Rectal Bleeding: Is It Anal Fissure or Something Else?

I would like to ask the doctor for an answer?

After using the restroom, I noticed a small streak of dark red blood on the toilet paper, which was very close to a brown color (when I smeared the blood, it also appeared close to brown).
Surrounding it was some light yellow, transparent mucus.
The amount of blood was minimal, and there were no obvious traces of blood in the stool.
Additionally, there is a slight pain and warmth around the anus.
Could this possibly be an anal fissure? Or could it be due to hard stools causing injury to the intestinal mucosa and bleeding? I do not have issues with internal hemorrhoids...
I'm a bit worried about whether there is something serious.
😅 I apologize for taking your time, and thank you for your response!

Niming, 10~19 year old female. Ask Date: 2018/02/26

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.
Although the likelihood of developing colorectal cancer at the age of 17 is not zero, it is generally very, very low.
Your symptoms also appear to resemble hemorrhoids.
It is advisable to maintain a light diet and good lifestyle habits, avoiding spicy, irritating, and greasy foods.
Increasing dietary fiber can also be beneficial.
If symptoms persist without improvement, you may want to consult a physician for medication or to undergo a colonoscopy.

Reply Date: 2018/02/26

More Info

When it comes to rectal bleeding, it can be concerning and often raises questions about the underlying causes. Based on your description, it sounds like you may be experiencing symptoms consistent with an anal fissure, but there are other possibilities to consider as well.

An anal fissure is a small tear in the lining of the anus, which can occur due to various reasons, the most common being the passage of hard stools. When stool is hard and difficult to pass, it can stretch the anal canal and cause a tear, leading to pain and bleeding. The blood you observed on the toilet paper, especially if it is dark red or brownish, could be indicative of this type of injury. The presence of a yellowish, transparent mucus could also be a normal response from the body as it tries to heal the area or protect it from further irritation.

In addition to anal fissures, other potential causes of rectal bleeding include hemorrhoids, which are swollen veins in the rectal area that can bleed, especially during bowel movements. However, you mentioned that you do not have a history of hemorrhoids, which makes this less likely. Another possibility is that the bleeding could be related to a more serious condition, such as inflammatory bowel disease (IBD) or colorectal polyps, but these are less common and usually present with additional symptoms.

Given that you are experiencing pain and a burning sensation around the anus, it is crucial to pay attention to these symptoms. Pain is a common symptom associated with anal fissures, and it can be exacerbated by bowel movements. If the pain persists or worsens, or if you notice an increase in bleeding, it is advisable to seek medical attention. A healthcare professional can perform a thorough examination to determine the exact cause of your symptoms and recommend appropriate treatment.

In the meantime, there are several self-care measures you can take to alleviate discomfort and promote healing. These include:
1. Dietary Changes: Increase your fiber intake to help soften stools and make them easier to pass. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying well-hydrated by drinking plenty of water is also essential.

2. Sitz Baths: Taking warm sitz baths can help soothe the anal area and promote relaxation of the muscles, which may alleviate pain.

3. Over-the-Counter Treatments: You may consider using topical treatments such as hydrocortisone creams or ointments designed for anal fissures to reduce inflammation and pain.

4. Avoid Straining: When using the bathroom, try to avoid straining or sitting for prolonged periods, as this can exacerbate the issue.

5. Consult a Doctor: If symptoms persist or worsen, or if you notice any other concerning signs such as significant weight loss, changes in bowel habits, or severe abdominal pain, it is important to consult a healthcare provider for further evaluation.

In conclusion, while your symptoms may suggest an anal fissure, it is essential to monitor your condition closely and seek medical advice if necessary. Early intervention can help prevent complications and ensure proper healing. Remember, it is always better to err on the side of caution when it comes to health concerns.

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