What Causes Rectal Discharge, and Is Treatment Needed?

Rectal discharge can be a concerning medical symptom. While it can occur after a bowel movement, rectal discharge can also happen at other times. You’re most likely to notice the problem when you wipe or as a wet sensation. It can also occur as a stain on your underwear during normal activities.

Rectal discharge can occur as a symptom of many problems, such as gastrointestinal conditions, infections, sexually transmitted infections (STIs), and certain drugs. It can include any type of fluid, with a consistency ranging from jellylike to watery. The severity of the problem and proper treatment depend on the cause.

11 Potential Causes of Rectal Discharge

1. Gastrointestinal Infections

Rectal discharge can occur as a symptom of GI infections due to food poisoning, parasites, or bacteria that infect your gastrointestinal system. Many GI infections occur from eating uncooked foods contaminated with bacteria such as enterotoxigenic Escherichia coli (E. coli), Campylobacter, and Salmonella. Common GI viruses such as norovirus that spread quickly in enclosed communities can also cause rectal discharge. Gastrointestinal parasites such as Giardia lamblia are spread by consuming contaminated water.

2. Ulcerative Colitis

Ulcerative colitis is a type of inflammatory bowel disease (IBD). It is caused by a defect in your immune system that causes an attack on the lining of your large intestine (rectum and colon). The attack causes inflammation (swelling) of the mucous membranes. It also causes ulcers (small sores) that can bleed and produce pus that appears as rectal discharge.

3. Crohn’s Disease

Crohn’s disease is a type of inflammatory bowel disease that can cause swelling in any part of your digestive tract, from your mouth to your anus. It is most likely to affect your small intestine and the start of your large intestine.

4. Anal Abscess, Fistula, or Fissure

Rectal discharge can occur when gastrointestinal conditions cause the formation of one of the following abnormalities and leakage occurs:

• Anal abscess: A collection of pus within the anal canal
• Anal fissure: A tear in the lining of your anus
• Anal fistula: An abnormal track or channel between the end of your bowel and anus

5. Hemorrhoids

Hemorrhoids, also called piles, are swollen and inflamed veins around your rectum or anus. Hemorrhoids can be external (located under the skin around your anus) or internal (located in the lining of your anus and lower rectum). Enlarged hemorrhoids can leak fluid in the form of rectal mucus.

6. Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS) affects the function and behavior of your intestines. It causes uncomfortable symptoms by disrupting the normal action of the muscles lining your intestines but does not damage your GI tract.

7. Rectal Prolapse

Rectal prolapse is a rare condition in which your rectum drops through your anus. As the lining of the protruding rectum thickens from being unattached, it may lead to seepage of mucus or other fluid. Being over age 50 increases your risk of rectal prolapse. The condition can occur in one of the following ways:

• Complete rectal prolapse: The entire wall of your rectum drops through your anus.
• Partial rectal prolapse: Only the lining of your rectum drops through your anus.

8. Medications

Some medications are known to increase your risk of having GI symptoms such as rectal discharge. Medications can produce rectal discharge by changing the physiology of your GI tract, causing tissue damage such as ulcers, changing your intestinal microbiota, or through unknown means. These medications include:

Drug classes include:

Specific drugs include:

9. Sexually Transmitted Infections

Rectal discharge can occur as a symptom of certain STIs, including:

When rectal discharge occurs with STIs, it is often a result of proctitis, an inflammation inside the rectum. Proctitis caused by STIs is common in people who have anal intercourse.

10. Anal Cancer

Though rare, anal cancer is a type of cancer that develops in the cells and tissues of the skin lining the inside or on the outside of your anus. Rectal discharge can occur as a symptom in the early stages of anal cancer.

11. Chemotherapy

Chemotherapy treatments can damage the mucous membranes that line your gastrointestinal tract and cause rectal discharge. While the discharge is often temporary, it can last for months or longer, depending on your condition and the treatments used.

Does Rectal Discharge Need Treatment?

Rectal discharge can be a nuisance and an embarrassment. Heavy and frequent rectal discharge can interfere with your ability to remain comfortable and confident during normal activities.

Without treatment, rectal discharge may persist or worsen, especially if an undiagnosed and untreated medical condition causes it. In many cases, getting an accurate diagnosis and appropriate treatment of an underlying condition can help reduce or remove symptoms of rectal discharge.

Treatment of rectal discharge can vary based on its cause. Some common therapies advised by your healthcare provider may include:

Conservative Management:

• Increased intake of fiber and fluid
• Warm baths to relieve hemorrhoids and anal fissures

Medications:

• Antibiotics to treat bacterial infections and STIs
• NSAIDs and anti-inflammatory medications to relieve pain and discomfort
• Prescription creams and ointments for hemorrhoids
• Prescription medications to treat certain GI diseases such as Crohn’s disease and ulcerative colitis

Surgery:

• Procedures to remove or correct more severe conditions
• Surgery to remove or correct structural abnormalities such as tumors, anal fistulas, anal fissures, or diseased tissue

Management of underlying conditions through medications or other interventions may also be considered as a treatment option.

Testing for Undiagnosed Conditions

Your healthcare provider will determine the type of testing most appropriate for your symptoms based on a physical examination and family and medical history. The purpose of testing will be to identify any undiagnosed conditions that may be causing your rectal discharge.

Some of the most common tests used to diagnose GI conditions that cause rectal discharge include:

• Complete blood counts (CBC): Blood tests can be used to identify some types of bacteria, parasites, STIs, and signs of some GI conditions.
• Fecal occult blood test: This test checks for occult (hidden) blood in your stool.
• Stool culture: A stool culture checks for the presence of abnormal bacteria in your digestive tract.
• Ultrasound: An ultrasound is an imaging test that uses a computer and high-frequency sound waves to produce images of organs, tissues, and blood vessels as they function.
• Computed tomography (CT) scan: A CT scan uses multiple X-rays to create a 3-D image of your organs. It can help your healthcare provider visualize almost every part of your body with images that are much more detailed than general X-rays.
• Magnetic resonance imaging (MRI): An MRI uses a large magnet, radio frequencies, and a computer to create detailed images of your organs and other bodily structures. It helps diagnose conditions that affect your organs, muscle, or other types of tissue.
• Oropharyngeal motility (also called modified barium swallow) study: This involves swallowing a liquid containing barium, a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an X-ray.
• Colonoscopy: This procedure involves the insertion of a colonoscope (a long, flexible tube with a camera) into your rectum to view the colon. It is used to screen for colon cancer, evaluate rectal discharge and bleeding, and evaluate changes in bowel structure.
• Upper GI (gastrointestinal) series and small bowel follow-through series: This diagnostic test uses X-rays of your upper digestive system, which includes your esophagus, stomach, duodenum (the first section of the small intestine), and small bowel after you swallow barium.
• Lower GI series (also called barium enema): This procedure uses X-rays to examine your rectum, large intestine, and the lower part of the small intestine after administration of a barium enema (a liquid containing barium sulfate that, when in the body, highlights parts of the GI tract) into your rectum.
• Radioisotope gastric-emptying scan: This test involves eating food containing a radioisotope (a slightly radioactive substance) that shows up on a scan. The radiation from the radioisotope allows radiologists to see the swallowed food and how it passes through your stomach.
• Colorectal transit study: This procedure requires swallowing capsules that contain small markers visible on X-rays. The test measures how well food moves through your colon based on abdominal X-rays taken several times over three to seven days after you swallow the capsules.
• Defecography: This X-ray of your anorectal area during a bowel movement is used to identify structural or functional problems in your rectum, anus, or pelvic floor that may be contributing to problems with bowel movements. It involves the insertion of a barium paste into your rectum. A series of X-rays are taken after you expel the paste.
• Anorectal manometry: This test determines the strength of the muscles in your rectum and anus that tighten and relax during bowel movements.

Type of Provider to Consult

Which type of provider you consult for symptoms of fecal discharge will depend on your symptoms and how they occur. Consider how the following types of healthcare providers may be involved in your treatment:

Primary Care Provider

Consult your primary healthcare provider if symptoms of fecal discharge occur without a known cause. They can help determine a primary cause and a diagnosis or direct you to the most appropriate type of specialist based on your condition.

Gastroenterologist

A gastroenterologist is a medical doctor who provides comprehensive care for a wide variety of gastrointestinal ailments such as colon polyps and cancer, hepatitis, and IBS. They also perform the majority of gastrointestinal endoscopic procedures and colonoscopy examinations.

Colon and Rectal Surgeon

Previously known as a proctologist, a colon and rectal surgeon is a type of medical doctor who specializes in surgeries for diseases and conditions of the lower digestive tract. They perform surgeries of the anus, rectum, and colon.

Oncologist

An oncologist specializes in the diagnosis and treatment of cancer. You may be referred to an oncologist if cancer is suspected or confirmed by your primary care provider. An oncologist may specialize in a specific type of cancer, long-term care, or one type of cancer treatment.

Summary

Rectal discharge can appear as a watery or phlegm-like substance. It can occur alone or with streaks of feces or blood. You may notice it when wiping after a bowel movement or as a wet stain in your underwear.

In healthy people, rectal discharge may be a sign of an infection or STI that can resolve with antibiotics. However, rectal discharge that persists may indicate a more serious medical condition. Treatment of the condition may be needed to resolve the rectal discharge.

Do not ignore rectal discharge that appears suddenly and does not improve. Contact your healthcare provider for a proper diagnosis and treatment of the condition.