Rectal Bleeding: Causes and Treatment Options

Rectal bleeding

Hello, doctor.
Recently, for the past week, I have felt no urge to have a bowel movement.
However, when I checked manually, I found stool (with blood streaks).
The stool is not particularly hard, but sometimes I feel discomfort in my anus.
After digging, I found stool with blood streaks, and the stool I retrieved was somewhat hard.
After using the bathroom in the morning, I felt very uncomfortable in my abdomen for a while and had the urge to go again, but it resolved shortly after.
I went to the hospital for an internal examination, and the doctor said I have internal hemorrhoids.
At night, I sometimes feel bloated in my abdomen.
What could be the issue?

He Xin, 10~19 year old female. Ask Date: 2017/04/13

Dr. Xu Kaixi reply Surgery

If the anal mucosa is damaged due to external force or friction from fingers, it may result in bleeding.
It is recommended that you visit a hospital for a fecal occult blood test to rule out the possibility of internal bleeding in the gastrointestinal tract.

Reply Date: 2017/04/13

More Info

Rectal bleeding can be a concerning symptom, and it is important to understand its potential causes and treatment options. Based on your description, it seems that you are experiencing some discomfort during bowel movements, along with the presence of blood in your stool, which has been diagnosed as internal hemorrhoids (or internal piles) by your doctor. Let's delve deeper into this condition and explore the possible causes, treatment options, and preventive measures.

Causes of Rectal Bleeding
1. Internal Hemorrhoids: These are swollen veins located inside the rectum. They can cause painless bleeding during bowel movements, which may appear as bright red blood on the toilet paper or in the stool. The discomfort you feel may be due to straining during bowel movements or the presence of hard stools.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain and bleeding during bowel movements.

3. Diverticular Disease: This condition involves the formation of small pouches in the colon wall, which can become inflamed or infected, leading to bleeding.

4. Colorectal Polyps or Cancer: While less common, polyps can bleed, and in some cases, they may be precursors to colorectal cancer. It is essential to monitor any changes in bowel habits or stool characteristics.

5. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause inflammation in the digestive tract, leading to symptoms such as abdominal pain, diarrhea, and rectal bleeding.

Treatment Options
1. Dietary Changes: Increasing fiber intake can help soften stools and reduce straining during bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying hydrated is also crucial.

2. Over-the-Counter Medications: Topical treatments, such as hydrocortisone creams or witch hazel pads, can help relieve itching and discomfort associated with hemorrhoids. Oral pain relievers may also be used to manage discomfort.

3. Sitz Baths: Soaking the anal area in warm water for 10-15 minutes several times a day can help soothe irritation and promote healing.

4. Minimally Invasive Procedures: If conservative measures do not provide relief, procedures such as rubber band ligation, sclerotherapy, or infrared coagulation may be recommended to treat internal hemorrhoids.

5. Surgery: In severe cases, surgical options may be necessary to remove hemorrhoids or address other underlying conditions.

Preventive Measures
- Regular Exercise: Physical activity can help stimulate bowel function and reduce the risk of constipation.

- Avoid Straining: Try not to strain during bowel movements, as this can exacerbate hemorrhoids and lead to further complications.

- Routine Check-ups: Regular visits to your healthcare provider can help monitor any changes in your condition and catch potential issues early.

When to Seek Medical Attention
It is essential to seek medical attention if you experience:
- Significant or persistent rectal bleeding
- Severe abdominal pain
- Changes in bowel habits (e.g., diarrhea or constipation lasting more than a few days)
- Unexplained weight loss
- Symptoms of anemia (fatigue, weakness, pale skin)
In conclusion, while internal hemorrhoids are a common cause of rectal bleeding, it is crucial to monitor your symptoms and maintain open communication with your healthcare provider. If your symptoms persist or worsen, further evaluation may be necessary to rule out other potential causes. Remember, early intervention can lead to better outcomes and improved quality of life.

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