Why Frequent Wiping After Bowel Movements Can Lead to Bleeding

After having a bowel movement, the anal sphincter can easily be irritated, leading to bleeding?

Hello, Doctor: Basically, I only go to the bathroom every two days, unless I eat a lot (I usually have a large appetite).
It's very difficult to clean up after a bowel movement, and I have to wipe at least 15 times or more (using both toilet paper and wet wipes), which often leads to bleeding.
My water intake should be sufficient, around 1800cc in winter and about 3000cc in summer.
I eat out often but still consume vegetables and fruits, although sometimes in smaller amounts.
I have been drinking chia seeds to increase fiber intake, but even with daily consumption (for a week), I only have regular bowel movements for the first two days, after which it returns to every two days, and it's still not easy to clean up.
When I drink chia seeds infrequently, like once a week, I notice effects the next day, but it's still difficult to clean up afterward.
I cannot use a bidet when I'm out, and this has been a long-standing issue.
I hope you can provide some insights.
Thank you.

yixin, 20~29 year old female. Ask Date: 2018/03/09

Dr. Ke Fangxu reply Surgery

Increasing the intake of dietary fiber is an effective way to address constipation.
However, it is important to consume a variety of fiber types by eating different kinds of vegetables and fruits to ensure a balanced intake of various fiber structures.
Additionally, developing a regular exercise routine is crucial, as a lack of physical activity can also lead to slowed intestinal motility.

Reply Date: 2018/03/09

More Info

Frequent wiping after bowel movements can indeed lead to bleeding, and there are several reasons for this phenomenon. When you wipe excessively, especially with rough toilet paper or wipes, you can irritate the sensitive skin around the anal area. This irritation can lead to inflammation and, in some cases, small tears in the skin, which can result in bleeding.
Additionally, if you are experiencing constipation or hard stools, the act of passing these stools can cause strain and pressure on the anal region, leading to conditions such as anal fissures or hemorrhoids. Both of these conditions can cause pain and bleeding during or after bowel movements.
From your description, it seems you have a pattern of infrequent bowel movements, occurring every two days, which can lead to harder stools. Even though you are consuming a significant amount of fluids and fiber, it may not be enough to ensure regular and soft bowel movements. The fact that you are using wet wipes and toilet paper extensively suggests that you might not be cleaning effectively, which can lead to irritation and the need for more wiping.
Here are some suggestions to help alleviate the issue:
1. Increase Fiber Intake: While you mentioned consuming chia seeds, consider incorporating a variety of high-fiber foods into your diet, such as fruits, vegetables, whole grains, and legumes. This can help soften your stools and promote more regular bowel movements.

2. Hydration: Ensure you are drinking enough fluids throughout the day. While you mentioned your fluid intake, it’s essential to maintain this consistently, especially if your diet is high in fiber.

3. Regular Bowel Movements: Try to establish a routine for bowel movements. This could involve setting aside time each day to sit on the toilet, which can help train your body to have more regular bowel movements.

4. Gentle Wiping Techniques: Instead of wiping multiple times, consider using a bidet or a handheld shower to clean the area after a bowel movement. This can reduce irritation and the need for excessive wiping. If a bidet is not available, using moist wipes designed for sensitive skin can be gentler than dry toilet paper.

5. Over-the-Counter Treatments: If you suspect you have hemorrhoids or anal fissures, over-the-counter creams or ointments may provide relief. These products can help reduce inflammation and promote healing.

6. Consult a Healthcare Provider: If the bleeding persists or worsens, it is crucial to consult a healthcare provider. They can assess for any underlying conditions, such as hemorrhoids or fissures, and provide appropriate treatment options.

7. Consider a Stool Softener: If you continue to experience hard stools, you might want to discuss the use of a stool softener with your healthcare provider. This can help make bowel movements easier and reduce the strain on your anal area.

In summary, frequent wiping can lead to bleeding due to irritation and potential injury to the anal area. By addressing your diet, hydration, and bowel habits, you can help mitigate this issue. If symptoms persist, seeking medical advice is essential to rule out any serious conditions and to receive tailored treatment.

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