Rectal Bleeding and Pain After Bowel Movements

Blood on toilet paper after wiping can indicate several issues, such as hemorrhoids, anal fissures, or other gastrointestinal conditions?

Hello Doctor, in the past few months, I have been experiencing pain in my anus a few hours after having a bowel movement, especially after walking for a while.
There have been one or two instances where I noticed a slight trace of blood when wiping after a bowel movement, but it went away after wiping a couple of times.
I am a 20-year-old college student.
In high school, I mostly ate home-cooked meals that were relatively light, and my bowel movements were normal, typically once a day in the morning, with a well-formed shape.
However, now I eat out for lunch almost every day, and I wonder if the greasy food is affecting me.
My bowel movement frequency has increased, usually occurring after meals, and my stools have become looser and broken into several segments.
Over the past six months, there have been a few instances where I noticed some mucus when wiping after a bowel movement, but no blood.
I usually do not eat spicy food, and I am really worried about whether this could be something serious like colon cancer.
Thank you!

Tongxue, 20~29 year old female. Ask Date: 2019/05/05

Dr. Ke Fangxu reply Surgery

At the age of 20, the likelihood of developing colorectal cancer is not zero, but generally speaking, it is extremely low.
Based on your description, it seems more like irritable bowel syndrome (IBS).
It is recommended to follow a light diet and maintain a good lifestyle.
Spicy, irritating, and greasy foods should be avoided, and increasing dietary fiber intake can also be beneficial.
If symptoms persist without improvement, you may consult a physician for medication or to undergo a colonoscopy.

Reply Date: 2019/05/05

More Info

Understanding rectal bleeding and pain after bowel movements can be concerning, especially for a young adult like yourself. Based on your description, there are several potential causes for your symptoms, and it's important to address them with a comprehensive understanding of the possible underlying issues.

Firstly, the pain you experience after bowel movements could be attributed to several factors, including hemorrhoids, anal fissures, or even irritation from changes in your diet. Hemorrhoids are swollen veins in the lower rectum and anus that can cause discomfort, especially during bowel movements. They can be internal or external and may lead to symptoms such as pain, itching, and bleeding. Anal fissures, on the other hand, are small tears in the lining of the anus, often caused by passing hard stools or straining during bowel movements. These can also result in sharp pain and bleeding, particularly during or after bowel movements.

The presence of a small amount of blood on toilet paper, as you described, can be alarming, but it is not uncommon. If the blood is bright red and only appears occasionally, it is often associated with hemorrhoids or fissures rather than more serious conditions. However, any rectal bleeding should be evaluated by a healthcare professional to rule out more serious issues, including inflammatory bowel disease (IBD) or colorectal cancer, especially if you have risk factors or if the symptoms persist.

Your dietary changes may also play a significant role in your symptoms. A diet that is high in fat and low in fiber can lead to changes in bowel habits, such as increased frequency and looser stools. This can contribute to irritation of the anal area and may exacerbate existing conditions like hemorrhoids or fissures. It is advisable to incorporate more fiber-rich foods into your diet, such as fruits, vegetables, and whole grains, which can help regulate bowel movements and reduce straining.

In addition to dietary adjustments, staying well-hydrated is crucial. Drinking plenty of water can help soften stools and make them easier to pass, reducing the risk of straining and subsequent pain. Regular physical activity can also promote healthy digestion and bowel function.

If you notice mucus in your stool, it may indicate irritation or inflammation in the intestines. While occasional mucus can be normal, persistent mucus production, especially if accompanied by other symptoms like abdominal pain or changes in bowel habits, warrants further investigation.

Given your concerns about colorectal cancer, it's important to remember that while your symptoms may be distressing, cancer is relatively rare in young adults. However, if you have a family history of colorectal cancer or other risk factors, it is essential to discuss these with your healthcare provider.

In summary, while your symptoms may be related to benign conditions such as hemorrhoids or anal fissures, it is crucial to consult with a healthcare professional for a thorough evaluation. They may recommend a physical examination, and possibly a colonoscopy or other diagnostic tests, to determine the exact cause of your symptoms. In the meantime, focus on maintaining a healthy diet, staying hydrated, and avoiding straining during bowel movements. If your symptoms worsen or do not improve, seek medical attention promptly.

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