
Call your doctor today to discuss the symptoms
and arrange for care.
If you cannot reach your doctor or you don't
have one, seek care today.
If it is evening, watch the symptoms and
seek care in the morning.
Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.
Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.
Home treatment for rectal itching
includes things like:
Keeping the area clean and dry.
the area with water several times a day and after bowel
Sitting in a few inches of warm water in a
Wearing loose-fitting cotton underwear.
a nonprescription hydrocortisone (1%) cream on the area.
Rectal itching is most often caused by
dry or irritated skin in the rectal area. It can also be a sign of pinworms,
especially in children.
Itching may be more serious if it occurs
with a rash or if it does not improve with home treatment.
Home treatment for rectal itching
depends on the cause of the itching.
Treat causes of anal itching
Try these home treatment
measures for the following causes of anal itching:
Poor hygiene. Clean the
area gently with water-moistened cotton balls, a warm washcloth, or
premoistened towelettes, such as Tucks or "baby wipes." A mild ointment, such
as A+D Ointment or Desitin, can be applied lightly to help soothe the skin and
protect it against further irritation.
Scented or colored toilet paper or scented soaps, lotions, or creams.
Buy white, unscented toilet
Do not use scented soaps, which can irritate skin.
Apply an ointment that contains
1% hydrocortisone. Do not use other steroid creams on this sensitive area
of your body, because skin damage can occur. Hydrocortisone cream should not be used
for longer than 7 to 10 days without talking with your doctor. Do
not use creams or ointments, such as Benadryl cream, that contain
antihistamines. Note: Do not use the cream on children younger than age 2
unless your doctor tells you to. Do not use in the rectal or vaginal area in
children younger than age 12 unless your doctor tells you to.
Excessive sweating. For anal itching caused by excessive sweating, avoid wearing
tight-fitting underwear, and wear cotton, rather than synthetic, undergarments.
You may use talcum powder to absorb moisture, but do not use cornstarch.
Cornstarch may cause a
skin infection. Before applying talcum powder, dry your rectal area with a hair dryer
set on the low setting.
To control itching
To control itching, try the
Break the itch-scratch cycle, because further
scratching leads to more itching. Take an oral
antihistamine at night to help lessen your nighttime
itching. Don't give antihistamines to your child unless you've checked with the
Take a warm
sitz bath 3 times each day and after each bowel
movement. Following the bath, dry the anus carefully. You may wish to use a
hair dryer set on low.
Avoid foods that can increase rectal
itching, such as coffee, tea, cola, alcoholic beverages, chocolate, tomatoes,
spicy foods, and excessive amounts of vitamin C, for a minimum of 2 weeks.
Gradually add the items back to your diet, one item at a time, to help
determine the cause of the itching.
Trim your fingernails short if
you find yourself scratching irritated skin at night. Wear cotton gloves or
socks on your hands at night to help stop the unconscious scratching that can
occur while you sleep.
stress. Being under stress and feeling anxious or
worried can cause some people to experience skin itching. If you find you are
scratching your anal area when you are anxious, try to take relaxation breaks
throughout the day, especially before bedtime. For more information, see the
The blood in your stool increases, or
your stools become red, black, or
Swelling or a lump in or around
your anus develops.
Symptoms become more severe or more
To prevent rectal problems:
Use white, unscented toilet paper.
not use scented soaps. These can irritate the
Practice good hygiene. Gently wipe the area with toilet paper
after each bowel movement. If irritation starts, use water-soaked cotton balls
to clean the area and then pat the area dry with dry cotton balls. Premoistened
pads, such as Tucks or "baby wipes," may be less irritating.
not sit on the toilet for long periods of time.
high-fiber diet that includes plenty of fruits and
vegetables and bran cereal every day.
Avoid foods that can cause
rectal problems. Examples of such foods include:
Regular or diet
Beer and other alcoholic
Any other items that you
know cause you to have gas or indigestion.
How this information was developed to help you make better health decisions.