Blood on Toilet Paper: Should You See a Doctor for This?

Blood on toilet paper after wiping can indicate several conditions, such as hemorrhoids, anal fissures, or gastrointestinal issues. It

About 3 to 4 years ago, I was diagnosed with mild hemorrhoids.
This year, I changed my work environment and I'm not sure if it's due to increased stress, but I sometimes experience diarrhea.
Yesterday afternoon, I had a bowel movement, and then again in the evening.
During the evening bowel movement, I noticed a little blood on the toilet paper when I wiped, but there was no blood in the stool.
My abdomen felt a bit uncomfortable the next day.
Should I go to the hospital for a consultation?

123, 20~29 year old female. Ask Date: 2016/08/02

Dr. Ke Fangxu reply Surgery

Based on your description, it seems to be a typical case of anal fissure, which is characterized by pain during bowel movements accompanied by slight bleeding.
If there is concurrent bleeding from hemorrhoids, the amount of blood may be greater.
The primary cause of anal fissures is usually hard stools, but diarrhea, frequent bowel movements, or prolonged straining can also lead to fissures.
It is recommended to improve bowel habits and to take warm sitz baths to alleviate symptoms.
Topical ointments and suppositories can also be used for treatment.
If symptoms persist for more than a week without improvement, it is important to consult a physician to identify the underlying issue.

Reply Date: 2016/08/02

More Info

Experiencing blood on toilet paper can be concerning, especially if you have a history of hemorrhoids. In your case, given that you have been diagnosed with hemorrhoids in the past and are currently experiencing changes in your bowel habits, it is advisable to see a doctor. While the presence of blood on toilet paper can sometimes be attributed to minor issues such as hemorrhoids or anal fissures, it is essential to rule out more serious conditions.

Hemorrhoids are swollen veins in the lower rectum or anus that can cause discomfort, itching, and bleeding during bowel movements. The blood from hemorrhoids is typically bright red and may appear on the toilet paper or in the toilet bowl. If your stool is not bloody and the blood is only on the toilet paper, it could indeed be related to your hemorrhoids, especially if you have been experiencing constipation or straining during bowel movements.

However, any new onset of rectal bleeding should be taken seriously. Other potential causes of blood on toilet paper can include anal fissures, which are small tears in the lining of the anus, or more serious conditions such as diverticular disease, colorectal polyps, or even colorectal cancer, particularly if you have risk factors such as age, family history, or significant changes in bowel habits.

Given that you mentioned feeling a bit of discomfort in your abdomen and having experienced diarrhea, it is also important to consider that gastrointestinal issues can sometimes lead to inflammation or irritation in the rectal area, which could contribute to bleeding.

Here are some recommendations:
1. Monitor Symptoms: Keep track of any additional symptoms you may experience, such as changes in bowel habits, abdominal pain, weight loss, or changes in appetite. This information will be helpful for your doctor.

2. Avoid Straining: If you are experiencing constipation, try to avoid straining during bowel movements, as this can exacerbate hemorrhoids and lead to more bleeding.

3. Dietary Changes: Incorporate more fiber into your diet to help regulate your bowel movements and prevent constipation. Drinking plenty of water can also help.

4. Over-the-Counter Treatments: You may consider using over-the-counter topical treatments for hemorrhoids, which can help alleviate symptoms and reduce irritation.

5. Consult a Doctor: Given your history and current symptoms, it is wise to consult a healthcare professional. They may recommend a physical examination, and possibly a colonoscopy or other imaging studies to rule out any serious conditions.

In summary, while it may be tempting to dismiss the blood on toilet paper as a minor issue related to hemorrhoids, it is crucial to consult with a healthcare provider to ensure that there are no underlying conditions that require attention. Early diagnosis and treatment can lead to better outcomes and peace of mind.

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