Bright Red Blood in Stool: Causes and Concerns - Surgery

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Rectal bleeding


Hello doctor, today after using the restroom, I noticed bright red blood in the toilet, but the amount was small.
I don't have any abdominal pain.
The first time I wiped with tissue, there was a bit of blood, but the second time there was none.
The stool was yellow, and it was initially hard, so I had to strain a bit.
After finishing, I felt a little pain in the anal area.
I've been eating out more often and rarely consume fruits.
Additionally, I'm nearing the end of my menstrual period and have some soreness in my lower back and pelvis, so I wanted to ask about this.

Niming, 20~29 year old female. Ask Date: 2016/11/15

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 more significant.
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 conservative treatment does not yield satisfactory results, surgical intervention may be considered.
If symptoms persist for more than a week without improvement, it is advisable to consult a physician to identify the underlying issue.
Regarding the lower back pain during menstruation, it may be best to consult a gynecologist for a more professional opinion.

Reply Date: 2016/11/15

More Info


Bright red blood in the stool can be concerning, but it is important to understand the potential causes and when to seek medical attention. In your case, the presence of bright red blood in the toilet after a bowel movement, especially if it is minimal and accompanied by hard stools, suggests a few possible explanations.

One common cause of bright red blood in the stool is hemorrhoids. Hemorrhoids are swollen veins in the lower rectum or anus that can become inflamed and bleed, especially during bowel movements. This is particularly likely if you have been experiencing hard stools, as straining can exacerbate the condition. The fact that you mentioned some pain in the anal area after the bowel movement also supports this possibility.

Another potential cause could be anal fissures, which are small tears in the lining of the anus that can occur due to passing hard stools. Like hemorrhoids, fissures can cause bright red bleeding and discomfort, particularly during or after bowel movements.

Given that you mentioned your diet consists of more takeout and less fruit, this could contribute to constipation and hard stools, which can lead to both hemorrhoids and fissures. Increasing your fiber intake through fruits, vegetables, and whole grains, as well as ensuring adequate hydration, can help soften your stools and reduce the risk of these issues.

While the absence of abdominal pain and the small amount of blood are reassuring signs, it is still essential to monitor your symptoms. If the bleeding persists, increases in volume, or is accompanied by other symptoms such as significant pain, changes in bowel habits, or weight loss, it is crucial to seek medical attention. These could be signs of more serious conditions, such as diverticular disease or, although less common, colorectal cancer.

Additionally, since you mentioned that you are nearing the end of your menstrual period and experiencing some discomfort in your lower back and pelvis, it is worth considering that hormonal changes can also affect bowel habits and may contribute to gastrointestinal symptoms. However, this should not overshadow the importance of addressing any gastrointestinal bleeding.

In summary, while bright red blood in the stool can often be attributed to benign causes like hemorrhoids or anal fissures, it is essential to pay attention to your body and seek medical advice if symptoms persist or worsen. Maintaining a healthy diet rich in fiber, staying hydrated, and avoiding excessive straining during bowel movements can help prevent these issues in the future. If you have any concerns or if the situation does not improve, consulting a healthcare professional for a thorough evaluation is always a wise choice.

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