Rectal Bleeding: When to Seek Medical Attention

Rectal bleeding

Hello doctor, I haven't had a bowel movement for a week.
Recently, my stools have been accompanied by blood: on the first day, there was no blood in the toilet, but I noticed blood that looked like mucus when wiping.
On the second day, there was blood at the front of the stool and a few drops in the toilet, and again blood when wiping.
On the third day, the toilet was filled with blood, and there was blood when wiping as well.
I often experience constipation, and previously, I had hard stools that caused a little blood when wiping.
My usual diet is light, and I drink about 600cc of water a day.
My mother had polyps found during a colonoscopy, and both my grandmother and grandfather had colon cancer.
Should I go to the hospital for an examination?

Niming, 10~19 year old female. Ask Date: 2016/05/30

Dr. Ke Fangxu reply Surgery

This situation likely indicates a higher possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Warm sitz baths may also help alleviate symptoms.
Over-the-counter hemorrhoidal suppositories can be used, but it is best not to take stool softeners indiscriminately.
At this age, increasing dietary fiber and fluid intake should be sufficient.
Although the risk of developing colorectal cancer at 18 years old is not zero, it is generally very low.
If bleeding persists, it is advisable to consult a physician.
A colonoscopy is likely unnecessary, but it can be discussed further with the doctor.

Reply Date: 2016/05/30

More Info

Rectal bleeding can be a concerning symptom, especially given your family history of colorectal issues. It's crucial to understand the potential causes and when to seek medical attention. Based on your description, it seems you have been experiencing rectal bleeding for several days, with varying amounts of blood present in your stool and on toilet paper. The presence of blood, especially if it is bright red, can indicate several conditions, some of which may require immediate medical evaluation.

When to Seek Medical Attention
1. Amount of Blood: If you notice a significant amount of blood in the toilet bowl or on toilet paper, this is a warning sign. While small amounts of blood can sometimes be due to hemorrhoids or anal fissures, larger amounts may indicate more serious conditions.

2. Duration of Symptoms: Since you have been experiencing rectal bleeding for several days, it is advisable to seek medical attention. Persistent bleeding should not be ignored.

3. Associated Symptoms: If you experience additional symptoms such as severe abdominal pain, dizziness, fainting, or changes in bowel habits (like diarrhea or constipation), you should seek immediate medical care.

4. Family History: Given your family history of colorectal cancer, it is particularly important to consult a healthcare provider. A history of polyps or colorectal cancer in family members increases your risk, and proactive screening is essential.

Possible Causes of Rectal Bleeding
- Hemorrhoids: Swollen blood vessels in the rectum or anus can cause bleeding, especially during bowel movements. This is often accompanied by pain or discomfort.

- Anal Fissures: Small tears in the lining of the anus can occur due to passing hard stools, leading to bleeding and pain during bowel movements.

- Diverticular Disease: Diverticulosis can lead to diverticulitis, which may cause bleeding.

- Polyps: Colorectal polyps can bleed and may be precursors to cancer. Given your family history, this is a significant concern.

- Colorectal Cancer: This is a serious condition that can present with rectal bleeding, especially in individuals with a family history of the disease.

Recommended Actions
1. Consult a Healthcare Provider: Schedule an appointment with your primary care physician or a gastroenterologist. They may recommend a colonoscopy to evaluate the source of the bleeding and to check for polyps or other abnormalities in the colon.

2. Dietary Changes: Increase your fluid intake and dietary fiber to help alleviate constipation. Aim for at least 2 liters of water daily and incorporate fruits, vegetables, and whole grains into your diet.

3. Monitor Symptoms: Keep track of any changes in your symptoms, including the amount of blood, consistency of your stool, and any associated pain or discomfort.

4. Avoid Straining: When having a bowel movement, try to avoid straining, as this can exacerbate hemorrhoids or fissures.

Conclusion
In summary, rectal bleeding is a symptom that should not be taken lightly, especially with your family history of colorectal issues. It is essential to seek medical evaluation promptly to determine the cause of the bleeding and to rule out any serious conditions. Early detection and intervention can significantly improve outcomes, particularly in cases related to colorectal cancer. Please prioritize your health and consult a healthcare professional as soon as possible.

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