Rectal Bleeding: Causes and When to Seek Medical Help - Gastroenterology and Hepatology

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Rectal bleeding can be a concerning symptom, and understanding its potential causes is crucial for determining the appropriate course of action. Based on your description, it seems you are experiencing a combination of symptoms, including pain during bowel movements, the presence of a lump near the anus, and significant bleeding. Let's break down the potential causes and when you should seek medical help.


Potential Causes of Rectal Bleeding
1. Hemorrhoids: One of the most common causes of rectal bleeding, hemorrhoids are swollen veins in the lower rectum or anus. They can cause pain, itching, and bleeding, especially during bowel movements. The lump you felt could be an external hemorrhoid.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain and bleeding during bowel movements, which aligns with your initial symptoms.

3. Polyps: The lump you mentioned could also be a polyp, which is a growth on the lining of the colon or rectum. While many polyps are benign, some can develop into cancer over time, making it essential to have them evaluated.

4. Diverticular Disease: Diverticulosis, which involves small pouches forming in the colon wall, can lead to diverticulitis, causing inflammation and bleeding. This might explain the left lower abdominal pain you mentioned.

5. Colorectal Cancer: While less common, rectal bleeding can be a sign of colorectal cancer, especially if accompanied by changes in bowel habits, weight loss, or persistent abdominal pain.

6. Infections or Inflammatory Conditions: Conditions like inflammatory bowel disease (IBD), including Crohn's disease or ulcerative colitis, can also cause rectal bleeding and abdominal pain.


When to Seek Medical Help
Given the symptoms you are experiencing, it is essential to seek medical attention promptly. Here are specific scenarios where you should definitely consult a healthcare professional:
- Significant Bleeding: If you notice a large amount of blood in the toilet or on toilet paper, especially if it is bright red, you should seek immediate medical care.


- Persistent Pain: If you experience ongoing or worsening abdominal pain, this could indicate a more serious condition that requires evaluation.

- Changes in Bowel Habits: If you notice changes in your bowel habits, such as diarrhea or constipation, particularly if accompanied by blood, this warrants further investigation.

- Presence of a Lump: If the lump you felt near the anus persists or changes in size or shape, it should be evaluated by a healthcare provider.

- Associated Symptoms: If you experience other symptoms such as weight loss, fever, or fatigue, these could indicate a more serious underlying condition.


Recommended Actions
1. Schedule an Appointment: Contact your healthcare provider to discuss your symptoms. They may recommend a physical examination, including a digital rectal exam, and possibly further tests such as a colonoscopy to visualize the colon and rectum.

2. Keep a Symptom Diary: Document your symptoms, including the frequency and amount of bleeding, any associated pain, and changes in bowel habits. This information can be helpful for your healthcare provider.

3. Avoid Straining: While waiting for your appointment, try to avoid straining during bowel movements. Consider increasing your fiber intake and staying hydrated to help soften stools.

4. Monitor Symptoms: Keep an eye on your symptoms. If they worsen or new symptoms develop, seek medical attention sooner.

In conclusion, while rectal bleeding can often be attributed to benign conditions like hemorrhoids or anal fissures, it is essential to take it seriously, especially given the amount of blood you described. Prompt evaluation by a healthcare professional is crucial to rule out more serious conditions and to receive appropriate treatment.