Rectal Bleeding and Pain: Causes and Concerns

Rectal bleeding and anal pain?

Hello Doctor: A few months ago, I noticed a small amount of blood when wiping after a bowel movement, but it stopped after one wipe and didn't return for several days.
However, today I feel particularly uncomfortable in my abdomen (this happens often).
Even though I had a bowel movement yesterday, I still have a strong urge to go today, which feels like straining (I'm sorry, I don't know how to describe it).
After using the restroom, I found a significant amount of bright red blood in the toilet, and this happened twice in a row.
I also feel pain around the anus, and the bleeding started after I finished my bowel movement.
Usually, my bowel movements are not very smooth, and I often have to strain, but I do go to the bathroom almost every day at the same time.
I'm not sure if this is due to anal fissures or hemorrhoids, or if there could be an issue with my colon.
As a student, I often sit for long periods; could this be a contributing factor?

Bian Bian, 10~19 year old female. Ask Date: 2018/03/05

Dr. Ke Fangxu reply Surgery

Based on your description, it seems more like a typical case of anal fissure combined with hemorrhoidal bleeding.
The common symptoms include pain during bowel movements accompanied by bleeding, often caused by constipation or diarrhea.
The fundamental treatment is to improve bowel habits, along with warm sitz baths.
You can also purchase over-the-counter hemorrhoid suppositories.
The likelihood of developing colorectal cancer at the age of 17 is virtually zero, so there is no need for excessive worry.
It is recommended to maintain a light diet and a good lifestyle routine, avoiding spicy, irritating, and greasy foods.
Increasing dietary fiber intake can also be beneficial.
If symptoms persist without improvement, it is advisable to consult a physician for further evaluation.

Reply Date: 2018/03/05

More Info

Rectal bleeding and pain can be concerning symptoms, and it's important to understand the potential causes and when to seek medical attention. Based on your description, there are several possibilities that could explain your symptoms, including hemorrhoids, anal fissures, or other gastrointestinal issues.

1. Hemorrhoids: Hemorrhoids are swollen veins in the lower rectum and anus that can cause discomfort, pain, and bleeding during bowel movements. They are often associated with straining during defecation, which can occur if you are experiencing constipation or if you are sitting for prolonged periods, as you mentioned. The blood from hemorrhoids is typically bright red and may appear on the toilet paper or in the toilet bowl after a bowel movement.

2. Anal Fissures: An anal fissure is a small tear in the lining of the anus, often caused by passing hard stools or straining during bowel movements. This can lead to sharp pain during and after bowel movements, as well as bleeding. The blood is usually bright red and may drip after a bowel movement, similar to what you described.

3. Gastrointestinal Issues: While hemorrhoids and fissures are common causes of rectal bleeding, other gastrointestinal issues could also be at play. Conditions such as diverticulosis, inflammatory bowel disease (IBD), or colorectal polyps can cause bleeding and discomfort. However, these conditions are less common in younger individuals without a significant family history.

4. Lifestyle Factors: Your lifestyle, including prolonged sitting and possibly inadequate dietary fiber intake, can contribute to constipation and straining during bowel movements. This can exacerbate hemorrhoids and fissures, leading to a cycle of pain and bleeding.

Given that you have experienced significant bleeding and pain, it is crucial to seek medical attention. A healthcare provider can perform a physical examination and may recommend additional tests, such as a colonoscopy, to rule out any serious conditions. It’s important to be open with your doctor about your symptoms, including the frequency of your bowel movements and any straining you experience.

Management and Prevention:
- Dietary Changes: Increasing your fiber intake through fruits, vegetables, and whole grains can help soften stools and reduce straining. Staying well-hydrated is also essential.

- Regular Exercise: Engaging in regular physical activity can promote healthy bowel function and reduce the risk of constipation.

- Avoid Straining: When using the toilet, try to relax and avoid straining. If you feel the urge to go, don’t delay.

- Sitz Baths: Taking warm sitz baths can help relieve pain and discomfort associated with hemorrhoids or fissures.

- Over-the-Counter Treatments: There are various over-the-counter creams and ointments available that can help alleviate the symptoms of hemorrhoids and fissures.

In conclusion, while hemorrhoids and anal fissures are common causes of rectal bleeding and pain, it is essential to consult a healthcare professional to determine the exact cause of your symptoms. Early diagnosis and appropriate management can help prevent complications and improve your quality of life. Remember, it’s always better to err on the side of caution when it comes to your health.

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