Is Rectal Itching a Sign of Cancer?

Comparing 5 Possible Causes of Pruritus Ani

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According to the American Cancer Society, over 44,000 people are diagnosed with rectal cancer in the United States each year. Although this accounts for less than half of the total number of colorectal cancer cases overall, it does not diminish the importance of rectal cancer awareness—not least of which is knowing the signs and symptoms of the disease.

Although persistent rectal itching (pruritus ani) can be a sign of rectal cancer, it is not the most common cause. There are many other benign or non-life-threatening conditions that are more likely to cause this.

Doctor reviewing medical chart with senior man
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Even so, differentiating the causes of rectal itching can be difficult. In the end, it is a good idea to see a healthcare provider if rectal itching persists, worsens, or is accompanied by other unusual signs and symptoms.

Anal Fissures

Anal fissures are commonly associated with rectal itchiness. These small tears in the thin, moist tissues (mucosa) of the anus are rarely life-threatening and often occur as a result of severe constipation, chronic diarrhea, or anal sex.

Symptoms of anal fissures include:

  • Rectal pain during and after a bowel movement
  • Blood in the surface of the stool
  • Blood on toilet paper
  • Rectal itching, often accompanied by burning and pain
  • Foul-smelling rectal discharge
  • Difficulty or discomfort urinating

Anal fissures can also occur as a result of inflammatory bowel disease (IBD) and sexually transmitted diseases (STDs) like chlamydia, gonorrhea, and syphilis. Straining during childbirth can also cause anal fissures.

Hemorrhoids

Hemorrhoids are one of the most common causes of rectal itching. Hemorrhoids, also known as piles, are enlarged, swollen veins that form on the inside and outside the rectum or anus. They are often caused by chronic constipation or diarrhea and are common in people who are overweight, pregnant, or lift heavy objects.

Signs and symptoms of hemorrhoids include:

  • Rectal itching
  • Rectal pain during bowel movements or while sitting
  • A hardened mass around the anus or in the rectum that is often tender or sore
  • Rectal bleeding, usually light
  • Blood on toilet paper

Contact Dermatitis

Contact dermatitis is a red, itchy rash caused by contact with a substance that irritates the skin or causes a localized allergic reaction. The rash isn't contagious but can cause significant itching and discomfort.

Contact dermatitis of the rectum can be caused by exposure to harsh soaps, laundry detergent, body lotions, perfumes, latex condoms, and condom lubricants (including spermicides).

Signs and symptoms of contact dermatitis of the rectum include:

  • A red rash
  • Dry, scaly skin
  • Itching, sometimes severe
  • Rectal swelling, burning, and tenderness
  • Tiny blisters that can ooze and crust

Contact dermatitis typically resolves once the offending substance is removed. 

Infections

Any localized infection in the rectum can cause itching. This includes STDs that are transmitted during anal sex. Anal warts caused by human papillomavirus (HPV) are another possible cause.

Parasitic causes include pinworms that are transmitted via the fecal-oral route, either by hand or by contact with contaminated food or objects. Scabies can also affect the rectum and are typically passed from person to person.

Rectal thrush (candidiasis) is a fungal cause typically associated with a weakened immune system.

The signs and symptoms of these infections can differ, but many cases can be entirely asymptomatic with the exception of rectal itching or discomfort. Persistent, severe, or worsening rectal itching should always warrant a visit to your healthcare provider.

Rectal Cancer

Rectal cancer is the least likely cause of anal itching and typically occurs alongside other symptoms involving the gastrointestinal tract. Rectal cancer often runs in families and is most common in people over 50 (unlike the other conditions that can occur at any age).

Signs and symptoms of rectal cancer can include:

With rectal cancer, any blood in stools will usually be bright red or burgundy-ish in color. With colon cancer, the stools are more likely to be dark maroon or even black.

Despite these tell-tale signs, there are other non-cancer conditions with similar features. These include Crohn's disease, ulcerative colitis, and diverticulosis of the small intestine.

A Word From Verywell

Rectal itching can be caused by many things, including eating too-spicy foods one night. But whenever the itchiness persists, you should pay attention. While rectal cancer is one of the least likely causes of pruritus ani, it is still a possibility. Don't let embarrassment or the fear of cancer prevent you from getting it looked at.

In the end, you cannot diagnose rectal cancer by symptoms alone. Only certain tests—most specifically a biopsy—can determine whether you have the disease or not. Even if you do, early diagnosis and treatment almost invariably lead to better outcomes.

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9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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