Diarrhea and Rectal Bleeding: When to Seek Medical Help

Diarrhea with bleeding?

Hello Doctor, last night at 7 PM I ate a cold bento box, and around midnight I had lamb soup, sesame oil noodles, and cold mixed tripe.
My bowel movements were normal (twice a day) until around 2 or 3 AM when I started experiencing diarrhea and my stomach was churning.
I went to the bathroom about ten times, but by noon I could hardly pass anything.
Sometimes it felt like just a little bit was coming out, similar to passing gas, but I still had the urge to go.
My stomach is churning, and I have pain around the anus, especially when sitting on the toilet.
The stool is dark yellow, watery, and not formed, just a little bit each time.
Around 3 PM, I ate some porridge, but I just had two more bowel movements, and during two of them, there was a larger volume, but it was very painful around the anus, and I noticed bright red blood in the toilet.
It's very alarming.
What should I do?

johncena, 30~39 year old female. Ask Date: 2016/08/22

Dr. Ke Fangxu reply Surgery

Based on your description, it seems to be a typical symptom 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: 2016/08/22

More Info

When experiencing diarrhea accompanied by rectal bleeding, it is crucial to understand the potential causes and when to seek medical help. Based on your description, it seems that you have developed acute diarrhea, possibly due to foodborne illness, given the consumption of a cold meal and subsequent symptoms. The presence of fresh red blood in the stool is concerning and indicates that there may be an issue in the lower gastrointestinal tract, such as the rectum or anus.

Understanding Your Symptoms
1. Diarrhea: This can be caused by various factors, including viral or bacterial infections, food intolerances, or even stress. In your case, the timing of your symptoms following the consumption of food suggests a possible foodborne illness. The fact that you have had multiple episodes of diarrhea, along with abdominal cramping, is typical of such conditions.

2. Rectal Bleeding: The appearance of fresh red blood in your stool is particularly alarming. This could be due to several reasons:
- Hemorrhoids: Swollen veins in the rectal area can cause bleeding, especially if there is straining during bowel movements.

- Anal fissures: Small tears in the lining of the anus can occur due to passing hard stools or straining, leading to pain and bleeding.

- Infections or inflammation: Conditions like diverticulitis or inflammatory bowel disease (IBD) can also cause bleeding.

- Colorectal issues: More serious conditions, such as polyps or colorectal cancer, could also present with rectal bleeding, though these are less common in younger individuals.

When to Seek Medical Help
Given your symptoms, it is advisable to seek medical attention promptly. Here are specific indicators that warrant immediate medical care:
- Persistent Diarrhea: If diarrhea lasts more than 24 hours, especially with severe abdominal pain, it is essential to consult a healthcare provider.

- Rectal Bleeding: The presence of fresh blood in the stool, especially if it is significant or accompanied by pain, should be evaluated by a doctor.

- Severe Abdominal Pain: If the pain is intense and does not improve, it could indicate a more serious underlying condition.

- Signs of Dehydration: Symptoms such as excessive thirst, dry mouth, reduced urination, dizziness, or weakness indicate dehydration, which can occur with prolonged diarrhea.

- Fever: A high fever (over 101°F or 38.3°C) accompanying diarrhea and bleeding is a sign of infection and requires medical evaluation.

What to Do Next
1. Hydration: Ensure you are drinking plenty of fluids to stay hydrated. Oral rehydration solutions can be beneficial.

2. Diet: Avoid solid foods until the diarrhea subsides. Gradually reintroduce bland foods like rice, bananas, and toast.

3. Avoid Certain Foods: Stay away from dairy, fatty, or spicy foods until your symptoms improve.

4. Medical Evaluation: Visit a healthcare provider as soon as possible. They may perform a physical examination, order laboratory tests, or conduct imaging studies to determine the cause of your symptoms.

Conclusion
In summary, while diarrhea can often resolve on its own, the presence of rectal bleeding is a significant concern that should not be ignored. Seeking medical attention is crucial to rule out serious conditions and to receive appropriate treatment. Your health and safety are paramount, so do not hesitate to reach out to a healthcare professional for guidance.

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