Rectal Bleeding: Causes and When to Seek Help

Rectal bleeding

Hello doctor, I am 18 years old.
For the past few days, I have noticed fresh blood on the toilet paper after having a bowel movement.
At first, I thought it was my menstrual period, but it has continued for several days.
The blood is bright red.
On the first day, there was only a small amount of blood; on the second day, there was a bit more; and on the third day, I noticed a small blood clot on the toilet paper.
However, I do not experience any pain during bowel movements, and my stools are normal and not constipated.
Should I be concerned about this? Which specialist should I see? This is the first time this has happened to me.
I do smoke and stay up late; could this be related? I am really worried.

Yuting, 10~19 year old female. Ask Date: 2017/08/02

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 the toilet.
Warm sitz baths may help alleviate symptoms, and you can also purchase over-the-counter hemorrhoidal suppositories.
It is best not to take stool softeners indiscriminately.
If bleeding persists, it is advisable to consult a physician.
If necessary, a colonoscopy can be arranged.
At 18 years old, it is best to avoid smoking.

Reply Date: 2017/08/02

More Info

Rectal bleeding can be alarming, especially for someone your age. It's important to understand the potential causes and when to seek medical help. Based on your description, the presence of bright red blood on toilet paper after bowel movements, along with the absence of pain or constipation, suggests that the bleeding might be originating from the lower part of the gastrointestinal tract, such as the rectum or anus.

Possible Causes of Rectal Bleeding
1. Hemorrhoids: One of the most common causes of rectal bleeding, especially in young adults, is hemorrhoids. These are swollen veins in the rectal area that can bleed during bowel movements, often resulting in bright red blood on the toilet paper.

2. Anal Fissures: Small tears in the lining of the anus can also cause bleeding. They are usually associated with painful bowel movements, but in some cases, they may not be painful.

3. Diverticular Disease: Although less common in younger individuals, diverticulosis can lead to diverticulitis, which may cause rectal bleeding.

4. Polyps or Colorectal Cancer: While less likely at your age, polyps can develop in the colon and rectum, and some can bleed. Colorectal cancer is rare in young adults but should be considered if symptoms persist.

5. Infections or Inflammatory Conditions: Conditions like inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, can also lead to rectal bleeding.

When to Seek Medical Help
You should definitely seek medical attention if:
- The bleeding persists for more than a few days.

- You notice a significant increase in the amount of blood.

- You experience any other symptoms such as abdominal pain, changes in bowel habits, or weight loss.

- You have any signs of anemia, such as fatigue or dizziness.

Recommended Actions
1. Consult a Healthcare Provider: Given your symptoms, it would be wise to see a gastroenterologist, a doctor who specializes in digestive system disorders. They can perform a thorough evaluation, which may include a physical examination and possibly a colonoscopy if deemed necessary.

2. Lifestyle Modifications: Since you mentioned smoking and staying up late, consider making lifestyle changes. Smoking can exacerbate gastrointestinal issues, and poor sleep can affect your overall health. A balanced diet rich in fiber can help maintain regular bowel movements and reduce the risk of hemorrhoids and fissures.

3. Monitor Symptoms: Keep track of your symptoms, including the frequency and amount of bleeding, any changes in bowel habits, and any associated symptoms like pain or discomfort. This information will be helpful for your healthcare provider.

Conclusion
While rectal bleeding can be caused by benign conditions like hemorrhoids or anal fissures, it is essential to take it seriously, especially since it is your first experience with this symptom. Seeking medical advice will help rule out any serious conditions and provide you with peace of mind. Remember, early intervention is key to managing any potential health issues effectively.

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