While the causes of anal and rectal problems are quite diverse, they may produce very similar symptoms. For instance, anal itching (pruritus ani) is extremely common and affects nearly everyone at some time.

Anal itching has numerous causes. Certain foods, such as spices, citrus fruits, coffee or beer, can cause itching. Poor or excessive hygiene can irritate the anus, causing itching. More serious causes include draining fistulas, infections and cancers. In some cases, the cause is not directly related to the anus or rectum. For instance, diabetes and liver disease have been associated with anal itching.

Significant changes in bowel consistency or frequency are also common symptoms of anal or rectal problems. For instance, constipation is a common symptom of obstruction and dyschezia. Because the stool cannot pass from the body, it remains in the intestine and becomes hard and dry. This form of constipation is often accompanied by a frequent or constant urge to defecate. Pseudodiarrhea may occur when watery mucus or liquid stool oozes around an obstruction. Anal stenosis may cause bowel movements to be very thin and difficult and may lead to bloating. Loss of appetite, nausea, vomiting and abdominal bloating may also occur when constipation results from an inability to pass stool from the body. However, diarrhea is usually caused by medical issues occurring higher in the intestines rather than the anus or rectum.

Mild to severe pain is a common symptom of several anal and rectal problems. Anal fissures often result in severe, tearing or burning pain that begins during a bowel movement and lasts for minutes or hours. Sudden, severe pain during bowel movements may also be a symptom of a foreign object in the rectum or anus. An anorectal abscess may produce severe, continuous, throbbing pain that gets worse when walking or straining during a bowel movement. Other potential causes of anal or rectal pain include hemorrhoids, anorectal fistula, proctitis and fecal impaction.

Many anal and rectal problems may cause streaks of blood in the stool or on toilet paper. Bleeding may be painless. Blood in the stool is usually associated with other gastrointestinal problems, such as polyps or peptic ulcers. Anorectal problems that may cause bleeding include hemorrhoids, fissures, proctitis or anorectal varices. These generally result in only small amounts of blood, but anorectal varices may cause massive, life-threatening bleeding. When bleeding is extensive, anemia may result. Any rectal bleeding could also signify more serious problems (e.g., cancer) and require a thorough evaluation by a physician or gastroenterologist.

Mucus discharge may occur in some anal and rectal problems such as hemorrhoids or proctitis. Pus discharge may result from other problems (e.g., anorectal fistulas). This discharge may seep through the anus or appear on the side of the stool.