Rectal Bleeding: Causes and Treatment Options

Rectal bleeding

Hello doctor, today I noticed blood when wiping after a bowel movement, but it only happened the first time and it was very little.
This is the second time it has occurred in the past few months, and I usually have issues with constipation.
Additionally, I have been experiencing itching around the anal area, which is located a bit away from the anus, and this itching has been present for several years (around 4 years).
There is no pain during bowel movements, and upon examination, I don't feel any lumps around the anus.
What could this be? In recent months, I have been using a hemorrhoid cream to relieve the itching, which helps temporarily, but I cannot seem to resolve the underlying symptoms.
Is this considered serious? Thank you, doctor.

7, 20~29 year old female. Ask Date: 2017/07/24

Dr. Ke Fangxu reply Surgery

Anal itching may be caused by excessive wiping.
In addition to medication and topical treatments, there are three important considerations: avoid scratching to prevent wound infection, temporarily refrain from consuming spicy foods to prevent capsaicin from irritating the skin, and avoid using soap or body wash to clean the anal area to prevent excessive removal of the skin's natural oils.
If these measures are followed, improvement can generally be seen in about a week.
However, if bleeding persists, it is advisable to consult a physician.
If necessary, a colonoscopy may also be arranged.

Reply Date: 2017/07/24

More Info

Rectal bleeding can be a concerning symptom, and it's important to understand its potential causes and treatment options. Based on your description, it seems that you are experiencing occasional rectal bleeding, which is accompanied by a history of constipation and itching around the anal area. Let's break down these symptoms and explore possible causes and treatments.

Possible Causes of Rectal Bleeding
1. Hemorrhoids: One of the most common causes of rectal bleeding is hemorrhoids, which are swollen veins in the rectal area. They can be internal or external and may cause bleeding, especially during bowel movements. The itching you experience could also be related to hemorrhoids.

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

3. Constipation: Chronic constipation can lead to straining during bowel movements, which increases the risk of hemorrhoids and anal fissures. It can also contribute to the itching sensation.

4. Skin Conditions: Conditions such as dermatitis or fungal infections can cause itching around the anal area, which may not be directly related to the bleeding.

5. Other Gastrointestinal Issues: While less common, conditions such as diverticulosis, inflammatory bowel disease (IBD), or colorectal polyps can also lead to rectal bleeding.

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

2. Over-the-Counter Treatments: You mentioned using "喜痔癒" (a topical treatment for hemorrhoids). Such treatments can help relieve symptoms associated with hemorrhoids, including itching and discomfort. However, they may not address the underlying cause of bleeding.

3. Warm Sitz Baths: Soaking in warm water can help soothe the anal area and relieve itching and discomfort.

4. Topical Steroids: If the itching persists, a doctor may recommend a mild topical steroid to reduce inflammation and itching.

5. Avoiding Irritants: Avoiding harsh soaps or scented products around the anal area can help reduce irritation.

6. Medical Evaluation: Given that you have experienced rectal bleeding on multiple occasions, it is advisable to consult a healthcare professional for a thorough evaluation. They may perform a physical examination and possibly recommend further tests, such as a colonoscopy, to rule out more serious conditions.

When to Seek Immediate Medical Attention
If you experience significant rectal bleeding (more than a small amount), severe pain, or changes in bowel habits, it is important to seek medical attention promptly. These could be signs of a more serious condition that requires immediate intervention.

Conclusion
While occasional rectal bleeding can often be attributed to benign causes such as hemorrhoids or anal fissures, it is essential to monitor your symptoms and consult a healthcare provider for a proper diagnosis and treatment plan. Addressing underlying issues like constipation and maintaining good anal hygiene can significantly improve your symptoms. Remember, early intervention can prevent complications and improve your overall health.

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