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
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
include:
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
anus.
Medicines, especially medicines that
cause diarrhea or constipation, such as
antibiotics.
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
benzocaine).
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
the topic
Hemorrhoids.
Certain foods, such as coffee, tea, cola,
alcoholic beverages, chocolate, tomatoes, spicy foods, and large amounts of
vitamin C.
Rectal pain
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.
Other
less common causes of rectal pain include:
Enlarged, swollen veins in the anus
(hemorrhoids).
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.
Bleeding can
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. Blood that has moved quickly through the
digestive tract or that begins near the rectum may appear red or dark red.
Review the Emergencies and Check Your Symptoms
sections to determine if and when you should see your health
professional.
If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.
Review
health risks that may increase the seriousness of your
symptoms.
If you have any of the following
symptoms, evaluate those symptoms first.
Review
health risks that may increase the seriousness of your
symptoms.
Note:
Call 911 or other emergency services if you have blood in your stool and any
signs of shock, such as:
Weakness, dizziness, and
fainting.
Cool, pale, clammy skin.
Weak fast
pulse.
Shallow, fast breathing.
Extreme thirst, nausea,
or vomiting.
Confusion or anxiety.
Certain foods and medicines can change
how the stool looks. Taking medicines that contain bismuth, such as
Pepto-Bismol, or iron tablets can make the stool black, and eating lots of
beets may turn the stool red. Some food colorings also can change the color of
your stool. Eating foods that contain black or dark blue food coloring can turn
your stool black.
Call your health professional immediately if you answer "Yes" to
any of the following questions.
Do you think
that a medicine is causing your rectal problem?
Note:
If your answer is Yes:
Call the health professional who
prescribed the medicine the same day to determine whether you should stop
taking the medicine or take a different one. An appointment may not be
needed.
If you are taking a medicine that was not prescribed by a
health professional, stop taking the medicine. Call your health professional if
you feel you need to keep taking the medicine or if you need help to control
your symptoms after you stop taking it.
If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.
Review
health risks that may increase the seriousness of your
symptoms.
If you have any of the following
symptoms, evaluate those symptoms first.
Review
health risks that may increase the seriousness of your
symptoms.
Note:
Call 911 or other emergency services if you have blood in your stool and any
signs of shock, such as:
Weakness, dizziness, and
fainting.
Cool, pale, clammy skin.
Weak fast
pulse.
Shallow, fast breathing.
Extreme thirst, nausea,
or vomiting.
Confusion or anxiety.
Certain foods and medicines can change
how the stool looks. Taking medicines that contain bismuth, such as
Pepto-Bismol, or iron tablets can make the stool black, and eating lots of
beets may turn the stool red. Some food colorings also can change the color of
your stool. Eating foods that contain black or dark blue food coloring can turn
your stool black.
Call your health professional immediately if you answer "Yes" to
any of the following questions.
Do you think
that a medicine is causing your rectal problem?
Note:
If your answer is Yes:
Call the health professional who
prescribed the medicine the same day to determine whether you should stop
taking the medicine or take a different one. An appointment may not be
needed.
If you are taking a medicine that was not prescribed by a
health professional, stop taking the medicine. Call your health professional if
you feel you need to keep taking the medicine or if you need help to control
your symptoms after you stop taking it.
If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.
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.
Buy white, unscented toilet
paper.
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; skin damage can occur. Hydrocortisone cream should not be used
for longer than 7 to 10 days without talking with your doctor. 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.
Reactions to topical creams. Apply an ointment that contains
1% hydrocortisone. Do not use other steroid creams on this sensitive area
of your body; skin damage can occur. Hydrocortisone cream should not be used
for longer than 7 to 10 days without talking with your health professional. Do
not use creams or ointments, such as Benadryl cream, that contain
antihistamines.
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. Dry your rectal area with a hair dryer
set on the low setting before applying talcum powder.
To control itching
To control itching, try the
following:
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
doctor first.
Take a warm
sitz bath, three 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.
Control your
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
topic
Stress Management.
For rectal bleeding
When you have rectal bleeding,
do not take
aspirin and other
nonsteroidal anti-inflammatory drugs (NSAIDs). Aspirin
and other NSAIDs, such as ibuprofen, can cause bleeding in the digestive tract,
which can increase the amount of
blood in your stools. These medicines can also make
bleeding hemorrhoids bleed more. If you need to use something for pain, try
taking
acetaminophen, such as Tylenol.
Rectal
bleeding can be caused by constipation, diarrhea, and hemorrhoids. For more
information, see the following topics:
Use the Check Your Symptoms section to
evaluate your symptoms if any of the following occur during home
treatment:
Pain increases.
Pain does not
improve in 24 to 48 hours.
The blood in your stool increases or
your stools become red, black, or
tarry.
Swelling or a lump in or around
your anus develops.
Your stool contains pus.
You develop a fever.
Symptoms become more severe or
more frequent.
Prevention
To prevent rectal problems:
Use white, unscented toilet
paper.
Do not use scented soaps, such as Irish Spring and Coast,
which can irritate skin.
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.
Do not sit on the toilet for long periods of
time.
Eat a
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
cola.
Coffee.
Beer and other alcoholic
beverages.
Dairy products.
Any other items that you
know cause you to have gas or indigestion.
Is there itching or a rash present on any
other part of your body?
Are other members of your family also
experiencing rectal itching?
For rectal pain
How severe is your pain? Is it constant or
does it come and go? Is it getting worse? Is it related only to having a bowel
movement?
Does the pain feel like it is coming from the inside or
the outside of your anus?
For rectal bleeding
What does the blood in your stools look like?
Is the stool mixed with blood, or does the blood coat the outside of formed
stools? Are there large clots of blood in the toilet water?
Do you
have bleeding from your gums, blood in your urine, large skin bruises, or a
skin rash that looks like measles?
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