Rectal Discharge: Colors, Causes & Treatments

Key takeaways:

• Rectal discharge has multiple causes.
• Some causes can be annoying to manage but are rarely life-threatening.
• If you are experiencing rectal discharge, talk to your doctor.

Discharge of fluid from the rectum can be an upsetting symptom. It’s natural to have questions and to be concerned. Patients may find it embarrassing to talk about – but don’t worry. This is a complaint doctors hear about regularly.

Many conditions can cause rectal discharge. Some are persistent and annoying to manage. Sometimes the only “treatment” is to deal with symptoms as well as you possibly can. One thing that’s important to know is there are risk factors that make some conditions more likely than others. Being honest and open as you discuss your symptoms will help your doctor arrive at a diagnosis more quickly. It may feel unpleasant, and even awkward, to speak frankly about your symptoms, but it will be worth it once you start feeling better.

Definition of rectal discharge

Rectal discharge is defined as fluid from the rectum that is discharged through the anus (butthole). The discharge can vary in terms of consistency. Is it more like mucus or pus, or is it watery? The color is also important. A discharge that is dark brown and foul-smelling likely means something different from a white/yellow discharge.

Symptoms of rectal discharge

Sometimes rectal discharge isn’t your only symptom. You may feel pain, either while having a bowel movement or just when sitting. If there is bleeding, that’s also an important thing to note. If you’ve had an infection around your anus before, this is important for your doctor to know. Also, let your doctor know if you’re having unprotected sex or anal sex. All this information can help guide your healthcare team in determining the diagnosis.

What rectal discharge looks like

The discharge from your rectum will have a certain color and consistency. It’s important to make note of this so you can relay the information to your doctor. These are the kinds of details that can help determine what’s causing your rectal discharge.

Colors

Yellow/green: Rectal discharge that ranges from white to yellowish green may indicate the presence of an anal fistula or a sexually transmitted infection (STI). This is an infected tube-like connection between the skin and the anus. This rectal discharge color may also be caused by certain skin conditions or proctitis (rectal inflammation).

Brown/green: Brown or green-colored discharge likely means that the discharge is feces or at least stained with feces. This would indicate fecal incontinence, meaning the inability to control bowel movements.

Straw-colored: Clear or straw-colored discharge points toward two possible causes: hidradenitis, a painful, chronic skin condition; or pilonidal disease, a painful skin condition in the crease of the buttocks.

Consistency

Serous: Fluid that is serous has a watery consistency. This kind of rectal discharge doesn’t usually indicate acute inflammation, like that found in proctitis or abscess. Diseases that are more chronic in nature such as hidradenitis or pilonidal disease cause serous discharge.

Purulent: Purulent discharge is thicker, like mucus or pus. It usually means there’s an acute or chronic inflammation such as abscess, proctitis, or fistula or a sexually transmitted infection (STI).

Causes of rectal discharge

Rectal discharge has numerous causes. Shown on this list are some of the most common causes.

Anal fistula

A fistula is an abnormal connection between two parts of the body. In the case of an anal fistula, the connection is between the skin around the anus and the anal canal itself. This usually follows an anal abscess (pocket of pus). After the abscess is drained, it forms a connection between the anal skin and the anal canal. This connection remains open and will start to drain fluid, typically purulent and foul-smelling. Fistulas require surgery or some form of intervention to heal.

Fecal incontinence

Fecal incontinence is the loss of control of gas and/or bowel movements. There are many reasons a patient develops fecal incontinence. The severity can range from partial loss of control of flatulence (farting) to complete inability to control bowel movements. There are treatment options available for fecal incontinence. If you think you may be suffering from this, don’t hesitate to talk to your doctor about it.

Pilonidal cyst

A pilonidal cyst is thought to arise from an ingrown hair in the groove between the buttocks. It causes painful swelling and skin that is red and tender. There are pits or small holes present in the middle or sides of the swelling. Fluid drains from these holes, which leads to rectal discharge. The treatment for pilonidal cysts is surgical removal.

Hidradenitis suppurativa

Hidradenitis suppurativa is an inflammatory skin condition that affects the armpits, groin, and anal areas. The cause is not completely understood, although it may be a disease of the hair follicles. It causes repeated painful infections and drainage in these areas. It is difficult to treat and may require specialized care from a dermatologist.

Proctitis

Proctitis is inflammation of the rectum. There are numerous causes, including infection, radiation, and sexually transmitted infections. Proctitis can cause discharge from the rectum that may be bloody or purulent. Pain during bowel movements is a common symptom as well. Treatment depends on the cause.

Perianal abscess

A perianal abscess is a collection of infected fluid near the anus. The skin is red and tender, and there may be drainage of purulent, foul-smelling fluid. This usually requires drainage to treat. It is possible that after drainage, the abscess may form a fistula, as previously discussed.

Diagnosing rectal discharge

Many of these conditions can be diagnosed with a history and physical exam. Your doctor may want to perform a medical procedure known as an anoscopy. This involves a small scope being placed into your anus to better examine it. Your doctor may also recommend a colonoscopy or sigmoidoscopy. With these procedures, you are given sedation, and a flexible tube with a camera is inserted into your rectum and colon to examine them.

Treatments for rectal discharge

Treatment for these conditions varies widely, depending on the specific diagnosis. Sometimes, surgical intervention is required.

At-home remedies

Sitz baths are a common remedy for patients with anorectal conditions. You sit in a warm tub of water, sometimes with added salt. Soaking in a sitz bath can help diminish swelling while alleviating pain around the anus.

Surgery

Surgical intervention, if needed, is targeted at the cause of your rectal discharge. For example, an abscess requires drainage. A fistula requires excision or plugging, whereas a pilonidal cyst requires removal. If surgery is deemed necessary in your case, your doctor will explain your individualized plan.

When to see a doctor about rectal discharge

Discharge from the rectum is not usually expected. If it persists beyond 48 hours, definitely consult with your doctor.

You should see a doctor if:

• You’ve had rectal discharge for more than 48 hours;
• You have pain around your anus;
• You’re having painful bowel movements;
• You’re passing blood from your anus.

You should go to the emergency room if:

• You have a fever and anal pain;
• You’re passing blood from your anus and feel dizzy or lightheaded;
• You haven’t had to urinate in the last six hours.

Questions to ask your doctor about rectal discharge

• What do you think is causing this?
• How long do you expect this to last?
• Are other tests needed?
• Is there anything I can do at home?

Frequently asked questions: rectal discharge

It is normal to have questions about rectal discharge. Please be sure to ask all your questions until you’re confident that you understand your condition.

What does watery rectal discharge mean?

Watery (serous) rectal discharge means chronic inflammation is present. It is less common in acute processes such as abscesses.

What if you have rectal discharge while pregnant?

See your doctor if you experience rectal discharge while pregnant.

What if you experience rectal discharge after a bowel movement?

If it happens once or twice and then goes away, it’s okay to watch and see if it returns. If it continues after 48 hours, call your doctor.

Closing thoughts

Rectal discharge is a difficult and concerning problem for many patients. It is normal to have questions, but also to feel uncertain about mentioning it to your physician. If it lasts longer than 48 hours, however, don’t hesitate to let your doctor know.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.

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