Rectal Bleeding and Pain: Causes and Solutions - Surgery

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Rectal bleeding and pain can be distressing symptoms that significantly impact your quality of life. Based on your description, it seems that you have been experiencing these issues for over six months, with a specific diagnosis of a wound near the anal area. This condition can be quite common and is often related to several underlying causes.


Possible Causes
1. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain during bowel movements and may cause bleeding. The pain can be severe, and patients often describe it as a "stabbing" sensation.

2. Hemorrhoids: Swollen blood vessels in the rectal area can cause pain, itching, and bleeding. They can be internal or external and may become thrombosed, leading to increased discomfort.

3. Infections or Abscesses: An infection in the anal area can lead to pain and bleeding. Abscesses can form as a result of blocked glands in the area, leading to localized pain and swelling.

4. Skin Conditions: Conditions such as dermatitis or psoriasis can affect the anal area, leading to irritation and bleeding.

5. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause rectal bleeding and pain, often accompanied by other gastrointestinal symptoms.

6. Cancer: Although less common, rectal bleeding can be a sign of colorectal cancer, especially in individuals over 50 or those with risk factors.


Recommended Solutions
Given your ongoing symptoms and the lack of improvement despite previous medical advice, it is crucial to seek further evaluation. Here are some steps you can consider:
1. Follow-Up with a Specialist: Since you have already seen a colorectal surgeon, consider returning for a follow-up appointment. If your symptoms persist, it may be beneficial to seek a second opinion from another specialist, preferably one who focuses on gastrointestinal disorders.

2. Diagnostic Procedures: Depending on your doctor's assessment, they may recommend additional diagnostic tests such as a colonoscopy or flexible sigmoidoscopy. These procedures allow for a direct view of the rectal and colonic lining and can help identify any abnormalities.

3. Pain Management: While waiting for further evaluation, consider discussing pain management options with your healthcare provider. Over-the-counter pain relievers may help alleviate discomfort during bowel movements.

4. Dietary Adjustments: Incorporating a high-fiber diet can help soften stools and reduce straining during bowel movements. Adequate hydration is also essential. Consider consulting a nutritionist for personalized dietary advice.

5. Topical Treatments: While your doctor advised against topical medications, some patients find relief with over-the-counter creams or ointments designed for anal fissures or hemorrhoids. Discuss this option with your healthcare provider.

6. Hygiene Practices: Continue to maintain good hygiene, but be gentle when cleaning the area. Avoid excessive wiping, which can further irritate the skin. Instead, consider using moist wipes or a bidet for cleaning after bowel movements.

7. Monitor Symptoms: Keep a diary of your symptoms, noting any changes in bowel habits, pain levels, and the appearance of blood. This information can be valuable for your healthcare provider in determining the next steps.


Conclusion
Your symptoms of rectal bleeding and pain are concerning and warrant further investigation. While the initial assessment pointed to a wound caused by excessive wiping, the persistence of your symptoms suggests that there may be additional factors at play. It is essential to advocate for your health by seeking further evaluation and exploring all possible causes. Remember, early intervention can lead to better outcomes, so do not hesitate to reach out to your healthcare provider for further assistance.