Scorching sensation of anus is often caused by downward migration of damp heat or invasion of stagnant heat in the large intestine into the rectum, usually seen in diarrhea due to heat or dysentery due to damp heat. Abdominal pain with frequent desire to defecate, prolapsing sensation of the anus and obstructive defecation is called tenesmus, often caused by internal retention of damp heat and obstruction of intestinal qi seen in dysentery. Difficult and astringent sensation in defecation accompanied by abdominal pain, distension and frequent flatus is caused by liver qi attacking the spleen and obstruction of intestinal qi; incontinence of stool is usually due to asthenia of the spleen and the kidney failing to control the anus, often seen in patients with weakness due to prolonged illness and senility or chronic diarrhea.

Fulminant diarrhea in new disease or spontaneous defecation with coma is also due to failure of the anus to control, but is not necessarily caused by weakness of the spleen and kidney. Prolapsing sensation of the anus or even prolapse of the anus is known as qi prolapse of the anus which often occurs after overstrain or becomes worsened after defecation, usually due to prolapse of the gastrosplenic qi and seen in patients with chronic diarrhea or prolonged dysentery.