Blood in the stool and itching in the anus: hemorrhoids or something else? A comprehensive guide to the causes, diagnosis and treatment
Blood in the stool and itching in the anus are symptoms that occur frequently and yet are often underestimated. Many people assume that the first cause is hemorrhoids – a common condition in the field of proctology. However, these symptoms can also indicate other conditions, from harmless ones such as anal fissures to serious ones such as bowel cancer or chronic inflammatory bowel disease.
This comprehensive article explains the most common causes of blood in the stool and itching in the anus, describes modern diagnostic procedures and presents all treatment options. You will also receive valuable tips on how to prevent symptoms and when a visit to the doctor is unavoidable.
Blood in the stool: possible causes and their symptoms
Blood in the stool can indicate a variety of conditions, depending on the color, amount and accompanying symptoms. From bright red, fresh blood to black, tar-like stools, there are many clues that point to the underlying cause.
Hemorrhoids as the most common cause
Hemorrhoids are vascular cushions in the rectum that can swell up and cause discomfort when strained.
- Typical symptoms:
- Bright red blood on the toilet paper, in the stool or the toilet.
- Often painless, occasionally associated with itching or a feeling of pressure.
- Causes:
- Chronic constipation and heavy pushing during bowel movements.
- Lack of exercise and prolonged sitting.
- Pregnancy, obesity and a low-fiber diet.
Anal fissures
A small tear in the sensitive mucous membrane of the anal canal can lead to bleeding.
- Symptoms:
- Bright red blood, often painful.
- Sharp pain during and after bowel movements, accompanied by a burning sensation.
- Common causes:
- Chronic constipation or hard stools.
- Trauma due to improper hygiene or repeated irritation.
Colorectal cancer
Bowel cancer is one of the most serious causes of blood in the stool.
- Symptoms:
- Dark blood or mucus in the stool.
- Irregular bowel habits, abdominal pain, fatigue and weight loss.
- Who is affected?
- People aged 50 and over or with a family history of the disease.
Chronic inflammatory bowel disease (IBD)
Crohn’s disease and ulcerative colitis can lead to bloody diarrhea.
Symptoms:
- Bloody, slimy diarrhea, abdominal cramps and fever.
- Long-term: weight loss, anemia and chronic fatigue.
Other causes
- Diverticular bleeding: Bleeding from small protrusions of the intestinal wall.
- Infections: E.g. bacterial infections such as Shigella or Campylobacter.
- Vascular malformations: Bleeding due to vascular anomalies in the intestine.
Itching in the anus: causes and differentiation
Itching in the anus, also known as pruritus ani, is a symptom that is often associated with haemorrhoids. However, there are many other possible causes, ranging from harmless to requiring treatment.
Hemorrhoids as a cause
Hemorrhoids can secrete mucus, which irritates the sensitive skin around the anus and causes itching.
- Additional complaints:
- Foreign body sensation or pressure in the anus.
- Irritation due to incomplete bowel movement.
Fungal infections
Fungal infections in the anal area occur frequently, especially in people with a weakened immune system.
- Symptoms: Intense itching, redness and occasionally whitish plaques.
- Favoring factors: Excessive sweating, tight clothing and antibiotic therapy.
Parasites (e.g. pinworms)
- Common in children: Intense nocturnal itching.
- Other symptoms: Abdominal pain and sleep disturbances.
Skin diseases and allergies
Eczema or allergic reactions to care products or toilet paper can irritate sensitive skin.
Other causes:
- Anal fistulas: Connecting ducts between the rectum and skin with inflammatory secretions.
- Chronic skin diseases: E.g. psoriasis or neurodermatitis.
Diagnostics: How are the causes clarified?
Early and thorough diagnosis is crucial in order to determine the exact cause and rule out serious illnesses.
Medical history
- Detailed survey of complaints, eating habits and previous illnesses.
- Clarification of accompanying symptoms such as pain, weight loss or fever.
Research methods
- Rectoscopy and proctoscopy: Examination of the anal canal and lower rectum.
- Colonoscopy: For a complete colon examination, especially if colon cancer or IBD is suspected.
- Microscopic examinations: For the detection of parasites, fungi or bacterial infections.
- Allergy tests: If allergic reactions or eczema are suspected.
Treatment options: What really helps?
Treatment of hemorrhoids
- Conservative measures:
- High-fiber diet, plenty of fluids, regular exercise.
- Sitz baths with anti-inflammatory additives.
- Drug therapy:
- Ointments, suppositories and creams with anti-inflammatory active ingredients.
- Modern procedures:
- Rubber band ligation: Gentle removal by ligation.
- Laser therapy: Minimally invasive method for tissue shrinkage.
- Sclerotherapy: Sclerotherapy by injections.
Treatment of fungal infections
- Topical antimycotics such as creams or ointments.
- For severe infections: oral antimycotics.
Treatment for anal fissures
- Acute fissures: Ointments with pain-relieving or muscle-relaxing active ingredients.
- Chronic fissures: Surgical therapy in severe cases.
Treatment of serious illnesses
- Colorectal cancer: Surgical removal, chemotherapy or radiotherapy.
- IBD: Anti-inflammatory drugs, immunosuppressants or biologics.
Prevention: How to avoid complaints
Healthy habits
- Nutrition:
- High in fiber, sufficient fluids, little processed food.
- Hygiene:
- Mild cleaning, no excessive hygiene.
- Movement:
- Regular activity promotes intestinal health.
Regular check-ups
- Particularly important from the age of 50 or if you have a family history of the disease.
Blood in the stool and itching in the anus require attention
Blood in the stool and itching in the anus are symptoms that can have many causes. While hemorrhoids are often the cause, other possible diseases should not be ignored. Early clarification by specialists in proctology, as in the VenaZiel Berlin MVZis crucial for effective treatment.
