Rectal Bleeding: Causes and When to Seek Help

Rectal bleeding

In the past two weeks, I have had blood in my stool once a week.
There is no blood in the stool itself, but after having a bowel movement, there are drops of blood, and wiping also reveals blood.
The stool is dark, with varying amounts—sometimes more, sometimes less.
I do not need to strain much to have a bowel movement.
I previously had constipation, but now I have a bowel movement once a day.
What should I do?

LIN, 10~19 year old female. Ask Date: 2016/07/05

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.
You can purchase over-the-counter hemorrhoid suppositories and use stool softeners, but it is best not to take them indiscriminately.
At this age, increasing the intake of dietary fiber and fluids should be sufficient.
If bleeding persists, it is advisable to consult a physician.
This level of bleeding is not life-threatening; girls typically experience menstrual bleeding that is several times greater than this, and no one has died from it.

Reply Date: 2016/07/05

More Info

Rectal bleeding can be concerning, and it's important to understand its potential causes and when to seek medical help. Based on your description, you are experiencing blood after bowel movements, with some black stools. This combination of symptoms warrants careful consideration.

Possible 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 bright red blood on the toilet paper or in the toilet bowl after a bowel movement. Hemorrhoids can be internal or external and may also cause discomfort or itching.

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 during bowel movements and may cause bleeding.

3. Diverticular Disease: Diverticulosis occurs when small pouches form in the colon wall. If these pouches become inflamed or infected (diverticulitis), they can cause bleeding.

4. Polyps or Colorectal Cancer: Polyps are growths on the lining of the colon or rectum that can bleed. Some polyps can develop into cancer over time, which is why any rectal bleeding should be evaluated.

5. Gastrointestinal Conditions: Conditions such as inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, can cause rectal bleeding and changes in bowel habits.

6. Upper Gastrointestinal Bleeding: Sometimes, bleeding from the upper gastrointestinal tract can lead to black, tarry stools (melena). This occurs when blood is digested as it passes through the intestines.

When to Seek Medical Help
Given your symptoms of rectal bleeding, especially with the presence of black stools, it is crucial to seek medical attention. You should consider seeing a healthcare provider if:
- The bleeding persists or worsens.

- You experience significant pain or discomfort.

- You notice changes in your bowel habits, such as increased frequency or consistency changes.

- You have other symptoms like weight loss, fatigue, or changes in appetite.

- You experience dizziness or fainting, which could indicate significant blood loss.

Diagnostic Approach
When you visit a healthcare provider, they may perform a physical examination and ask about your medical history, including any previous gastrointestinal issues. They might recommend:
- Digital Rectal Exam (DRE): To check for hemorrhoids or fissures.

- Colonoscopy: This procedure allows the doctor to view the entire colon and rectum, helping to identify any polyps, tumors, or sources of bleeding.

- Blood Tests: To check for anemia or other underlying conditions.

Management and Treatment
The treatment for rectal bleeding depends on the underlying cause. For example:
- Hemorrhoids: May be treated with lifestyle changes, topical treatments, or procedures like rubber band ligation.

- Anal Fissures: Often managed with dietary changes to soften stools, topical medications, and sometimes surgical intervention.

- Diverticular Disease: May require dietary modifications, antibiotics, or surgery in severe cases.

- Polyps or Cancer: Removal of polyps during colonoscopy or further treatment for cancer if diagnosed.

Conclusion
In summary, rectal bleeding is a symptom that should not be ignored, especially with the presence of black stools. It is essential to consult a healthcare provider for a thorough evaluation and appropriate management. Early diagnosis and treatment can significantly improve outcomes and prevent complications. Please prioritize your health and seek medical attention promptly.

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