Rectal Bleeding: When to Worry About Hemorrhoids and More

Rectal bleeding

Hello, doctor.
I had hemorrhoids last year, and occasionally I would have blood in my stool, but it usually returned to normal after a few days.
However, since the beginning of this year, I have been experiencing continuous bleeding.
I went for an examination, and the doctor said it was internal hemorrhoids.
I have been taking medication for a week and using suppositories, but my condition has not improved, and I still have bleeding.
The blood is bright red, and there is also some mucus mixed with the blood in my stool.
I mentioned this to the doctor, but he said the likelihood of hemorrhoids is higher.
I typically have a bowel movement every 2 to 3 days, I often stay up late, and I prefer salty foods.
My appetite is good, but I have lost a kilogram compared to before.
Occasionally, I experience abdominal pain, but I used to have this occasionally as well.
I have read a lot online and am a bit worried that it could be something like cancer...

Niming, 20~29 year old female. Ask Date: 2019/01/24

Dr. Ke Fangxu reply Surgery

At the age of 22, the likelihood of developing colorectal cancer is not zero, but it is generally very low.
Based on your description, it seems more like hemorrhoids.
It is recommended to maintain a light diet and a good lifestyle.
Spicy, irritating, and greasy foods should be avoided, and increasing dietary fiber intake can also be helpful.
If symptoms persist without improvement, you may want to consult a physician for medication or to undergo a colonoscopy.

Reply Date: 2019/01/24

More Info

Rectal bleeding can be a concerning symptom, and it’s important to understand the potential causes and when to seek further medical evaluation. In your case, you have a history of hemorrhoids and have been experiencing persistent rectal bleeding since the beginning of the year. While hemorrhoids can certainly cause bright red blood during bowel movements, especially if they are inflamed or thrombosed, the persistence and nature of your symptoms warrant a closer look.

Understanding Hemorrhoids and Rectal Bleeding
Hemorrhoids are swollen veins in the lower rectum or anus that can cause discomfort, itching, and bleeding. The blood from hemorrhoids is typically bright red and may appear on the toilet paper or in the toilet bowl. However, if you are experiencing ongoing bleeding, especially if it is accompanied by other symptoms such as abdominal pain, changes in bowel habits, or weight loss, it is crucial to consider other potential causes.

When to Worry
1. Duration and Frequency of Bleeding: If the bleeding has been persistent for several weeks, this is a red flag. While hemorrhoids can cause intermittent bleeding, continuous bleeding should be evaluated further.

2. Accompanying Symptoms: You mentioned experiencing abdominal pain and unintentional weight loss. These symptoms, combined with persistent rectal bleeding, could indicate a more serious condition that requires further investigation.

3. Change in Bowel Habits: If you notice changes in your bowel habits, such as diarrhea or constipation, or if you see mucus or blood mixed with your stool, it’s important to discuss these changes with your doctor.

4. Age and Risk Factors: Depending on your age and family history, certain gastrointestinal conditions, including colorectal cancer, may be more likely. It’s essential to take any new or worsening symptoms seriously.

Next Steps
Given your situation, it would be prudent to follow up with your healthcare provider. Here are some recommendations:
- Seek a Second Opinion: If you feel your concerns are not being adequately addressed, consider seeking a second opinion from a gastroenterologist. They can perform a more thorough evaluation, which may include a colonoscopy to visualize the colon and rectum directly.

- Diagnostic Tests: Your doctor may recommend tests such as a colonoscopy, flexible sigmoidoscopy, or imaging studies to rule out other conditions, including inflammatory bowel disease, polyps, or malignancies.

- Lifestyle Modifications: While you wait for further evaluation, consider making dietary changes to increase fiber intake, stay hydrated, and avoid straining during bowel movements. These changes can help alleviate symptoms associated with hemorrhoids.

- Monitor Symptoms: Keep a detailed record of your symptoms, including the frequency and amount of bleeding, any changes in bowel habits, and any other associated symptoms. This information can be valuable for your healthcare provider.

Conclusion
While hemorrhoids are a common cause of rectal bleeding, the persistence of your symptoms and the presence of additional concerning signs necessitate further evaluation. It’s essential to communicate openly with your healthcare provider about your concerns and advocate for the necessary tests to rule out more serious conditions. Early detection and intervention can significantly improve outcomes, so don’t hesitate to seek the care you need.

Similar Q&A

Understanding Rectal Bleeding: When to Seek Further Evaluation

Dr. Chen: Hello, I would like to ask you about external hemorrhoids that have not been painful but are associated with frequent bright red rectal bleeding and occasional dark red blood clots (similar to menstrual blood). Additionally, there is sometimes bleeding when passing gas....

Dr. Chen Zhiping reply Gastroenterology and Hepatology
Hello, you can schedule a rectal (or colon) examination with a gastroenterologist or a colorectal surgeon to rule out other serious conditions (such as colitis, tumors, etc.). If no other issues are found and hemorrhoids are frequently bleeding, it is still recommended to increas...

Understanding Rectal Bleeding: Causes and When to Seek Help

I have been experiencing rectal bleeding for the past week or two. Initially, I noticed bright red blood on the toilet paper when wiping. In the last couple of days, I have seen drops of blood while sitting on the toilet, and today, my bowel movement was accompanied by a signific...

Dr. Chen Jiaming reply Surgery
Based on your description, the likelihood of this condition being caused by hemorrhoids (external hemorrhoids) is higher; however, the possibility of cancer cannot be completely ruled out. It is recommended to first consult a colorectal surgeon or a gastroenterologist to further ...

Understanding Rectal Bleeding: Is It Hemorrhoids or Something Else?

If a 63-year-old woman experiences rectal bleeding after wiping, it is important to determine whether it is due to hemorrhoids or another cause. Since this is her first occurrence, and considering that she had a colonoscopy last month where the doctor noted ulcerative bleeding in...

Dr. Zhang Shuhao reply Surgery
For the situation of bleeding when wiping, the following recommendations are suggested: 1. Bleeding characteristics: It is important to observe the color, amount, and nature of the bleeding. If the blood is bright red, it is usually associated with hemorrhoids; if the color is da...

Understanding Rectal Bleeding: Causes, Concerns, and When to Seek Help

Hello doctor, I have a problem with hemorrhoids and a habit of staying up late. My diet is light with little meat, and I occasionally eat fried foods. Sometimes when I eat out, I experience constipation. In the past month or two, I've noticed that after having a bowel moveme...

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 int...