Rectal Bleeding and Blood Clots: Causes and Solutions

Blood in stool with clots?

Hello doctor, I occasionally notice blood in my stool, and I experience mild constipation with dry stools, having a bowel movement every 2-3 days.
Before my menstrual period, the constipation worsens, and I may go 4-5 days without a bowel movement.
The bleeding is more severe and painful when using a squat toilet.
The stool consistency varies; sometimes it is hard and bulky, other times it is pellet-like, and occasionally it appears as golden-yellow strips.
There is bleeding, sometimes presenting as bright red drops, and recently I have noticed blood clots resembling menstrual blood, which can also adhere to the stool.
Additionally, I sometimes experience sudden, painful swelling in the anal area, which can be intense enough to make me tremble and feel restless.
The discomfort in the anal area worsens during my menstrual period.
Seeing blood is very frightening.
Thank you, doctor!

Chen Tongxue, 20~29 year old female. Ask Date: 2019/05/09

Dr. Chen Jiaming reply Surgery

Your issue arises from constipation, which leads to harder stools that cause friction against the internal hemorrhoids (resulting from long-term constipation) and subsequently results in bleeding.
The solution is to "soften the stool" to reduce friction, allowing the mucosa to heal naturally.
To soften the stool, I generally recommend that young individuals increase their daily water intake by an additional 1500 milliliters (about 500 milliliters with each meal, including drinks and soups).
This approach usually yields results.
If stool softening is still not achieved, then considering the use of stool softeners (medications) may be necessary.
Additionally, increasing the intake of fruits and vegetables at this time may not help in softening the stool and could even have the opposite effect (resulting in more stool and more severe bleeding).

Reply Date: 2019/05/09

More Info

Rectal bleeding can be a concerning symptom, and it's important to understand its potential causes and solutions. Based on your description, it seems that you are experiencing rectal bleeding associated with constipation, hard stools, and significant pain during bowel movements. The presence of bright red blood and blood clots can indicate several underlying issues, and it’s crucial to address these symptoms with a healthcare professional.

Possible Causes of Rectal Bleeding
1. Hemorrhoids: One of the most common causes of rectal bleeding, especially if the blood is bright red and appears on the surface of the stool or on toilet paper. Hemorrhoids can be internal or external and are often associated with straining during bowel movements, which can occur with constipation.

2. Anal Fissures: These are small tears in the lining of the anus that can occur due to passing hard stools. They can cause sharp pain and bleeding during bowel movements, often described as a "tearing" sensation.

3. Diverticular Disease: Diverticulosis can lead to diverticulitis, which may cause bleeding. This condition involves the formation of small pouches in the colon wall that can become inflamed or infected.

4. Polyps or Colorectal Cancer: While less common, polyps can bleed, and in some cases, they can be precursors to colorectal cancer. The presence of blood clots and changes in bowel habits warrant further investigation.

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

Solutions and Recommendations
1. Dietary Changes: Increasing your fiber intake can help soften stools and reduce straining during bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Additionally, staying well-hydrated is essential.

2. Over-the-Counter Remedies: Stool softeners or mild laxatives may help alleviate constipation. However, it's important to use these under the guidance of a healthcare professional.

3. Warm Sitz Baths: Taking warm baths can help soothe anal pain and discomfort associated with hemorrhoids or fissures.

4. Avoid Straining: Try to avoid prolonged sitting on the toilet and straining during bowel movements, as this can exacerbate hemorrhoids and fissures.

5. Consult a Healthcare Professional: Given the severity of your symptoms, including the presence of blood clots and significant pain, it is crucial to seek medical attention. A healthcare provider may recommend a physical examination, and possibly a colonoscopy, to rule out serious conditions such as colorectal cancer or significant gastrointestinal issues.

6. Monitor Symptoms: Keep track of your symptoms, including the frequency and amount of bleeding, any changes in bowel habits, and any associated pain. This information will be helpful for your healthcare provider.

Conclusion
While rectal bleeding can be alarming, many causes are treatable, especially when addressed early. Your symptoms suggest that you may be dealing with hemorrhoids or anal fissures, but it is essential to rule out more serious conditions. Please make an appointment with a healthcare provider as soon as possible to discuss your symptoms in detail and receive appropriate care. Remember, early intervention can lead to better outcomes and relief from discomfort.

Similar Q&A

Understanding Rectal Bleeding and Blood Clots: Causes and Solutions

Hello Dr. Hou, I have been suffering from hemorrhoids since my senior year in high school, and I typically have a bowel movement every 2 to 5 days. Due to severe constipation, I often use enemas. About three years ago, I started regularly taking San Huang pills produced by Shun T...

Dr. Hou Yongji reply Surgery
Hello Lucia: Since you are currently abroad and seeking medical care is inconvenient, here are some suggestions you can follow for now. 1. Dietary Recommendations: Increase your intake of fluids, vegetables, and fruits while reducing the consumption of irritant foods such as sp...

Understanding Rectal Bleeding: Causes, Concerns, and Care Tips

Hello, doctor. In January, I had a positive fecal occult blood test and went to the hospital for a colonoscopy. I recently reviewed the report, which indicates rectal bleeding (the biopsy report showed no issues). I need to undergo another sigmoidoscopy in a month. The doctor pre...

Dr. Zhang Shuhao reply Surgery
Common causes of rectal bleeding include rectal polyps, anal conditions (such as hemorrhoids or anal fissures), rectal inflammation (such as ulcerative colitis or ischemic colitis), and rectal cancer. The doctor has prescribed laxatives and stool softeners, likely to alleviate yo...

Understanding Rectal Bleeding: Causes, Symptoms, and Treatment Options

Recently, I have been experiencing bleeding from both my anus and rectum, regardless of whether it's a bowel movement or not. The blood is dark red and there are also small blood clots. I am also prone to diarrhea. Thank you for your response, doctor.

Dr. He Zhenming reply Surgery
It is most likely that the anal fissure is caused by hemorrhoids. Please see a colorectal clinic. He Zhenming.

Understanding Unexplained Rectal Bleeding: Causes and Solutions

Dr. Lin, I have been experiencing significant rectal bleeding during bowel movements, with fresh blood that sprays out, amounting to over ten cc.

Dr. Lin Hongmao reply Surgery
Hello, There are many causes of rectal bleeding, including common conditions such as hemorrhoids, anal fissures, and colitis, as well as less common issues like diverticulosis, vascular lesions, and tumors. However, based on your description and the sudden onset without pain, i...