The anus is the opening of the rectum through which stool passes out of your body. Problems with the anus are common. They include hemorrhoids, abscesses, fissures (cracks), and cancer.

You may be embarrassed to talk about your anal troubles. But it is important to let your doctor know, especially if you have pain or bleeding. The more details you can give about your problem, the better your doctor will be able to help you. Treatments vary depending on the particular problem.

Imperforate anus is a birth defect where the opening to the anus is missing or blocked. The anus, also known as the rectum, is the opening at the end of the intestines through which stool (bowel movement) leaves the body. Imperforate anus may end in a pouch, be too narrow (stenotic or atresic), or open into part of the urinary system, female or male reproductive system, or other system of body. Symptoms may include absence of the first stool within 24 to 48 hours after birth, no anal opening, anal opening in an abnormal place, stool coming out from the vagina, base of penis, scrotum, or urethra, and/or swollen belly.

Although the exact cause of imperforate anus is not fully understood, it is believed to be due to the abnormal development of the rectum when the embryo is forming inside the womb. Many forms of imperforate anus occur with other birth defects. Imperforate anus may also be part of a syndrome with multiple birth defects.

Treatment may include colostomy and surgery to correct the defect. Prognosis depends on the severity and type of imperforate anus and the severity and type of any other birth defects.

The rectum is the lower part of your large intestine where your body stores stool. Problems with rectum are common. They include hemorrhoids, abscesses, incontinence and cancer.

Many people are embarrassed to talk about rectal troubles. But seeing your doctor about problems in this area is important. This is especially true if you have pain or bleeding. Treatments vary depending on the particular problem.

What are hemorrhoids?

Hemorrhoids are swollen, inflamed veins around your anus or the lower part of your rectum. There are two types:

• External hemorrhoids, which form under the skin around your anus
• Internal hemorrhoids, which form in the lining of your anus and lower rectum

What causes hemorrhoids?

Hemorrhoids happen when there is too much pressure on the veins around the anus. This can be caused by:

• Straining during bowel movements.
• Sitting on the toilet for long periods of time.
• Chronic constipation or diarrhea.
• A low-fiber diet.
• Weakening of the supporting tissues in your anus and rectum. This can happen with aging and pregnancy.
• Frequently lifting heavy objects.

What are the symptoms of hemorrhoids?

The symptoms of hemorrhoids depend on which type you have:

With external hemorrhoids, you may have:

• Anal itching
• One or more hard, tender lumps near your anus
• Anal pain, especially when sitting

Too much straining, rubbing, or cleaning around your anus may make your symptoms worse. For many people, the symptoms of external hemorrhoids go away within a few days.

With internal hemorrhoids, you may have:

• Bleeding from your rectum - you would see bright red blood in your stool, on toilet paper, or in the toilet bowl after a bowel movement
• Prolapse, which is a hemorrhoid that has fallen through your anal opening

Internal hemorrhoids are usually not painful unless they are prolapsed. Prolapsed internal hemorrhoids may cause pain and discomfort.

How can I treat hemorrhoids at home?

You can most often treat your hemorrhoids at home by:

• Eating foods that are high in fiber.
• Taking a stool softener or a fiber supplement.
• Drinking enough fluids every day.
• Not straining during bowel movements.
• Not sitting on the toilet for long periods of time.
• Taking over-the-counter pain relievers.
• Taking warm baths several times a day to help relieve pain. This could be a regular bath or a sitz bath. With a sitz bath, you use a special plastic tub that allows you to sit in a few inches of warm water.
• Using over-the-counter hemorrhoid creams, ointments, or suppositories to relieve mild pain, swelling, and itching of external hemorrhoids.

When do I need to see a health care provider for hemorrhoids?

You should see your health care provider if you:

• Still have symptoms after 1 week of at-home treatment.
• Have bleeding from your rectum. Hemorrhoids are a common cause of bleeding, but other conditions can also cause bleeding. They include Crohn's disease, ulcerative colitis, colorectal cancer, and anal cancer. So it's important to see your provider to find the cause of the bleeding.

How are hemorrhoids diagnosed?

To find out if you have hemorrhoids, your health care provider:

• Will ask about your medical history.
• Will do a physical exam. Often providers can diagnose external hemorrhoids by looking at the area around your anus.
• Will do a digital rectal exam to check for internal hemorrhoids. For this, the provider will insert a lubricated, gloved finger into the rectum to feel for anything that is abnormal.
• May do procedures such as an anoscopy to check for internal hemorrhoids.

What are the treatments for hemorrhoids?

If at-home treatments for hemorrhoids don't help you, you may need a medical procedure. There are several different procedures that your provider can do in the office. These procedures use different techniques to cause scar tissue to form in the hemorrhoids. This cuts off the blood supply, which usually shrinks the hemorrhoids. In severe cases, you may need surgery.

Can hemorrhoids be prevented?

You can help prevent hemorrhoids by:

• Eating foods that are high in fiber
• Taking a stool softener or a fiber supplement
• Drinking enough fluids every day
• Not straining during bowel movements
• Not sitting on the toilet for long periods of time

The anus is where stool leaves your body when you go to the bathroom. It is made up of your outer layers of skin and the end of your large intestine. Anal cancer is a disease in which cancer cells form in the tissues of the anus.

Anal cancer is rare. It is more common in smokers and people over 50. You are also at higher risk if you have HPV, have anal sex, or have many sexual partners.

Symptoms include bleeding, pain, or lumps in the anal area. Anal itching and discharge can also be signs of anal cancer.

Doctors use tests that examine the anus to diagnose anal cancer. They include a physical exam, endoscopy, ultrasound, and biopsy.

Treatments include radiation therapy, chemotherapy, and surgery.

KEY POINTS

• Anal cancer is a disease in which malignant (cancer) cells form in the tissues of the anus.
• Being infected with the human papillomavirus (HPV) increases the risk of developing anal cancer.
• Signs of anal cancer include bleeding from the anus or rectum or a lump near the anus.
• Tests that examine the rectum and anus are used to detect (find) and diagnose anal cancer.
• Certain factors affect the prognosis (chance of recovery) and treatment options.

Anal cancer is a disease in which malignant (cancer) cells form in the tissues of the anus.

The anus is the end of the large intestine, below the rectum, through which stool (solid waste) leaves the body. The anus is formed partly from the outer skin layers of the body and partly from the intestine. Two ring-like muscles, called sphincter muscles, open and close the anal opening and let stool pass out of the body. The anal canal, the part of the anus between the rectum and the anal opening, is about 1-1½ inches long.

The skin around the outside of the anus is called the perianal area. Tumors in this area are skin tumors, not anal cancer.

The rectum continues from the sigmoid colon to the anal canal and has a thick muscular layer. It follows the curvature of the sacrum and is firmly attached to it by connective tissue. The rectum ends about 5 cm below the tip of the coccyx, at the beginning of the anal canal.

The last 2 to 3 cm of the digestive tract is the anal canal, which continues from the rectum and opens to the outside at the anus. The mucosa of the rectum is folded to form longitudinal anal columns. The smooth muscle layer is thick and forms the internal anal sphincter at the superior end of the anal canal. This sphincter is under involuntary control. There is an external anal sphincter at the inferior end of the anal canal. This sphincter is composed of skeletal muscle and is under voluntary control.