Rectal Bleeding: Causes and When to Seek Help

Rectal bleeding

I have been experiencing blood in my stool for the past three days, and there is pain in my anus during bowel movements.
For the first two days, I only noticed blood on the toilet paper when wiping, but after the second wipe, there was no blood.
On October 12th, there was blood in the toilet after I had a bowel movement, and I also noticed blood when wiping, but again, there was none after the second wipe.
After this bowel movement, I felt a burning and tingling sensation in my anus, and the blood was bright red.
My stool is shaped like a long cylinder.
A few months ago, I started drinking 2000 cc of water daily, and since then, I have been having regular bowel movements.
I often eat out, and my job requires me to either stand or sit for long periods.

Sherry, 20~29 year old female. Ask Date: 2017/10/12

Dr. Ke Fangxu reply Surgery

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, along with warm sitz baths.
You can also purchase hemorrhoid suppositories at the pharmacy for relief.
If symptoms persist without improvement, it is advisable to consult a physician for further evaluation.

Reply Date: 2017/10/12

More Info

Rectal bleeding can be a concerning symptom, and understanding its potential causes is crucial for determining when to seek medical attention. Based on your description, it appears that you are experiencing bright red blood during bowel movements, which can be indicative of several conditions.

Common Causes of Rectal Bleeding
1. Hemorrhoids: One of the most common causes of bright red blood in the stool is hemorrhoids, which are swollen veins in the rectum or anus. They can cause pain, itching, and bleeding, especially during bowel movements. The blood is typically bright red and may be seen on toilet paper or in the toilet bowl.

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

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can lead to diverticulitis if these pouches become inflamed. This condition can cause rectal bleeding, along with abdominal pain and changes in bowel habits.

4. Colorectal Polyps or Cancer: Although less common, polyps (growths on the colon lining) or colorectal cancer can also cause rectal bleeding. The blood may be bright red or darker, depending on the location of the bleeding.

5. Gastrointestinal Infections: Certain infections can lead to inflammation of the intestines, resulting in bloody diarrhea.

When to Seek Medical Help
Given your symptoms—specifically the presence of blood during bowel movements, pain in the anal area, and the change in stool shape (long and thin)—it is essential to consult a healthcare professional. You should seek immediate medical attention if you experience any of the following:
- Severe Pain: If the pain becomes unbearable or is accompanied by other symptoms like fever or chills.

- Large Amounts of Blood: If you notice significant bleeding, especially if it is accompanied by dizziness or fainting.

- Changes in Bowel Habits: If you experience persistent changes in your bowel habits, such as diarrhea or constipation.

- Weight Loss: Unexplained weight loss or changes in appetite.

Recommendations for Management
1. Dietary Changes: Since you mentioned being an "外食族" (frequent diner), consider incorporating more fiber into your diet to help soften stools and reduce straining during bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying well-hydrated is also crucial.

2. Avoid Straining: When using the bathroom, try to avoid straining, as this can exacerbate hemorrhoids or fissures. If you feel the urge to go, do so promptly rather than holding it in.

3. Warm Baths: Taking warm baths can help soothe anal pain and promote relaxation of the anal sphincter.

4. Over-the-Counter Treatments: Over-the-counter creams or ointments for hemorrhoids may provide temporary relief if hemorrhoids are suspected.

5. Follow-Up Care: Make sure to follow up with your healthcare provider for a thorough evaluation. They may recommend a physical examination, and possibly a colonoscopy, to determine the exact cause of your symptoms.

In conclusion, while rectal bleeding can often be attributed to benign conditions like hemorrhoids or fissures, it is essential to take it seriously and seek medical evaluation, especially given your symptoms. Early diagnosis and treatment can help prevent complications and improve your overall health.

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