Bright Red Blood on Toilet Paper: Causes and What to Do - Surgery

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Blood on toilet paper after wiping can indicate several conditions, including hemorrhoids, anal fissures, or gastrointestinal issues. It is important to consult a healthcare professional for


Hello doctor, I just finished having a bowel movement and noticed a large amount of bright red blood on the toilet paper.
After getting up, I also saw blood in the toilet.
I haven't had a bowel movement for two days, and I experienced some pain in my anus during the process.
Could this situation indicate an injury to the anus? Thank you.

Li, 20~29 year old female. Ask Date: 2016/04/24

Dr. Xu Kaixi reply Surgery


Rectal bleeding is an abnormal symptom that can range from common conditions like hemorrhoids to more serious gastrointestinal diseases.
Based on your description, it is more likely that the bleeding is caused by hemorrhoids (internal hemorrhoids).
It is recommended that you visit a gastroenterology or surgical outpatient clinic for further examination and treatment.

Reply Date: 2016/04/24

More Info


Bright red blood on toilet paper after a bowel movement can be alarming and may indicate several potential issues. Based on your description, it sounds like you may be experiencing a common condition related to the anal area, such as hemorrhoids or anal fissures, especially since you mentioned having not had a bowel movement for two days and experiencing some pain during the process.

Hemorrhoids are swollen veins in the lower rectum and anus that can cause bleeding, especially during bowel movements. They can be classified as either internal or external. Internal hemorrhoids are usually not painful but can bleed, while external hemorrhoids can be painful and may cause discomfort. The bright red blood you see on the toilet paper is often a sign of hemorrhoidal bleeding, particularly if the blood is fresh and not mixed with the stool.

Anal fissures, on the other hand, are small tears in the lining of the anus that can occur due to passing hard stools or straining during bowel movements. This can lead to sharp pain during and after bowel movements, along with bright red blood on the toilet paper. Given that you mentioned some pain during your bowel movement, this could also be a contributing factor.

In your case, since you have not had a bowel movement for two days, it is possible that constipation has led to straining, which can exacerbate either condition. When the stool is hard, it can cause trauma to the anal area, leading to bleeding.
What to Do:
1. Increase Fiber Intake: To prevent constipation, aim to include more fiber in your diet. Foods such as fruits, vegetables, whole grains, and legumes can help soften your stool and make bowel movements easier.

2. Stay Hydrated: Drinking plenty of water is crucial. Adequate hydration helps keep your stool soft and can prevent straining during bowel movements.

3. Avoid Straining: When you feel the urge to go, try not to delay the bowel movement. Straining can worsen hemorrhoids and fissures.

4. Warm Baths: Taking warm baths can help soothe the area and reduce discomfort. This is often referred to as a sitz bath and can be beneficial for both hemorrhoids and fissures.

5. Over-the-Counter Treatments: There are various over-the-counter creams and ointments available that can help relieve pain and inflammation associated with hemorrhoids.

6. Monitor Symptoms: Keep an eye on your symptoms. If the bleeding persists, increases, or is accompanied by severe pain, changes in bowel habits, or other concerning symptoms (like weight loss or changes in appetite), it’s important to seek medical attention.

7. Consult a Healthcare Provider: If you are unsure about the cause of the bleeding or if it continues, it’s advisable to consult a healthcare provider. They can perform a thorough examination and may recommend further tests if necessary to rule out other conditions.

In conclusion, while bright red blood on toilet paper can often be attributed to hemorrhoids or anal fissures, it is essential to address the underlying causes, such as constipation, and to monitor your symptoms closely. Taking proactive steps to improve your bowel health can significantly reduce the likelihood of recurrence.

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