Proctitis is a relatively uncommon cause of painless rectal bleeding. Very often the stool doesn't just contain some blood, but there is mucus as well. Not infrequently there is also the urge to move ones bowels very frequently and the amounts of stool passed at one time will be very small.
Proctitis causes the lining of the rectum to become inflamed and raw appearing. The cause of proctitis is unknown, and it can be the beginnings of a more severe disease such as ulcerative colitis or Crohn's disease. In most cases, however, proctitis is a mild disease and is easily treated or even reverses itself without treatment.
Pruritus is an extremely common skin condition and very frequently misdiagnosed as "hemorrhoids". Pruritus causes itching (pruritus is the medical term for itching). Hemorrhoids do not itch. The only other condition to cause itching is a fungal infection around the rectum, which is a very uncommon problem.
Pruritus is usually the result of the following:
caffeine - this is the most common cause of pruritus .
chronic moisture - the causes for this are multiple, including any of the conditions that are listed under "drainage" on the home page; note that pruritus itself can cause drainage, therefore this condition can be self-perpetuating like a vicious circle
use of soap - typically people that have pruritus feel that they need to clean themselves very carefully and use soap to clean; as a result they perpetuate the problem by stripping the natural oils that the protect the skin in that location .
A skin tag is another extremely common condition and is commonly associated with other anorectal problems. The name is very descriptive in that there is a tag or an extra fold of skin. The skin tag is noticed by the patient as a painless protrusion which is soft. Very frequently there is an external hemorrhoid underlying the tag. Skin tags are thought by laypeople as well as doctors as causing pain. Frequently, one finds an associated fissure which is the actual cause of the pain. Skin tags are, therefore, another frequently misdiagnosed condition and, sadly, give rise to many unnecessary or inappropriate surgical procedures. Beware of the surgeon that suggests surgery for this diagnosis!
Levator muscle spasm is a rather common condition. It is often caused by other conditions, most commonly fissures and thrombosed hemorrhoids as well as the pain after surgical procedures around the anorectum. However it can often be present by itself. The amount of pain can be anywhere from mild to severe and intolerable. Its duration can be from a momentary spasm of pain to a continuous condition. Levator muscle spasm can, in fact, be completely debilitating in some unusual cases.
Levator muscle spasm is another condition that is often misdiagnosed. The most common condition blamed incorrectly for the pain of levator muscle spasms are, once again, hemorrhoids. And, once again, hemorrhoids do not cause pain, except as described before (see external hemorrhoid and internal hemorrhoids).
Cancer of the rectum and anal cancer are different forms of cancer that afflict the anorectal area. They cause several different symptoms which may be similar to symptoms caused by non-cancer diseases and this is the reason that any significant symptom should be investigated by qualified medical personnel. Symptoms of cancers in this region include protrusion, bleeding, pain, sensation of incomplete evacuation, changes in stool size or shape, and others. At the risk of being repetitive: it is important to take anorectal symptoms seriously so that the possibility of cancer can be excluded. A simple digital rectal exam (finger examination) is not sufficient to exclude cancer. A complete rectal exam includes a visual exam with a proctoscope or flexible sigmoidoscope, also. If you have a family history of cancer of the colon (large intestine) or recum and you are over 35 years of age then you are at higher risk for cancer as well. It is that much more important for you to have a complete rectal exam.