Step 4: Read and complete the decision guide to learn more about your symptoms.
Rectal Pain or Itching
Most people with pain in the rectal or anal area that is not closely associated with bowel movements have one of the following conditions:
Hemorrhoids are veins just beneath the inside surface of the rectum and anus. Hemorrhoids can become overfilled and bulging, particularly when straining to push out a bowel movement repeatedly interferes with normal circulation out of these veins. A bulging hemorrhoid can develop a weak area that can allow small amounts of blood to spill into the rectum. Hemorrhoids can cause itching or can soil or moisten your underwear. Most hemorrhoids do not cause pain, but some can be extremely painful. Pain from hemorrhoids usually comes after a blood clot forms, creating a "thrombosed" hemorrhoid.
An anal abscess is also known as a "perianal abscess" or a "perirectal abscess." Injury or inflammation in the lining of the rectum may permit bacteria to contaminate one of the mucus glands that surround the rectum. The mucus glands are normal structures that help to lubricate your rectum. When they become infected, the infection may quickly intensify to create a pocket of pus. An anal abscess may cause pain with bowel movements or continuous pain. It commonly causes irritation of the nearby skin so it can create a red, tender or itchy patch of skin within an inch or two of the anus. Frequently, white or yellow pus can be seen through the center of this skin patch as the abscess prepares to drain pus. It is possible for an abscess in this area to make you dangerously ill. An anal abscess requires drainage by your doctor.
Blockage of a hair follicle can allow sweat glands just beneath the hair root to become congested and inflamed. When this occurs, the sweat glands can deteriorate and combine into pockets of fluid under the skin. This can make the skin look as if it has acne, it can cause scarring, and it can cause you to form repeated "boils" (pockets of pus underneath the skin). If you have a lot of problems from congestion and inflammation of your sweat glands, your condition is called "hidradenitis suppurativa" (also known as "acne inversus"). Antibiotics may be helpful; large boils may require drainage by your doctor.
Herpes is a virus infection that is spread by sexual contact. It can cause a blistering and painful rash on the skin, or it may cause an open sore in the lining of the rectum (called a rectal ulcer). Swelling around a rectal ulcer can cause a sensation that your rectum will not completely empty, and it can also cause you to pass mucus with or between your stools.
Conditions that are less common but are concerning include:
Cancer in the rectum can cause pain or itching in the rectum, and it commonly causes rectal bleeding. You are at a higher risk for colorectal cancer (cancer in the colon or rectum) if you have a family history of polyps or cancer in the colon, or if you are over the age of 50.
Cancer at the rim of the anus is sometimes the result of a sexually passed infection, human papillomavirus. Anal cancer is more likely to result from this virus if you are infected with HIV (human immunodeficiency virus). Anal cancer may look like a skin sore that will not heal. It commonly causes bleeding with bowel movements.
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