Blood When Wiping: Possible Causes and Concerns

Blood on toilet paper after wiping can indicate several potential issues, such as hemorrhoids, anal fissures, or gastrointestinal bleeding?

Hello, this week I've noticed blood when wiping after using the bathroom, but it's only a little bit.
There was one instance where there was more blood on the toilet paper, and I had to wipe three or four times to feel clean.
It seems to happen when I wipe too hard on my anus.
This morning, I couldn't have a bowel movement (probably due to not eating enough vegetables), but there was still a little bit of blood when I wiped.
It feels like it's just a small amount that got on the paper; my blood isn't flowing or spraying.
There's no blood in the toilet or in my stool, only when I wipe.
The blood is bright red.
Actually, I think I've had this issue for a few months, but it stopped bleeding, so I didn't pay much attention to it.
This time, it has been ongoing for almost a week.
I've looked up many symptoms of colorectal cancer, and aside from blood in my stool, I seem to be fine (for example, no urgency, weight loss, anemia, etc.), but maybe it's psychological because I feel like my bowel movements haven't been complete lately, and I've been going less often.
I don't know if this is internal hemorrhoids or possibly colorectal cancer.
I really don't want to have either, as treatment would take time, and I've been busy preparing for the college entrance exam.
By the way, I'm a senior in high school, and I've been staying late for self-study, so I've been eating out a lot.
Could this be a reason? Or is it because I often take my phone into the bathroom and end up sitting for a long time (about ten minutes, or even up to twenty minutes sometimes)? Thank you.

Niming, 10~19 year old female. Ask Date: 2016/10/29

Dr. Ke Fangxu reply Surgery

At the age of 18, the likelihood of developing colorectal cancer is not zero, but it is generally very low.
Based on your description, it seems more like hemorrhoidal bleeding.
I recommend starting with a light diet and maintaining a good lifestyle.
If the symptoms persist without improvement, you may consult a physician for medication.
If there is still no improvement or if you are very concerned, you can also arrange for a colonoscopy.

Reply Date: 2016/10/29

More Info

It sounds like you are experiencing some concerning symptoms related to rectal bleeding, and it's understandable to feel anxious about what this could mean for your health. Let's break down the potential causes and concerns related to your situation.

Possible Causes of Rectal Bleeding
1. Hemorrhoids: One of the most common causes of bright red blood on toilet paper is hemorrhoids, which are swollen veins in the rectal area. They can be caused by straining during bowel movements, which may happen if you're not consuming enough fiber in your diet. Given that you mentioned not eating enough vegetables, this could be a contributing factor.

2. Anal Fissures: Another possibility is an anal fissure, which is a small tear in the lining of the anus. This can occur due to passing hard stools or straining, and it often results in sharp pain and bleeding during bowel movements.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can also lead to bleeding. This condition is more common in older adults but can occur in younger individuals, especially if there are dietary issues.

4. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause rectal bleeding, along with other symptoms such as abdominal pain and diarrhea. However, these conditions usually present with additional symptoms beyond just bleeding.

5. Colorectal Cancer: While it's less common in younger individuals, rectal bleeding can be a symptom of colorectal cancer. However, this is typically accompanied by other symptoms such as changes in bowel habits, weight loss, and fatigue.

Concerns and Recommendations
Given that you have been experiencing this bleeding for about a week and that it has occurred intermittently over the past few months, it is important to consult a healthcare professional. They can perform a thorough evaluation, which may include a physical examination and possibly a colonoscopy, to determine the exact cause of your symptoms.

Lifestyle Factors
Your mention of busy schedules, late-night study sessions, and reliance on fast food could contribute to your gastrointestinal issues. A diet low in fiber can lead to constipation and straining, which can exacerbate hemorrhoids or cause fissures. Here are some recommendations:
- Increase Fiber Intake: Aim to include more fruits, vegetables, whole grains, and legumes in your diet. This can help soften stools and reduce straining during bowel movements.

- Stay Hydrated: Drinking plenty of water is essential for digestive health and can help prevent constipation.

- Limit Straining: Try to avoid sitting on the toilet for extended periods, as this can increase pressure on the rectal area and lead to hemorrhoids or fissures.

- Regular Exercise: Physical activity can help promote regular bowel movements and overall digestive health.

Conclusion
While it is natural to worry about serious conditions like colorectal cancer, many cases of rectal bleeding are due to benign causes such as hemorrhoids or anal fissures. However, given your symptoms and their persistence, it is crucial to seek medical advice. A healthcare provider can help you understand your symptoms better and guide you toward appropriate treatment options. Remember, early intervention is key to managing any health concerns effectively.

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