Rectal Bleeding: Causes and Remedies for Hemorrhoids and Fissures

Q: Rectal Bleeding: Causes and Remedies for Hemorrhoids and Fissures

Hello： 1. If you have an anal fissure, straining during bowel movements or passing larger stools may cause the scabbed wound to reopen and bleed. 2. You can soak in warm water. 3. If you purchase over-the-counter ointments or suppositories and still experience

Regarding the issue of rectal bleeding?

Hello, doctor.
I have a habit of having a bowel movement every day, but I forgot to do so for the past two days.
When I finally felt the urge, although I could sense that the stool was close to the anus, I still had to exert some effort to push it out.
As a result, I noticed bright red blood on the toilet paper after wiping.
I have had issues with anal fissures in the past and underwent a sigmoidoscopy and colonoscopy 2-3 years ago, both of which showed normal results.
I also had a fecal occult blood test afterward, which was negative.

Could it be that if I have an anal fissure, straining during bowel movements could cause the scabbed wound to reopen and bleed again? Additionally, I have the urge to go to the bathroom, but I'm afraid that straining too much will cause bleeding again.
Should I still try to go and then take a warm sitz bath for 10 minutes afterward, and avoid sitting for long periods to help with the bleeding? Or would it be more beneficial for me to buy an ointment or suppository? Thank you!

renner, 30~39 year old female. Ask Date: 2018/02/21

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: 1.
If you have an anal fissure, straining during bowel movements or passing larger stools may cause the scabbed wound to reopen and bleed.
2.
You can soak in warm water.
3.
If you purchase over-the-counter ointments or suppositories and still experience bleeding, it is recommended to consult a colorectal specialist or a gastroenterologist at Changhua Hospital for your health.
Dr.
Cai Anshun.

Reply Date: 2018/02/21

More Info

Rectal bleeding can be a concerning symptom, and understanding its causes and remedies is essential for effective management. Based on your description, it seems that you may be experiencing symptoms related to hemorrhoids or anal fissures, both of which are common conditions that can lead to bright red blood on toilet paper or in the toilet bowl after a bowel movement.

Causes of Rectal Bleeding:
1. Hemorrhoids: These are swollen veins in the lower rectum or anus that can cause bleeding during bowel movements, especially if you are straining. Hemorrhoids can be internal (inside the rectum) or external (under the skin around the anus). Symptoms often include itching, discomfort, and bright red blood.

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

3. Other Causes: While hemorrhoids and fissures are the most common causes, other potential causes of rectal bleeding include diverticular disease, inflammatory bowel disease (IBD), colorectal polyps, or even colorectal cancer. However, given your history of normal colonoscopies and fecal occult blood tests, these are less likely.

Management and Remedies:
1. Dietary Changes: Increasing your fiber intake can help soften your stools, making them easier to pass and reducing the risk of straining. Foods high in fiber include fruits, vegetables, whole grains, and legumes. Additionally, staying well-hydrated by drinking plenty of water is crucial.

2. Avoid Straining: If you feel the urge to have a bowel movement, it’s important to respond to that urge rather than delaying it. Straining can exacerbate hemorrhoids and fissures. If you find it difficult to pass stools, consider using a stool softener or a fiber supplement.

3. Warm Sitz Baths: Taking a warm sitz bath for about 10-15 minutes can help soothe the area, promote healing, and reduce discomfort. This can be particularly beneficial after bowel movements.

4. Topical Treatments: Over-the-counter creams or ointments designed for hemorrhoids can provide relief from itching and discomfort. If you have fissures, topical anesthetics or hydrocortisone creams may also help. In some cases, a prescription for a topical nitroglycerin ointment or calcium channel blockers may be recommended to help relax the anal sphincter and promote healing.

5. Avoid Prolonged Sitting: If you have a sedentary lifestyle, try to incorporate regular movement and avoid sitting for long periods, which can exacerbate hemorrhoids.

6. Consult a Healthcare Provider: If your symptoms persist or worsen, or if you experience significant pain, changes in bowel habits, or other concerning symptoms, it’s important to consult a healthcare provider. They may recommend further evaluation or treatment options, including procedures to remove hemorrhoids or treat fissures if conservative measures fail.

In summary, while your history of anal fissures and the recent experience of rectal bleeding may indicate a recurrence, implementing dietary changes, practicing good bowel habits, and utilizing topical treatments can significantly aid in recovery. Always listen to your body, and don’t hesitate to seek medical advice if you have concerns about your symptoms.

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