Rectal Bleeding: Causes and Concerns for Patients

Rectal bleeding

A week ago, I experienced significant pain in my anus while using the restroom, and there was bright red blood on the toilet paper (about the size of two folded sheets) as well as in the toilet bowl.
Since I was in Japan at the time, I purchased hemorrhoid cream the day after noticing the blood.
That day, I had diarrhea, and the pain persisted during bowel movements, with some blood visible in the toilet.
After two days without a bowel movement, I used the restroom at the airport before returning home, and I noticed what appeared to be some discharge on the toilet paper.
Once I returned home, I did not experience any anal pain during bowel movements, but today, the pain returned, and I felt a sharp pain during the process.
When I wiped, there was a small amount of pink blood on the toilet paper.
I would like to know what could be causing this.
My diet is normal; I haven't eaten too much meat and try to eat vegetables.
I drink water daily, although it's less than 2000 cc, but still over 1000 cc...
so I am quite worried.

Niming, 20~29 year old female. Ask Date: 2017/08/24

Dr. Ke Fangxu reply Surgery

At the age of 24, the likelihood of developing colorectal cancer is not zero, but generally, it is very, very low.
Based on your description, it seems more like the typical symptoms of an anal fissure, which include pain during bowel movements accompanied by slight bleeding.
The common causes are often constipation or diarrhea.
The fundamental treatment is to improve bowel habits, and warm sitz baths can also be beneficial.
Over-the-counter hemorrhoid suppositories can be purchased for use.
If symptoms persist without improvement, it is advisable to consult a physician for further evaluation.

Reply Date: 2017/08/24

More Info

Rectal bleeding can be a concerning symptom, and it is important to understand its potential causes and implications. Based on your description, it seems that you have experienced rectal pain and bleeding during bowel movements, which can be indicative of several conditions.
One of the most common causes of rectal bleeding, especially in younger individuals, is hemorrhoids. Hemorrhoids are swollen blood vessels in the rectal area that can become inflamed or irritated, often leading to pain and bleeding during bowel movements. The fact that you mentioned using a hemorrhoid cream suggests that this was a consideration for your symptoms. However, if the bleeding persists or worsens, further evaluation is warranted.

Another potential cause of rectal bleeding could be anal fissures, which are small tears in the lining of the anus. These can occur due to passing hard stools or straining during bowel movements, leading to sharp pain and bleeding. The description of your pain as "刺刺痛痛" (sharp pain) during bowel movements aligns with this possibility.

In some cases, rectal bleeding can also be a sign of more serious conditions, such as inflammatory bowel disease (IBD), diverticulosis, or even colorectal cancer, particularly if there are other accompanying symptoms such as changes in bowel habits, weight loss, or persistent abdominal pain. Given that you have experienced intermittent bleeding and pain, it is essential to monitor your symptoms closely.

Here are some recommendations for managing your symptoms and concerns:
1. Dietary Adjustments: Continue to maintain a diet rich in fiber, which can help soften stools and reduce straining during bowel movements. Foods such as fruits, vegetables, whole grains, and legumes are excellent sources of fiber. Additionally, ensure you are adequately hydrated, as this can also help prevent constipation.

2. Over-the-Counter Treatments: While you have already used a hemorrhoid cream, consider other over-the-counter treatments such as stool softeners or fiber supplements if you are experiencing constipation. These can help ease the passage of stools and reduce the risk of further irritation.

3. Avoid Straining: When using the restroom, try to avoid straining, as this can exacerbate hemorrhoids or fissures. If you feel the urge to go, do so promptly rather than waiting, as this can lead to harder stools.

4. Monitor Symptoms: Keep track of your symptoms, including the frequency and amount of bleeding, any changes in bowel habits, and the presence of pain. If you notice any significant changes or if the bleeding persists, it is crucial to seek medical attention.

5. Consult a Healthcare Provider: Given your ongoing symptoms, it would be wise to consult a healthcare provider for a thorough evaluation. They may recommend a physical examination, and possibly a colonoscopy or other imaging studies, to determine the underlying cause of your rectal bleeding.

In summary, while hemorrhoids and anal fissures are common causes of rectal bleeding, it is essential to rule out more serious conditions, especially if symptoms persist. Maintaining a healthy diet, avoiding straining, and seeking medical advice will be key steps in addressing your concerns. Remember, early intervention can lead to better outcomes, so do not hesitate to reach out to a healthcare professional for further evaluation.

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