Post-Injection Bleeding and Bowel Issues After Skin Treatment

After receiving an injection for an internal mole, there has been bleeding on the day of the procedure, and there are blood stains in the stool every day since then?

Hello Dr.
Ke,
About a month ago, I noticed some blood stains in my stool and experienced a burning sensation in my anus after bowel movements.
The doctor performed a digital rectal exam and diagnosed it as a flare-up of hemorrhoids.
A week later, the burning sensation during bowel movements worsened, and I was concerned that I might not be taking care of myself properly, so I returned for a follow-up.
During that visit, the digital exam was more forceful, resulting in a tear in the perineum.
I then took a week-long course of antibiotics prescribed by a gynecologist and followed the instructions from a colorectal surgeon to use topical medication and suppositories for a month.

Afterward, I developed itching and a burning sensation in the anal area.
I consulted another colorectal surgeon, who diagnosed me with severe eczema, noting some internal and external hemorrhoids.
In addition to undergoing a procedure for the internal hemorrhoids, I was advised to continue gynecological treatment.
I received another week of antibiotics from the gynecologist and used the colorectal suppositories for another week.
On April 20, during a follow-up visit, I noticed some blood stains when wiping after a bowel movement on the morning of April 18.
I thought it was due to the internal hemorrhoids shedding, so I didn’t mention it to the doctor.
During the consultation, the doctor said there was improvement, indicating that some of the hemorrhoids had fallen off, but there were still some remaining.
The doctor administered an injection without informing me at that moment.
When I returned home, I used wet wipes and noticed deep brown blood, and by the time I went to bed, there was a bit of bright red blood when I wiped after using the restroom.
Gradually, this subsided.
However, I am more concerned because yesterday and this morning, I noticed a bit of bright red blood when wiping after bowel movements.
Today, there was slightly more blood in the stool, but it wasn’t dripping; the stool appeared to have some blood as well (the toilet had a faint pinkish water that was only noticeable upon close inspection).
Additionally, I felt a slight foreign body sensation around the anus, and the stool was somewhat hard.
I read your responses and noted that bleeding for three days to a week after the injection is normal, but I would like to ask if my current situation is considered normal.
My next follow-up appointment is in two weeks; should I return for a visit in the next few days? I apologize for the concern, as I have seen several colorectal specialists recently, and I am genuinely worried about whether this will resolve.
Thank you.

Ms. Chen, 40~49 year old female. Ask Date: 2018/04/22

Dr. Ke Fangxu reply Surgery

Based on your description, the bleeding does not seem to be severe.
If there is no pain or inflammation, there is no need to rush back for a follow-up.
The injection of hemostatic agents can cause damage to the hemorrhoidal tissue, so mild bleeding is a normal occurrence.
During this time, just avoid constipation and increase sitz baths.

Reply Date: 2018/04/22

More Info

It sounds like you have been experiencing a complex series of symptoms following your skin treatment, particularly with bleeding and discomfort during bowel movements. While I cannot provide a definitive diagnosis or treatment plan, I can offer some general insights into your situation based on the information you've shared.

Firstly, it's important to understand that post-injection bleeding can occur, especially if the injection was administered in a sensitive area or if there was any trauma to the tissue during the procedure. The presence of blood in your stool, along with the burning sensation in the anal area, suggests that there may be irritation or inflammation in the rectal or anal region, possibly exacerbated by the treatments you've undergone.

From your description, it seems that you have been diagnosed with hemorrhoids (痔瘡) and possibly some form of dermatitis or eczema in the anal area. Hemorrhoids can cause bleeding, especially during bowel movements, and the burning sensation you are experiencing could be due to irritation from hard stools or inflammation. The fact that you have noticed blood on toilet paper and in the toilet bowl indicates that there may be some bleeding from the hemorrhoids or possibly from anal fissures, which can occur if the stool is hard and causes tearing during passage.

The use of antibiotics and topical treatments as prescribed by your doctors is a common approach to managing infections and inflammation. However, it is crucial to monitor your symptoms closely. If you notice an increase in bleeding, persistent pain, or any new symptoms, it is advisable to seek medical attention sooner rather than later. The presence of fresh blood, especially if it increases in quantity or is accompanied by significant pain, warrants a prompt evaluation by a healthcare professional.

In terms of managing your symptoms at home, here are a few suggestions that may help alleviate discomfort:
1. Dietary Adjustments: Ensure you are consuming a high-fiber diet to help soften your stools. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying well-hydrated is also essential.

2. Sitz Baths: Taking warm sitz baths can help soothe the anal area and reduce discomfort. This involves sitting in a few inches of warm water for about 15-20 minutes several times a day.

3. Topical Treatments: If you have been prescribed topical medications, continue to use them as directed. Over-the-counter creams or ointments specifically for hemorrhoids may also provide relief.

4. Avoid Straining: When having a bowel movement, try to avoid straining, as this can exacerbate hemorrhoids and lead to further bleeding.

5. Follow-Up Care: Since you have a follow-up appointment in two weeks, it is essential to keep that appointment. However, if your symptoms worsen or you have significant concerns, do not hesitate to reach out to your healthcare provider sooner.

In conclusion, while some bleeding and discomfort can be expected after certain skin treatments, it is essential to monitor your symptoms closely. If you experience any significant changes or worsening of your condition, seek medical advice promptly. Your health and comfort are paramount, and your healthcare providers are there to help you navigate these challenges.

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