Painful Bowel Movements: Causes and Solutions

I haven't had a bowel movement for several days, and when I finally do, it is painful and accompanied by bleeding?

I haven't felt the urge to have a bowel movement for 5 to 6 days.
Finally, I felt some abdominal pain and went to the bathroom, but I struggled to pass stool.
I had to push through the pain to expel the stool, which was hard and had blood and blood streaks.
My anus is also very painful; I can't find a comfortable position whether standing, sitting, or lying down.
The next day, the pain in my anus persisted, so much so that it made me feel dizzy.
I didn't have a bowel movement after that, and now I go every other day, but each time there is blood and pain, although not as severe as the first day.
What could be the cause of this?

Xiao Jia, 10~19 year old female. Ask Date: 2016/08/28

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 advisable to consult a physician to identify the underlying issue.

Reply Date: 2016/08/28

More Info

Understanding painful bowel movements can be quite complex, as various factors can contribute to the discomfort and symptoms you are experiencing. Based on your description, it seems you are dealing with a combination of constipation, potential anal fissures, and possibly hemorrhoids, which can all lead to painful bowel movements and the presence of blood in your stool.

Causes of Your Symptoms
1. Constipation: The fact that you have not felt the urge to have a bowel movement for 5-6 days indicates that you may be experiencing constipation. This condition can lead to hard stools, which are difficult to pass and can cause significant discomfort. When you finally do manage to have a bowel movement, the straining required to pass hard stools can lead to pain and even injury to the anal area.

2. Anal Fissures: The presence of blood and blood streaks in your stool, along with severe pain during bowel movements, suggests that you may have developed anal fissures. These are small tears in the lining of the anus that can occur when hard stools are passed. They are often very painful and can cause bleeding, especially during or after a bowel movement.

3. Hemorrhoids: Another possibility is the presence of hemorrhoids, which are swollen veins in the lower rectum and anus. They can be caused by straining during bowel movements, prolonged sitting, or increased pressure in the pelvic area. Hemorrhoids can lead to pain, itching, and bleeding, particularly during bowel movements.

Solutions and Recommendations
1. Dietary Changes: To alleviate constipation, consider increasing your fiber intake. Foods high in fiber, such as fruits, vegetables, whole grains, and legumes, can help soften your stool and promote regular bowel movements. Additionally, ensure you are drinking plenty of water throughout the day, as hydration is crucial for digestive health.

2. Over-the-Counter Remedies: You might find relief from constipation by using over-the-counter laxatives or stool softeners. However, these should be used sparingly and not as a long-term solution. If you choose to use a laxative, consult with a healthcare professional for recommendations that are appropriate for your situation.

3. Warm Baths: Taking warm baths can help soothe the pain associated with anal fissures and hemorrhoids. The warmth can promote relaxation of the anal sphincter and provide temporary relief from discomfort.

4. Topical Treatments: Over-the-counter creams or ointments designed for hemorrhoids can help reduce inflammation and pain. These products often contain ingredients that provide a numbing effect or promote healing.

5. Avoid Straining: When you feel the urge to have a bowel movement, try to respond promptly. Straining can exacerbate your symptoms and lead to further complications. If you find it difficult to pass stool, consider using a stool softener or a gentle laxative as mentioned earlier.

6. Consult a Healthcare Professional: Given the severity of your symptoms, including the presence of blood and significant pain, it is essential to consult a healthcare professional. They can perform a thorough examination, possibly including a digital rectal exam or other diagnostic tests, to determine the exact cause of your symptoms and recommend appropriate treatment.

Conclusion
Painful bowel movements can significantly impact your quality of life, and it is crucial to address the underlying causes effectively. By making dietary changes, utilizing over-the-counter remedies, and seeking professional medical advice, you can work towards alleviating your symptoms and improving your bowel health. Remember, persistent symptoms, especially those involving blood, warrant prompt medical attention to rule out any serious conditions.

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