Rectal Bleeding: Causes and When to Seek Help

Rectal bleeding

In the past six months, there has been rectal bleeding occurring about once a month, and in the last two days, there have been three consecutive bowel movements with blood.
The shape and color of the stool are mostly normal, but there is a streak of blood dragged out by the stool in the toilet, and there is blood on the toilet paper, although the amount of bleeding is not significant (the entire toilet is not filled with blood).
The blood is bright red.
What could be the cause?

Niming, 20~29 year old female. Ask Date: 2018/04/24

Dr. Ke Fangxu reply Surgery

This situation likely indicates a higher possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on the toilet.
Increasing dietary fiber intake can also be helpful.
Warm sitz baths may assist in alleviating symptoms, and over-the-counter hemorrhoid suppositories can be used.
It is best to avoid taking stool softeners indiscriminately.
If bleeding persists, it is advisable to consult a physician for evaluation.
If necessary, a colonoscopy can also be arranged.

Reply Date: 2018/04/24

More Info

Rectal bleeding can be a concerning symptom, and it is important to understand its potential causes and when to seek medical help. Based on your description, experiencing rectal bleeding once a month for the past six months, with recent occurrences of blood on the stool and toilet paper, suggests that there may be an underlying issue that needs to be evaluated.

The bright red color of the blood you are observing typically indicates that the bleeding is coming from the lower gastrointestinal tract, such as the rectum or anus. Common causes of rectal bleeding include:
1. Hemorrhoids: Swollen blood vessels in the rectal area can cause bright red blood during bowel movements. Hemorrhoids can be internal or external and are often associated with straining during bowel movements, constipation, or prolonged sitting.

2. Anal Fissures: Small tears in the lining of the anus can occur due to passing hard stools. These fissures can cause sharp pain during bowel movements and may result in bright red blood.

3. Diverticular Disease: Diverticulosis, the presence of small pouches in the colon wall, can lead to diverticulitis, which may cause bleeding.

4. Colorectal Polyps or Cancer: While less common, polyps (growths on the colon lining) can bleed, and in some cases, they may be precursors to colorectal cancer. It is essential to rule out these possibilities, especially if you have a family history of colorectal cancer.

5. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause inflammation in the gastrointestinal tract, leading to bleeding.

6. Gastrointestinal Infections: Certain infections can cause inflammation and bleeding in the intestines.

Given that you have experienced rectal bleeding multiple times, it is crucial to seek medical attention. A healthcare provider will likely perform a thorough evaluation, which may include:
- Medical History and Physical Examination: Discussing your symptoms, medical history, and any associated symptoms (such as pain, changes in bowel habits, or weight loss) is essential.

- Digital Rectal Examination (DRE): This examination allows the doctor to check for hemorrhoids, fissures, or other abnormalities.

- Colonoscopy: This procedure involves using a flexible tube with a camera to visualize the colon and rectum. It is the gold standard for diagnosing conditions that may cause rectal bleeding, including polyps and cancer.

- Laboratory Tests: Blood tests may be ordered to check for anemia or signs of infection.

It is important not to ignore rectal bleeding, especially if it is recurrent or accompanied by other symptoms such as abdominal pain, changes in bowel habits, or weight loss. Early diagnosis and treatment can significantly improve outcomes and address any underlying conditions effectively.

In summary, while there are several potential causes for rectal bleeding, it is essential to consult a healthcare professional for a proper evaluation and diagnosis. They can guide you through the necessary tests and treatment options based on your specific situation. Remember, timely intervention is key to managing any health concerns effectively.

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