Rectal Bleeding: Causes and When to Seek Help

Rectal bleeding issues?

Dear Dr.
Ke,
Yesterday evening, I had a bowel movement without any pain, and the stool was solid, yellow, of normal size, and without blood clots.
However, after getting up, I noticed fresh blood in the toilet bowl, which was a significant amount and bright red, along with some minor splattering of blood.
Later that evening, I experienced a slight urge to have another bowel movement and observed a small amount of bright red blood again.
This morning, my bowel movement was normal, and I did not notice any fresh blood.
Recently, I have not experienced any abdominal discomfort, but I am still concerned and would like to seek your assistance for clarification.
Thank you.

Jason, 30~39 year old female. Ask Date: 2016/08/01

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 medications 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 for evaluation.

Reply Date: 2016/08/01

More Info

Rectal bleeding can be a concerning symptom, and understanding its potential causes is crucial for determining when to seek medical help. Based on your description, it appears that you experienced bright red blood in the toilet bowl after a normal bowel movement, which is often indicative of bleeding from the lower gastrointestinal tract, particularly the rectum or anus. The fact that you did not experience pain during the bowel movement and that your stool was normal in appearance is noteworthy.

There are several potential causes of rectal bleeding, and they can range from benign to serious. Some common causes include:
1. Hemorrhoids: Swollen blood vessels in the rectal area can lead to bright red blood during bowel movements. This is one of the most common causes of rectal bleeding, especially if the bleeding is painless.

2. Anal Fissures: Small tears in the lining of the anus can occur, often due to passing hard stools. These can cause sharp pain during bowel movements and may result in blood on the stool or toilet paper.

3. Diverticular Disease: Diverticula are small pouches that can form in the colon wall. If these become inflamed or infected, they can cause bleeding.

4. Colorectal Polyps or Cancer: While less common, polyps (growths on the colon lining) can bleed, and in some cases, they may be precursors to colorectal cancer. It is essential to monitor any changes in bowel habits or bleeding patterns.

5. Gastrointestinal Infections: Certain infections can lead to inflammation and bleeding in the gastrointestinal tract.

Given that you experienced a significant amount of bright red blood but had a normal bowel movement afterward, it is essential to monitor your symptoms closely. Here are some guidelines on when to seek medical attention:
- If the bleeding persists or worsens, especially if you notice large amounts of blood or clots.

- If you experience any accompanying symptoms such as severe abdominal pain, dizziness, weakness, or changes in your bowel habits (e.g., diarrhea or constipation).

- If you notice any changes in your stool color or consistency, such as black or tarry stools, which could indicate bleeding higher up in the gastrointestinal tract.

- If you have a history of gastrointestinal issues or if you are over the age of 50, it is advisable to consult a healthcare provider for a thorough evaluation.

In the meantime, maintaining a healthy diet rich in fiber can help prevent constipation and reduce the risk of hemorrhoids and fissures. Staying hydrated and avoiding straining during bowel movements is also beneficial.

If the bleeding resolves and does not recur, it may be a one-time incident related to a benign cause. However, if you have any lingering concerns or if the bleeding returns, it is prudent to consult a healthcare professional for further evaluation, which may include a physical examination, laboratory tests, or imaging studies to rule out any serious underlying conditions.

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