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Abdominal Problems

Rectal Problems

Prevention - Home Treatment - When to Call a Health Professional

The rectum is the lower part of the large intestine. At the end of the rectum is the anus, where stools pass out of the body.

Rectal problems are common. Most everyone experiences itching, pain, or bleeding in the rectal or anal area at some time. These problems are often minor and will go away on their own or with Home Treatment.

Anal itching can have many causes. Skin around the anus may become irritated because of stool leakage. Caffeine and spicy foods can irritate the lining of the rectum, causing anal itching and discomfort. If the anus is not kept clean, itching may result. However, trying to keep the area too clean by rubbing it with dry toilet paper or using harsh soap may injure the skin.

Hemorrhoids are enlarged and inflamed veins that may develop inside or outside of the anus. Straining to pass hard stools, being overweight or pregnant, and prolonged sitting or standing can all cause hemorrhoids.

The symptoms of hemorrhoids include bright red streaks of blood on stools or spurting from the anus; leakage of mucus from the anus; and irritation or itching around the anus. Sometimes an internal hemorrhoid will actually stick out of the anus, and it may have to be pushed back into place with a finger. Pain is not usually a symptom, unless a blood clot forms in a hemorrhoid. A clotted hemorrhoid may be extremely painful but is not dangerous. Hemorrhoids generally last several days and often come back (recur).

You may want to consider surgery if you have hemorrhoids that bleed persistently, are very uncomfortable, or make it difficult to keep your anal area clean. Talk to your doctor about your options for surgery.

An anal fissure may cause pain during bowel movements and streaks of blood on stools. Anal fissures are long, narrow sores that usually develop when the tissue in the anal area is torn during a bowel movement.

Prevention

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  • Keep your stools soft. Include plenty of water, fresh fruits and vegetables, and whole grains in your diet. Include up to 30 ml (2 tbsp) of bran or a commercial stool softener, such as Prodiem, in your diet each day. Regular exercise promotes smooth bowel movements. Also see Constipation on See Constipation.

  • Try not to strain during bowel movements, and never hold your breath. Take your time, but don't sit on the toilet too long.

  • Avoid sitting or standing too much. Take short walks to increase blood flow in your pelvic region.

  • Keep the anal area clean, but be gentle when cleansing it. Use water and a fragrance-free soap, such as Ivory, or use baby wipes or Tucks pads.

    Flexible Sigmoidoscopy

    Flexible sigmoidoscopy is a screening test for precancerous growths and cancers of the colon and rectum. The sigmoidoscope is a flexible viewing instrument that is inserted into the rectum to examine the lower bowel. The exam takes about 10 to 15 minutes, is only mildly uncomfortable, and is very safe.

    Having flexible sigmoidoscopy exams reduces your risk of dying from colorectal cancer. Most experts recommend that you have a flexible sigmoidoscopy exam around age 50. However, experts disagree about how often you should have repeat exams. Recommendations usually range from every 3 years to every 10 years. In addition to screening for cancer, doctors sometimes wish to examine the colon to check for the cause of rectal bleeding, diarrhea, or constipation.

Home Treatment

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  • Take warm baths. They are soothing and cleansing, especially after you have a bowel movement. Sitz baths (warm baths with just enough water to cover the anal area) are also helpful for hemorrhoids but may worsen anal itching.

  • Wear cotton underwear and loose clothing to decrease moisture in the anal area.

  • Apply a cold compress on the anus for 10 minutes, 4 times a day.

  • Ease itching and irritation with zinc oxide, petroleum jelly, or hydrocortisone (1 percent) cream. Use medicated suppositories to relieve pain and lubricate the anal canal during bowel movements. Ask your doctor before using any product that contains a local anaesthetic (these products have the suffix "-caine" in the name or ingredients). Such products cause allergic reactions in some people.

When to Call a Health Professional

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  • If rectal bleeding occurs for no apparent reason and is not associated with trying to pass stools.

  • If rectal bleeding continues for more than 1 week or occurs more than once.

  • If stools become more narrow than usual (may be no wider than a pencil).

  • If pain caused by hemorrhoids is severe, or if moderate anal pain lasts longer than 1 week after Home Treatment.

  • If any unusual material or tissue seeps or sticks out of the anus.

  • If a lump near the anus gets bigger or becomes more painful and you develop a fever.

  • If fever accompanies bloody stools.

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