Rectal Bleeding: Causes and When to Seek Help

Rectal bleeding

Hello Doctor, I would like to ask about something.
Last Wednesday and Thursday night, I had bowel movements twice in one night, with about a three-hour interval between them.
Each time, I sat on the toilet for about an hour.
The next evening, when I went to have a bowel movement, shortly after sitting down, I noticed bright red blood flowing before I could even pass stool.
It was quite a lot! This continued for two to three days.
Sometimes there was a little bit of fresh blood in my stool, and I intentionally tried not to sit down completely to avoid stimulating it, which helped reduce the bleeding.
However, not being able to have a normal bowel movement has been quite painful.
I would like to know what symptoms this might indicate.
I'm very worried.
Thank you!

MOMO, 30~39 year old female. Ask Date: 2017/06/29

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 major concern.
Your issue seems to be related to prolonged bowel movements rather than the act of sitting itself.
It is advisable to avoid constipation during this period and to shorten the time spent on the toilet.
Warm sitz baths may help alleviate symptoms, and you can also purchase hemorrhoidal suppositories at the pharmacy.
It is best not to take stool softeners indiscriminately.
If bleeding persists, it is recommended to consult a physician for evaluation.
If necessary, a colonoscopy can also be arranged.

Reply Date: 2017/06/29

More Info

Rectal bleeding can be a concerning symptom, and it’s important to understand its potential causes and when to seek medical attention. Based on your description, it appears that you have experienced bright red blood during bowel movements, which can indicate several underlying issues.
One common cause of rectal bleeding is hemorrhoids, which are swollen veins in the lower rectum or anus. Hemorrhoids can cause bright red blood on the toilet paper or in the toilet bowl, especially after straining during bowel movements. They can also lead to discomfort and pain, particularly if they become thrombosed (develop a blood clot). Another possibility is anal fissures, which are small tears in the lining of the anus that can occur due to passing hard stools. These can also result in bright red blood and significant pain during bowel movements.

Other potential causes of rectal bleeding include diverticular disease, inflammatory bowel disease (IBD) such as Crohn's disease or ulcerative colitis, colorectal polyps, or even colorectal cancer, especially if you have a family history of these conditions or if you are over the age of 50. Infections or conditions affecting the gastrointestinal tract can also lead to bleeding.

Given that you have experienced this bleeding multiple times over a few days, it is crucial to seek medical attention. While some causes of rectal bleeding, such as hemorrhoids or fissures, can be managed with conservative treatments (like dietary changes, increased fiber intake, and topical medications), other causes may require more extensive evaluation and treatment.
When you visit a healthcare provider, they will likely perform a thorough history and physical examination. They may also recommend diagnostic tests such as a digital rectal exam, colonoscopy, or flexible sigmoidoscopy to visualize the rectum and colon. These tests can help identify the source of the bleeding and guide appropriate treatment.

In the meantime, it’s important to avoid straining during bowel movements, as this can exacerbate any existing issues. Increasing your fiber intake through fruits, vegetables, and whole grains can help soften stools and make bowel movements easier. Staying well-hydrated is also essential. If you are experiencing pain or discomfort, over-the-counter pain relievers may provide some relief, but be cautious with medications that can affect bleeding, such as nonsteroidal anti-inflammatory drugs (NSAIDs).

In summary, while rectal bleeding can be caused by relatively benign conditions like hemorrhoids or fissures, it can also signal more serious issues. Given your symptoms, it is advisable to consult a healthcare professional for a proper evaluation and to discuss your concerns. Early diagnosis and treatment can help prevent complications and ensure better outcomes.

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