There are many possible causes of rectal discharge, including gastrointestinal conditions, sexually transmitted infections, and bowel-related conditions.

This article will cover rectal discharge in more detail, including its causes, other symptoms, and treatments.

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Rectal discharge refers to any substance other than feces that comes out of the rectum.

For example, a person might notice rectal discharge in the form of mucus, pus, or blood in their stools or underwear.

The following conditions can lead to rectal discharge:

Hemorrhoids

Hemorrhoids, also known as piles, are swollen veins in or around the rectum or anus. External hemorrhoids develop under the skin surrounding the anus. Internal hemorrhoids develop inside the tissue lining the rectum.

Hemorrhoids can lead to bleeding and discharge from the rectum. Some other common symptoms of hemorrhoids include:

  • anal itching
  • discomfort, soreness, or pain in the anal area
  • lumps or swelling in the anal area
  • a burning sensation in the anus
  • bloody stools, either with or without pain

Hemorrhoids are relatively common causes of rectal discharge. According to the National Institute of Diabetes and Digestive and Kidney Diseases, hemorrhoids affect around 5% of people in the United States and 50% of adults aged 50 years and above.

Learn more about hemorrhoids here.

Inflammatory bowel disease

Inflammatory bowel disease (IBD) refers to a group of conditions that involve chronic inflammation of the gastrointestinal (GI) tract. They include Crohn’s disease and ulcerative colitis.

Crohn’s disease can affect any part of the GI tract. However, it most often develops in the small intestine. Ulcerative colitis, meanwhile, leads to inflammation in the rectum that can spread to the large intestine.

The exact cause of IBD remains unknown, but researchers suspect that the following factors may contribute to these conditions:

  • problems with the immune response
  • genetic factors
  • eating a high fat diet
  • severe or persistent emotional or physical stress
  • certain medications, such as antibiotics, birth control pills, and anti-inflammatory drugs

Common symptoms of IBD include:

IBD itself does not cause rectal discharge, but it can lead to fistulas and abscesses near the rectum that often produce discharge.

Learn more about IBD here.

Anal abscess or anal fistula

An anal abscess is an infected sac of tissue filled with pus. Anal abscesses usually develop inside infected anal glands.

Symptoms of an anal abscess include:

  • rectal discharge or bleeding
  • swelling, pain, or tenderness of the skin in the anal region
  • constipation
  • fatigue

Without treatment, the infection may spread to surrounding tissue and, in some instances, form a tunnel between the infected abscess and an opening in the skin. This is known as an anal fistula.

Symptoms of an anal fistula include:

  • severe anal pain, especially during bowel movements
  • rectal bleeding or discharge
  • fever
  • fatigue

Sexually transmitted infections

Sexually transmitted infections (STIs) can spread to the rectum from the genital region or through anal sex.

Some STIs that can affect the anal area include:

Some common symptoms of STIs in the anal region may include:

  • irritation or itching affecting the anal region
  • swelling, pain, or tenderness in the anal area
  • rectal discharge
  • pain, bleeding, or both during bowel movements
  • growths of skin, blisters, or open sores on or near the anus

Learn more about STIs here.

Proctitis

Proctitis is a condition characterized by a persistent or frequent need to empty the bowels.

Rectal pain, abdominal pain, and bloody stools are common symptoms of proctitis. Occasionally, if there is a fistula or uncontrollable diarrhea, rectal discharge may also be present.

The following factors can cause proctitis:

  • STIs, foodborne illnesses, and other infections
  • IBD
  • injury to the anus or rectum
  • certain antibiotics
  • a history of radiation therapy

Learn more about proctitis here.

Anal cancer

Anal cancer is when a tumor grows in the area of the anus. A discharge of mucus can be a sign of anal cancer.

Other syptoms include:

  • bleeding from the rectum
  • itching and pain around the anus
  • small lumps around and inside the anal area
  • fecal incontinence
  • needing to poo often
  • loose or runny stools

Some people have no symptoms or symptoms may resemble those of hemorrhoids or an anal fissure. Anyone with concerns about changes in the anal area should seek medical advice.

How can you tell if you have hemorrhoids or cancer?

Rectal cancer

Colorectal cancer refers to cancer of the colon and cancer of the rectum, although there are differences. The rectum is the part of the digestive tract between the colon and the anus.

A mucus discharge or anal leakage can be a sign of rectal cancer.

Other signs of rectal cancer include:

  • bleeding from the rectum, usually bright red blood
  • changes in bowel habits
  • constipation, diarrhea, or both
  • pain

Rectal prolapse

A rectal prolapse is when the rectum partially or totally drops down through the anus. Doctors do not always know why it happens. Structural problems or weak muscles in the anus and pelvic floor may play a role.

A discharge of mucus and blood may be present.

A person may also notice:

  • a reddish lump protruding from the anus
  • constipation, diarrhea, or both
  • a feeling that a bowel movement is not quite finished
  • fecal incontinence

A doctor can diagnose an underlying condition contributing to rectal discharge and recommend effective treatment.

The diagnostic process usually begins with the doctor asking about the person’s current symptoms, medical history, and family history. They may also follow up with a physical exam.

The doctor may use one or more of the following tests to confirm a diagnosis:

Treatments will vary depending on the underlying cause. Rectal discharge will usually resolve after treating any underlying GI tract condition or infection.

Some treatment options include:

Hemorrhoids

People with mild-to-moderate symptoms may want to consider the following at-home and over-the-counter (OTC) treatments:

  • applying topical hemorrhoid creams
  • trying a hydrocortisone suppository
  • taking oral pain relievers and anti-inflammatory medications
  • soaking the anal area in warm water
  • eating foods rich in fiber, such as fruits, vegetables, and whole grains
  • taking stool softeners

A doctor can prescribe more potent anti-inflammatory medications and hydrocortisone suppositories for severe hemorrhoids that do not respond to OTC or at-home treatments.

Also, doctors can surgically remove hemorrhoids using one of the following techniques:

  • rubber band ligation
  • stapled hemorrhoidopexy
  • cutting a hemorrhoid and the surrounding tissue with a scalpel
  • laser treatment

How long do hemorrhoids last?

IBD

The following medications can relieve IBD symptoms by either suppressing an overactive immune system or reducing inflammation:

  • aminosalicylates, such as sulfasalazine and mesalamine
  • corticosteroids, such as prednisone and hydrocortisone
  • immunosuppressants, such as azathioprine and 6-mercaptopurine
  • biologic therapies, such as infliximab (Remicade) or adalimumab (Humira)

Some people with IBD may require surgery to remove damaged tissue in the GI tract.

Doctors can treat ulcerative colitis by removing the colon and rectum. Recovery from this procedure can take 4–6 weeks.

What is the difference between IBD and IBS?

Anal abscess or anal fistula

A doctor will most likely drain an anal abscess before it erupts. They will also prescribe pain medications and antibiotics after this procedure.

Treatments options for an anal fistula include:

  • fistulotomy, which involves surgically opening a fistula so that it can drain and heal from the inside
  • reconstructive surgery
  • filling the fistula with a special glue

What happens in fistula surgery?

STIs

Treatment will vary depending on which STI is causing rectal discharge. The most common STI-related cause of rectal discharge is gonorrhea. Treatment options include antibiotics.

Doctors may also suggest future prevention by receiving vaccinations or using barrier method contraception during sex.

When should you seek medical advice for an STI?

Proctitis

Treatment for proctitis will vary depending on the underlying cause.

Acute cases of inflammation may require more direct treatments. If a chronic condition is causing proctitis, a person may require a combination of medical treatment and long-term changes to their diet and lifestyle.

What is the difference between proctitis and ulcerative colitis?

Cancer

Treatment for anal or rectal cancer will depend on the individual, the type of cancer, and the stage at diagnosis.

Possible options include:

Rectal prolapse

Surgery is the usual treatment for rectal prolapse.

Without treatment, symptoms can worsen, and complications can arise, such as ulceration.

What should you do if you have rectal pain?

It is important that people discuss any new or worsening rectal discharge, bleeding, or other GI symptoms with a doctor.

People may want to consider seeking medical attention for GI symptoms that persist for longer than a week despite trying at-home treatments.

Here are some answers to questions people often ask about recal discharge.

Is rectal discharge normal?

Rectal discharge is usually a sign of an underlying problem. Discharge that occurs with hemorrhoids may resolve without treatment, but discharge and leakage can be a sign of more serious problems, such as a rectal prolapse or cancer.

Why is my bottom leaking?

Possible reasons for rectal discharge or leakage of stool include an infection, cancer, rectal prolapse, an abscess, a fistula, or hemorroids.

Will it go away?

If the cause is hemorrhoids, it may go away without treatment or with OTC remedies. However if you notice new or worsening symptoms, it is best to see a doctor to find out the reason. Some causes may need prompt medical intervention.

Rectal discharge can cause discomfort and concern, as it usually signifies the presence of an underlying condition.

A person should contact a doctor if they experience any new or worsening rectal discharge. A doctor can diagnose and treat the underlying causes of rectal discharge with lifestyle and diet recommendations, medication, and surgery.