Rectal Bleeding: Causes and Concerns for Patients

Rectal bleeding

Hello Doctor: I have noticed blood in my stool over the past few days, and there is a sharp pain in my anus during bowel movements.
My stools are quite hard, and there is blood and clots when I wipe, but there is no bleeding after I finish.
Previously, I sometimes experienced diarrhea and at other times constipation, with stools being thick and hard (the bleeding has occurred again in the past few days, and I had a similar issue a few years ago).
When I was younger, I had a significant polyp during a bowel movement, but only the exposed part was removed, and the end retracted back into the anus.
I also have a small lump outside my anus now (I'm not sure if it's a polyp or a hemorrhoid?).
A few years ago, my stool sample during a health check was normal.
I would like to ask the doctor what might be causing the blood in my stool now.
Thank you!

Karen, 30~39 year old female. Ask Date: 2016/03/28

Dr. Ke Fangxu reply Surgery

Based on your description, it seems to be an anal fissure.
The typical symptoms include pain during bowel movements accompanied by slight bleeding.
The primary cause of anal fissures is usually hard stools; however, diarrhea, frequent bowel movements, or prolonged straining can also lead to fissures.
It is advisable to improve bowel habits and take warm sitz baths to alleviate symptoms.
Topical ointments and suppositories can also be used for treatment.
If symptoms persist for more than a week without improvement, it is important to consult a physician to identify the underlying issue.

Reply Date: 2016/03/28

More Info

Rectal bleeding can be a concerning symptom for many patients, and it is important to understand the potential causes and implications. Based on your description, it seems that you are experiencing rectal bleeding associated with hard stools and pain during bowel movements. This situation can arise from several underlying conditions, and it is crucial to address them appropriately.

One of the most common causes of rectal bleeding, especially when accompanied by hard stools and pain, is hemorrhoids. Hemorrhoids are swollen veins in the lower rectum or anus that can become inflamed and bleed, particularly during bowel movements. The presence of small lumps or "meatballs" around the anus, as you described, could indicate external hemorrhoids or possibly skin tags resulting from previous hemorrhoidal issues.

Another potential cause of rectal bleeding is anal fissures, which are small tears in the lining of the anus that can occur due to passing hard stools. These fissures can cause sharp pain and bleeding during bowel movements, and they often heal with proper care and dietary adjustments.

Given your history of having polyps removed, it is also essential to consider the possibility of new growths or changes in the rectal area. While most polyps are benign, some can develop into cancer over time. Regular screening and monitoring are vital, especially if you have a history of polyps or colorectal issues.

Your mention of alternating between diarrhea and constipation suggests that you may be experiencing irritable bowel syndrome (IBS) or another gastrointestinal condition that affects bowel habits. This fluctuation can lead to straining during bowel movements, further exacerbating hemorrhoids or fissures.

It is also worth noting that rectal bleeding can sometimes be a sign of more serious conditions, such as diverticulosis, inflammatory bowel disease (IBD), or colorectal cancer. While these conditions may not be the most likely causes based on your symptoms, they should not be ruled out, especially if the bleeding persists or worsens.

To address your concerns and manage your symptoms effectively, consider the following steps:
1. Dietary Changes: Increase your fiber intake through fruits, vegetables, and whole grains to help soften your stools and reduce straining during bowel movements. Staying well-hydrated is also crucial.

2. Over-the-Counter Treatments: You may find relief from hemorrhoids or fissures with over-the-counter topical treatments, such as hydrocortisone creams or witch hazel pads. Sitz baths can also help soothe the area.

3. Avoid Straining: When using the bathroom, try to relax and avoid straining. If you feel the urge to go, respond promptly to avoid hardening stools.

4. Consult a Healthcare Provider: It is essential to schedule an appointment with a healthcare provider or a gastroenterologist for a thorough evaluation. They may recommend a physical examination, a colonoscopy, or other diagnostic tests to determine the exact cause of your bleeding.

5. Monitor Symptoms: Keep track of your symptoms, including the frequency and amount of bleeding, any changes in bowel habits, and any associated pain. This information will be valuable for your healthcare provider.

In conclusion, while rectal bleeding can often be attributed to benign conditions such as hemorrhoids or anal fissures, it is essential to seek medical advice to rule out more serious issues, especially given your medical history. Early diagnosis and appropriate management can significantly improve your quality of life and prevent complications.

Similar Q&A

Understanding Rectal Bleeding: Causes, Concerns, and Care Tips

Hello, doctor. In January, I had a positive fecal occult blood test and went to the hospital for a colonoscopy. I recently reviewed the report, which indicates rectal bleeding (the biopsy report showed no issues). I need to undergo another sigmoidoscopy in a month. The doctor pre...

Dr. Zhang Shuhao reply Surgery
Common causes of rectal bleeding include rectal polyps, anal conditions (such as hemorrhoids or anal fissures), rectal inflammation (such as ulcerative colitis or ischemic colitis), and rectal cancer. The doctor has prescribed laxatives and stool softeners, likely to alleviate yo...

Understanding Rectal Bleeding: Causes, Symptoms, and When to Seek Help

Dear Dr. Tsai, I have reviewed the frequently asked questions regarding rectal bleeding, and while my situation is somewhat similar, there are still differences, so I would like to seek your advice. I have been experiencing rectal bleeding for about a week now, which occurs afte...

Dr. Cai Yaozhou reply Internal Medicine
Hemorrhoids refer to the presence of blood in the stool or a positive fecal occult blood test. The causes may include gastrointestinal bleeding, tumors, anal fissures, hemorrhoids, or acute infectious enteritis, among others. The differential diagnosis and treatment involve... Wh...

Understanding Rectal Bleeding: Causes and When to Seek Help

Hello, doctor. My wife has recently been experiencing rectal bleeding. Could you please explain what the situation might be regarding the e-hospital in Taiwan? Thank you.

Dr. Xie Yonghui reply Internal Medicine
Hello, Xiao Zhang: Your spouse has recently experienced rectal bleeding. It is important to first observe the nature of the blood in the stool. If it is black (tarry stool), this indicates upper gastrointestinal bleeding, most commonly caused by peptic ulcers (gastric or duodenal...

Understanding Unexplained Rectal Bleeding: Causes and Solutions

Dr. Lin, I have been experiencing significant rectal bleeding during bowel movements, with fresh blood that sprays out, amounting to over ten cc.

Dr. Lin Hongmao reply Surgery
Hello, There are many causes of rectal bleeding, including common conditions such as hemorrhoids, anal fissures, and colitis, as well as less common issues like diverticulosis, vascular lesions, and tumors. However, based on your description and the sudden onset without pain, i...