Self Care Articles

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.