Rectal discharge is defined as the release of any substance other than normal, solid stool from the anus. This symptom is often noticed on underwear, toilet paper after wiping, or mixed with feces. The discharge originates from the rectum or the anal canal, the final section of the large intestine. While the presence of discharge can be alarming, it signals an irritation, inflammation, or structural issue within the lower gastrointestinal system, representing a wide range of underlying conditions.
Understanding the Appearance and Characteristics
Observing the precise nature of the discharge provides initial clues about its origin. Mucus is a common type, appearing as a clear, white, or yellowish jelly-like substance naturally produced by the colon lining to protect the walls and lubricate stool. An increased volume of mucus often points to internal irritation, such as with Irritable Bowel Syndrome (IBS) or an inflammatory condition like Ulcerative Colitis.
Discharge containing blood can appear bright red or dark, depending on the source of the bleeding within the digestive tract. Bright red blood typically indicates a lower gastrointestinal issue, such as hemorrhoids or an anal fissure. Darker blood may signal bleeding higher up in the colon. The presence of pus, a thick, opaque, yellow or green fluid, strongly suggests a bacterial infection or the formation of an abscess, often accompanied by a foul odor and localized pain.
Underlying Causes of Rectal Discharge
The causes of rectal discharge fall into three categories: structural problems, inflammatory conditions, and infections affecting the lower gastrointestinal tract. Structural issues involve physical damage or displacement of tissue around the anus and rectum. Hemorrhoids, which are swollen veins, frequently cause bright red bleeding and sometimes mucus leakage.
An anal fissure is a small tear in the anal canal lining that typically produces small amounts of bright red blood and pain during bowel movements. Rectal prolapse, where the rectal walls slide out through the anus, can also lead to mucus and blood discharge due to physical irritation and loss of sphincter control.
Inflammatory conditions are characterized by chronic inflammation of the bowel lining. Inflammatory Bowel Disease (IBD), including Crohn’s disease and Ulcerative Colitis, can cause the rectum to produce large amounts of bloody mucus and pus. Proctitis, inflammation limited specifically to the rectum, commonly results in mucus or pus discharge, often alongside a persistent feeling of needing to pass stool.
Infections are a significant cause, ranging from common gastrointestinal illnesses to sexually transmitted infections (STIs). Bacterial infections from foodborne illnesses, such as Campylobacter or Salmonella, can lead to diarrhea that includes blood and mucus. STIs like chlamydia, gonorrhea, herpes, and syphilis can cause proctitis, resulting in anal discharge that may be the only noticeable symptom.
When to Seek Medical Care and Diagnostic Procedures
While some mild, temporary discharge may resolve on its own, certain symptoms warrant prompt medical attention to rule out serious conditions. Immediate care is recommended if the discharge is accompanied by a high fever, severe or persistent abdominal pain, or a large volume of blood. Any sudden inability to control bowel movements or significant, unexplained weight loss alongside the discharge should be evaluated without delay.
A healthcare provider will begin the diagnostic process with a comprehensive physical examination, including a digital rectal exam to check for structural abnormalities like hemorrhoids or abscesses. To identify infections or inflammation, a stool sample analysis may be ordered to look for hidden blood, bacteria, or parasites.
If the cause is not easily determined, further procedures may be necessary. These include an anoscopy or sigmoidoscopy, which use a small, lighted tube to visualize the lower rectum and anal canal. For a more extensive examination, a colonoscopy may be performed to inspect the intestinal lining and collect tissue samples if needed.