Rectal Bleeding: Is It Anal Fissure?

There is a small amount of blood on the toilet paper?

Hello Doctor, I would like to ask you a question.
Recently, after having a bowel movement, I have experienced some pain in my anus, and there are small amounts of blood on the toilet paper, which usually stops after the second wipe.
There is no blood in the stool, but yesterday, when I didn't have a bowel movement, I wiped my bottom vigorously several times and noticed a little bit of blood.
After reading your numerous responses, I suspect that I might have an anal fissure and would like to ask for your opinion.
Thank you!

Niming, 20~29 year old female. Ask Date: 2016/04/10

Dr. Xu Kaixi reply Surgery

Pain and slight bleeding after bowel movements indicate that there may be a tear or abrasion in the anal mucosa.
If this condition persists without improvement, it could lead to a chronic wound or fissure.
It is recommended to visit a surgical outpatient clinic for further examination and treatment.

Reply Date: 2016/04/10

More Info

Rectal bleeding can be concerning, and it's important to understand the potential causes and implications. Based on your description, it seems likely that you may be experiencing an anal fissure, which is a small tear in the lining of the anus. This condition is often associated with pain during bowel movements and can lead to minor bleeding, particularly when wiping after a bowel movement.

Anal fissures are commonly caused by passing hard stools, which can occur due to constipation or straining during bowel movements. The pain you experience after having a bowel movement, along with the presence of blood on the toilet paper, aligns with typical symptoms of an anal fissure. The blood is usually bright red, indicating that it is fresh and comes from the lower part of the digestive tract, which is consistent with your observations.

In addition to anal fissures, other potential causes of rectal bleeding can include hemorrhoids, which are swollen veins in the rectal area that can also cause pain and bleeding, especially during bowel movements. Other less common causes could be infections, inflammatory bowel disease, or even more serious conditions such as colorectal cancer, especially if the bleeding persists or is accompanied by other symptoms like significant pain, changes in bowel habits, or weight loss.

Given that you mentioned the bleeding occurs primarily when you wipe and is not present in your stool, it does suggest a localized issue rather than a systemic one. However, it is essential to monitor your symptoms closely. If the bleeding continues, worsens, or if you experience significant pain, it would be advisable to consult a healthcare professional for a thorough evaluation. They may perform a physical examination and possibly recommend further tests, such as a colonoscopy, to rule out any serious underlying conditions.

In the meantime, there are several self-care measures you can take to help alleviate your symptoms and promote healing:
1. Increase Fiber Intake: Eating a diet high in fiber can help soften your stools, making them easier to pass and reducing the strain during bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes.

2. Stay Hydrated: Drinking plenty of water can also help prevent constipation and promote regular bowel movements.

3. Warm Baths: Soaking in a warm bath can help relax the anal muscles and relieve pain associated with fissures.

4. Topical Treatments: Over-the-counter creams or ointments designed for anal fissures or hemorrhoids may provide relief from pain and promote healing.

5. Avoid Straining: When using the bathroom, try to relax and avoid straining, as this can exacerbate the issue.

6. Consult a Doctor: If your symptoms do not improve with these measures or if you have any concerns, it is important to seek medical advice.

In summary, while your symptoms are suggestive of an anal fissure, it is crucial to keep an eye on your condition and consult a healthcare provider if the bleeding persists or if you have any other concerning symptoms. Early intervention can help prevent complications and ensure proper treatment.

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