Hi, Thanks for posting in HCM. I understand your concern. Itching sensation in the rectum with a small hole that bleeds is nothing but anal fistula . You need to consult Surgeon and get a per rectal examination to know the status of it. Accordingly, you need to undergo surgery called fistulectomy to cure your illness. You need to avoid constipation by consuming diet rich in fibres along with consuming good quantity of water and taking laxatives, if necessary. Kindly get it done at the earliest so as to avoid further complications. Hope the information provided would be helpful. All the best.