Rectal Bleeding: Symptoms, Causes, and When to Seek Help

Melena or hematochezia

On the evening of April 29th, I suddenly experienced pain in my anus while having a bowel movement, and upon inspection, I noticed blood.
The stool was hard, and I thought it was just an anal fissure.
On the morning of May 3rd, after having lunch that included corn, I noticed that my stool was somewhat dark and contained undigested corn.
Could this be a sign of colon cancer? However, I have normal bowel movements every day, although I sometimes experience constipation or incomplete digestion.
If I need to undergo testing, will it be very expensive?

Xiao Guang, 20~29 year old female. Ask Date: 2019/05/03

Dr. Chen Jiaming reply Surgery

Based on your description and age, it is most likely that you have an internal hemorrhoid that has been irritated and caused bleeding due to friction from hard stools.
It is recommended to increase your daily water intake by about 1000-1500 milliliters to help soften your stools, which can reduce mucosal damage from further friction.
Most cases can heal naturally.
However, if your symptoms persist or you are very concerned, it is advisable to consult a colorectal surgeon for further evaluation (medical costs may vary based on health insurance regulations and the specific examinations conducted at different facilities).

Reply Date: 2019/05/03

More Info

Rectal bleeding can be a concerning symptom, and understanding its potential causes, associated symptoms, and when to seek medical attention is crucial for your health. Based on your description, it seems you experienced rectal bleeding after a painful bowel movement, which could be indicative of a few different conditions.

Symptoms and Causes
1. Hemorrhoids: One of the most common causes of rectal bleeding, especially if you experienced pain during bowel movements. Hemorrhoids can be internal or external and often result from straining during bowel movements, which can lead to bleeding and discomfort.

2. Anal Fissures: As you suspected, anal fissures are small tears in the lining of the anus, often caused by passing hard stools. They can cause sharp pain and bleeding during or after bowel movements.

3. Diverticular Disease: This condition involves the formation of small pouches in the colon wall, which can become inflamed or infected, leading to bleeding.

4. Polyps or Colorectal Cancer: While less common, the presence of black stools (melena) can indicate bleeding from higher up in the digestive tract, such as the stomach or small intestine. If you have a family history of colorectal cancer or other risk factors, this could be a concern.

5. Gastrointestinal Issues: Other gastrointestinal conditions, such as inflammatory bowel disease (IBD) or infections, can also lead to rectal bleeding.

When to Seek Help
You should seek medical attention if you experience any of the following:
- Significant or persistent rectal bleeding.

- Blood in your stool that is bright red or dark (indicating possible upper gastrointestinal bleeding).

- Severe abdominal pain or cramping.

- Changes in bowel habits, such as persistent diarrhea or constipation.

- Unexplained weight loss or fatigue.

Diagnostic Tests
If you decide to see a healthcare provider, they may recommend several tests to determine the cause of your symptoms. These could include:
- Physical Examination: A thorough examination, including a digital rectal exam, can help identify hemorrhoids or fissures.

- Colonoscopy: This is a common procedure used to visualize the inside of your colon and rectum. It allows for the detection of polyps, tumors, or other abnormalities.

- Stool Tests: These tests can check for blood in the stool or infections.

Cost Considerations
The cost of diagnostic tests can vary widely based on your location, insurance coverage, and the specific tests performed. A colonoscopy can be more expensive, often ranging from several hundred to a few thousand dollars, depending on whether sedation is used and if any additional procedures (like polyp removal) are necessary. It's advisable to check with your insurance provider to understand your coverage and any out-of-pocket expenses.

Conclusion
While your symptoms could be due to benign conditions like hemorrhoids or anal fissures, it's essential to monitor your symptoms closely. If you notice any worsening or new symptoms, or if the bleeding persists, it would be prudent to consult a healthcare professional. Early diagnosis and treatment can help prevent complications and ensure better health outcomes. Remember, it's always better to err on the side of caution when it comes to your health.

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