Rectal Bleeding: Is It Hemorrhoids or Something Else?

Rectal bleeding

Hello Doctor: Recently, I have been experiencing bleeding during bowel movements, sometimes even feeling drops of fresh blood.
After using the restroom, I feel a warmth around the anal area, but there is not much pain.
After finishing, when I intentionally exert pressure even though I do not have a bowel movement, a little blood still comes out, which is bright red.
I have had this issue for about four to five years, but it would usually resolve itself within two to three days to a week, and then I would be fine for six months to a year.
However, in the past two weeks, I have noticed blood every time I use the restroom.
I have observed the color of my stool, which is mostly brown, with only one or two instances of bright red blood on the outside.
I usually eat out but do not particularly enjoy eating meat, and I drink about 1200-1600 cc of water daily.
Could this be hemorrhoids, or could it be indicative of another condition?

Niming, 20~29 year old female. Ask Date: 2017/01/05

Dr. Ke Fangxu reply Surgery

This situation likely indicates a higher possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Warm sitz baths may also help alleviate symptoms.
Over-the-counter hemorrhoidal suppositories can be used, but it is best not to take laxatives indiscriminately.
At this age, increasing dietary fiber and hydration should be sufficient.
Although the risk of developing colorectal cancer at 25 years old is not zero, it is generally very low.
A light diet and maintaining a good lifestyle are advised, while spicy, irritating, and greasy foods should be avoided.
If symptoms persist without improvement, a physician can prescribe medication.
If there is still no improvement or if there are significant concerns, a colonoscopy can be arranged.

Reply Date: 2017/01/05

More Info

Rectal bleeding can be a concerning symptom, and it’s important to understand the potential causes and implications. Based on your description, it seems that you have been experiencing rectal bleeding intermittently for several years, with a recent increase in frequency. The blood you observe is bright red, which typically indicates that the source of the bleeding is near the anus or rectum, rather than higher up in the gastrointestinal tract.

One common cause of bright red blood during bowel movements is hemorrhoids. Hemorrhoids are swollen veins in the rectal area that can become inflamed or irritated, often leading to bleeding, especially during bowel movements. Other symptoms may include itching, discomfort, or a feeling of fullness in the rectal area. Given that you mentioned a sensation of heat and the presence of blood after straining, this could indeed suggest hemorrhoids.

However, it’s crucial to consider other potential causes of rectal bleeding as well. Conditions such as anal fissures, which are small tears in the lining of the anus, can also lead to bright red bleeding and discomfort during bowel movements. Additionally, more serious conditions such as diverticular disease, colorectal polyps, or even colorectal cancer can present with rectal bleeding, especially if there are changes in bowel habits or other accompanying symptoms.

The fact that you have experienced this issue intermittently over several years, with a recent increase in frequency, warrants further investigation. While hemorrhoids are a common and often benign cause of rectal bleeding, the persistence and change in your symptoms suggest that it would be prudent to consult a healthcare professional for a thorough evaluation. A doctor may recommend a physical examination, and possibly a colonoscopy, to visualize the rectum and colon and rule out any serious conditions.

In terms of management, if hemorrhoids are confirmed, treatment options may include lifestyle changes such as increasing fiber intake, staying hydrated, and avoiding straining during bowel movements. Over-the-counter topical treatments can also provide relief from symptoms. However, if the bleeding persists or worsens, or if you experience other symptoms such as significant pain, changes in bowel habits, or weight loss, it is essential to seek medical attention promptly.

In summary, while your symptoms may suggest hemorrhoids, the increase in frequency and the history of rectal bleeding necessitate a thorough evaluation by a healthcare professional to rule out other potential causes. Early diagnosis and appropriate management are key to addressing any underlying issues and ensuring your overall health.

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