Rectal Bleeding and Painful Bumps: When to Seek Help

Rectal bleeding with a protruding mass at the anal opening?

I previously noticed a small amount of blood on the toilet paper when wiping after a bowel movement, but it didn't hurt.
However, in the past few months, I've been experiencing bleeding with bowel movements accompanied by pain.
At times, I can even hear drops of blood hitting the toilet without having a bowel movement.
After finishing, a red, swollen protrusion appears near the anus, and there is a burning, sharp pain.
Additionally, I've noticed an increase in flatulence, and my lower abdomen often feels bloated with the urge to pass gas.
Could you please advise what symptoms this might indicate? Should I seek immediate medical attention?

Ren, 20~29 year old female. Ask Date: 2018/01/14

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

Reply Date: 2018/01/14

More Info

Based on your description, it sounds like you are experiencing symptoms that could be related to several conditions affecting the rectal area. The presence of rectal bleeding, painful bumps, and changes in bowel habits can be concerning and warrant further evaluation.
The symptoms you describe—bleeding during bowel movements, pain, and the appearance of a red, swollen bump—could be indicative of hemorrhoids, anal fissures, or possibly more serious conditions such as rectal polyps or even colorectal cancer. Hemorrhoids are swollen blood vessels in the rectal area that can cause pain, itching, and bleeding, especially during bowel movements. Anal fissures are small tears in the lining of the anus that can also lead to bleeding and significant pain. Both conditions can be exacerbated by straining during bowel movements, which may explain the increased frequency of your symptoms.

The fact that you are experiencing a burning sensation and a feeling of fullness in your lower abdomen, along with increased flatulence, could suggest that there is some underlying gastrointestinal issue, such as constipation or irritable bowel syndrome (IBS). IBS can lead to changes in bowel habits, including increased gas and bloating, which may contribute to the discomfort you are feeling.

Given the persistence and severity of your symptoms, especially the rectal bleeding and the painful bump, it is important to seek medical attention promptly. While hemorrhoids and fissures are common and often treatable with conservative measures (such as dietary changes, increased fiber intake, topical treatments, and sitz baths), the presence of a painful bump and significant bleeding could indicate a need for further investigation.

Here are some steps you should consider taking:
1. Schedule an Appointment with a Healthcare Provider: It is crucial to see a doctor, preferably a gastroenterologist or a colorectal specialist, who can perform a thorough examination. They may recommend a digital rectal exam or a colonoscopy to assess the condition of your rectum and colon.

2. Keep a Symptom Diary: Document your symptoms, including the frequency of bleeding, any changes in bowel habits, and the nature of the pain. This information can help your doctor make a more accurate diagnosis.

3. Avoid Straining: Try to avoid straining during bowel movements, as this can worsen hemorrhoids and fissures. Ensure you are drinking plenty of fluids and consuming a high-fiber diet to promote regular bowel movements.

4. Consider Over-the-Counter Treatments: While waiting for your appointment, you may find relief from over-the-counter treatments for hemorrhoids, such as creams or suppositories that contain hydrocortisone or witch hazel.

5. Monitor for Additional Symptoms: Be vigilant for any new symptoms, such as significant weight loss, changes in appetite, or severe abdominal pain, which could indicate a more serious condition.

In conclusion, while your symptoms may be due to common conditions like hemorrhoids or anal fissures, the combination of rectal bleeding, pain, and the appearance of a bump should not be ignored. Seeking medical attention is essential to rule out any serious underlying issues and to receive appropriate treatment.

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