Symptoms related to this sensitive area can be very troubling, yet many people are reluctant to discuss them. Itching (pruritis ani), painful defecation, stained underwear, spotting of blood, and offensive odor add up to embarrassment, distress, social handicap and anguish. These complaints of anal discomfort are very common. Symptoms may coexist with the irritable bowel syndrome or other functional bowel disease. Diarrhea and constipation may aggravate them. Anal symptoms are not part of these conditions as they may occur independently. They may be due to or associated with many local diseases. Whatever the association, perianal irritation can be treated. Find out how to get help and what to do about it. Reviewed and updated 2009.