Blood in Stool: Causes and When to Seek Help

The presence of bright red blood in the stool..?

Doctor, I’m sorry to bother you, but I have a question.
Sometimes when I have a bowel movement, I’m not sure if it’s because I’m not drinking enough water or if I don’t have a bowel movement every day (about every 2 to 3 days), which causes my stool to be harder and leads to pain in my anus.
I experience a tearing sensation, and when I wipe, I notice a small amount of fresh blood on the toilet paper.
After a few wipes, it stops.
This situation usually improves when my stool becomes more normal and less hard, and I no longer experience bleeding or anal pain.
However, this morning when I had a bowel movement, I encountered this issue again.
Although my stool wasn’t very hard, I still felt some pain in my anus.
When I wiped for the first time, the toilet paper had blood on it, and the amount was similar to menstrual bleeding.
But after wiping a second and third time, the fresh blood decreased significantly.
I’m unsure what these symptoms indicate about my health.
Could you please help me understand?

Niming, 20~29 year old female. Ask Date: 2016/03/27

Dr. Ke Fangxu reply Surgery

This situation likely indicates a higher possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Warm sitz baths may also help alleviate symptoms.
You can purchase hemorrhoidal suppositories at the pharmacy for use.
It is best not to take stool softeners indiscriminately; at this age, increasing dietary fiber and hydration should be sufficient.
If bleeding persists, it is advisable to consult a physician for evaluation.

Reply Date: 2016/03/27

More Info

When it comes to blood in the stool, it can be concerning and may indicate a variety of underlying issues. Based on your description, it seems that you are experiencing pain during bowel movements, a tearing sensation, and the presence of fresh blood on the toilet paper after wiping. These symptoms can be indicative of several conditions, most commonly related to the anal area or the lower gastrointestinal tract.

One of the most frequent causes of blood in the stool, especially when accompanied by pain, is anal fissures. Anal fissures are small tears in the lining of the anus, often caused by passing hard or large stools. This can lead to sharp pain during bowel movements and may result in bleeding, which is typically bright red. The blood you see on the toilet paper is likely from the fissure rather than from deeper within the gastrointestinal tract.

Another potential cause could be hemorrhoids, which are swollen blood vessels in the rectal area. Hemorrhoids can cause discomfort, pain, and bleeding, especially during bowel movements. The blood from hemorrhoids is also usually bright red and may be seen on the toilet paper or in the toilet bowl.

Your mention of infrequent bowel movements (every 2-3 days) and hard stools suggests that constipation may be a contributing factor. Insufficient fluid intake and a low-fiber diet can lead to harder stools, making them more difficult to pass and increasing the risk of anal fissures or hemorrhoids. It is essential to maintain adequate hydration and consume a diet rich in fiber to promote regular bowel movements and softer stools.

While your symptoms may improve with dietary changes and increased hydration, it is crucial to monitor the situation closely. If the bleeding persists, increases in volume, or is accompanied by other symptoms such as severe pain, changes in bowel habits, or any signs of infection (such as fever), it is important to seek medical attention promptly. A healthcare professional can perform a thorough evaluation, which may include a physical examination and possibly further diagnostic tests, to determine the exact cause of your symptoms.

In summary, while your symptoms may be related to anal fissures or hemorrhoids due to constipation, it is essential to address the underlying causes by improving your diet and hydration. However, do not hesitate to consult a healthcare provider if your symptoms do not improve or if you have any concerns. Early intervention can help prevent complications and ensure proper treatment.

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