Anal Pain and Bleeding: Causes and Care Tips

Experiencing pain during bowel movements and noticing blood upon wiping?

Hello Doctor: I usually have a bowel movement every day, sometimes even two or three times a day.
The day before yesterday, I experienced severe pain in my anus during a bowel movement, which felt somewhat like the stool was too hard.
However, the stool that came out was only hard at the front and soft at the back.
When I wiped, there was only a faint strawberry red color on the toilet paper (after wiping three or four times, there was no blood color), and the stool in the toilet did not appear to have any blood.
After the bowel movement, the pain in my anus persisted for about 5-10 minutes, then subsided, but sometimes I suddenly feel dryness and slight pain in the anus.
Because of this, I have been waiting until the evening to accumulate stool before going to the bathroom (afraid of pain if I go too many times).
Today, during my bowel movement, there was no pain in the anus, and there were no traces of blood when I wiped.
However, I am unsure if I am overly focused on my anus.
While sitting on the carpet today, I suddenly felt a bit of dryness and discomfort in my anus.
I would like to ask the doctor: 1.
Is this an anal fissure or hemorrhoids? 2.
Since it is difficult to obtain medications in Europe, how should I care for myself? 3.
Should I avoid focusing too much on my anus 😂 to reduce the activity of the sphincter? Thank you, Doctor, for taking the time to respond 🙂

TAT, 20~29 year old female. Ask Date: 2017/09/06

Dr. Ke Fangxu reply Surgery

1.
Based on your description, it seems more like a combination of anal fissure and hemorrhoidal bleeding.
The typical symptoms include pain during bowel movements accompanied by slight bleeding, often caused by constipation or diarrhea.

2.
You can purchase hemorrhoid suppositories over the counter at a pharmacy.
If obtaining medication is difficult, it is advisable to avoid constipation and take warm sitz baths.
If symptoms persist without improvement, it is best to consult a physician.

3.
Maintain a calm mindset, and if possible, try to take warm sitz baths regularly, as this can help you recover more quickly.

4.
If bowel movement patterns do not improve, there is a 100% guarantee of recurrence.

Reply Date: 2017/09/06

More Info

Anal pain and bleeding can be concerning symptoms, and understanding their potential causes is crucial for effective management. Based on your description, it seems you may be experiencing symptoms consistent with either anal fissures or hemorrhoids, both of which are common conditions that can lead to pain and bleeding during bowel movements.

1. Causes:
- Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard or large stools. Symptoms typically include sharp pain during and after bowel movements, and you may notice bright red blood on the toilet paper or in the stool. The pain can last for several minutes to hours after a bowel movement.

- Hemorrhoids: These are swollen blood vessels in the rectal area that can become inflamed or thrombosed (clotted), leading to pain, itching, and bleeding. Hemorrhoids can be internal (inside the rectum) or external (under the skin around the anus). Bleeding from hemorrhoids is usually bright red and may occur with or without pain.

2. Management and Care Tips:
- Dietary Changes: To prevent hard stools, increase your fiber intake by consuming more fruits, vegetables, whole grains, and legumes. Fiber supplements like psyllium husk can also be beneficial. Additionally, ensure you are drinking plenty of water to stay hydrated.

- Bowel Habits: Avoid straining during bowel movements, as this can exacerbate fissures and hemorrhoids. Establish a regular bowel routine and try not to delay going to the bathroom when you feel the urge.

- Sitz Baths: Taking warm sitz baths for 10-15 minutes several times a day can help soothe the area, reduce pain, and promote healing.

- Topical Treatments: Over-the-counter creams or ointments containing hydrocortisone can help reduce inflammation and discomfort. If you have access to them, topical anesthetics may also provide temporary relief.

- Avoiding Irritation: Be gentle when wiping after a bowel movement. Consider using moist wipes instead of toilet paper to reduce irritation. Wearing loose-fitting cotton underwear can also help keep the area dry and comfortable.

3. Mental Focus: While it’s natural to be concerned about discomfort, try to avoid fixating on the area, as this can lead to increased tension in the anal sphincter muscles, potentially worsening the pain. Engaging in relaxation techniques or distractions may help reduce this focus.

4. When to Seek Medical Attention: If your symptoms persist, worsen, or if you experience significant bleeding, it’s important to consult a healthcare professional. They can provide a thorough examination and may recommend additional treatments, such as prescription medications or procedures if necessary.

In summary, while your symptoms may suggest anal fissures or hemorrhoids, proper dietary management, good bowel habits, and self-care techniques can significantly alleviate discomfort and promote healing. If symptoms continue or escalate, seeking medical advice is essential for appropriate care.

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