Painful Bowel Movements: Causes and Concerns

Bowel movement issues?

Hello doctor, for the past few months, I have been experiencing pain during bowel movements, and there is a significant amount of bleeding afterward.
There is also blood on the toilet paper when I wipe, and my anus feels sore.
My stools are often quite large and sometimes hard.
In the past, I would also experience bleeding if my stools were too large.
This situation has persisted for quite a while; even when my stools are not very thick, I still experience pain and bleeding.
My bowel habits are about once every 1 to 2 days, but sometimes when I travel, I become constipated, and afterward, my stools become very hard and large.
I am very concerned that this situation could be a sign of colorectal cancer or another underlying condition, or could it be hemorrhoids?

Miss Lin, 20~29 year old female. Ask Date: 2020/01/20

Dr. Ke Fangxu reply Surgery

At the age of 22, the likelihood of developing colorectal cancer is not zero, but generally speaking, it is very, very low.
Based on your description, it seems more like bleeding from hemorrhoids combined with pain from anal fissures.
It is advisable to maintain a light diet and good lifestyle habits, while avoiding spicy, irritating, and greasy foods.
Increasing your intake of dietary fiber from plant sources can also be beneficial.
If symptoms persist without improvement, you may want to consult a physician for medication or to undergo a colonoscopy.

Reply Date: 2020/01/20

More Info

Experiencing painful bowel movements accompanied by significant bleeding can be concerning and warrants a thorough evaluation. Based on the symptoms you've described—pain during bowel movements, blood on toilet paper, and the presence of hard, large stools—there are several potential causes to consider.

Possible Causes
1. Hemorrhoids: One of the most common causes of pain and bleeding during bowel movements is hemorrhoids. These are swollen veins in the rectal area that can become inflamed and painful, especially when passing hard stools. The bleeding is usually bright red and can occur during or after a bowel movement.

2. Anal Fissures: An anal fissure is a small tear in the lining of the anus, often caused by passing hard or large stools. This condition can lead to sharp pain during bowel movements and may also cause bleeding. The pain can be severe and may persist even after the bowel movement.

3. Constipation: Chronic constipation can lead to the formation of hard stools, which can exacerbate both hemorrhoids and anal fissures. If you are experiencing infrequent bowel movements (1-2 days), it may contribute to the hardness of your stools, making them more difficult to pass.

4. Diverticular Disease: Diverticulosis and diverticulitis can also cause discomfort and changes in bowel habits. Diverticulosis involves the formation of small pouches in the colon wall, which can become inflamed or infected, leading to pain and changes in bowel habits.

5. Colorectal Conditions: While less common, conditions such as colorectal polyps or colorectal cancer can present with similar symptoms, particularly in individuals with risk factors such as age, family history, or changes in bowel habits. However, these conditions typically present with other symptoms as well.

Concerns About Colorectal Cancer
Your concern about colorectal cancer is understandable, especially given the symptoms of pain and bleeding. While these symptoms can be associated with more benign conditions like hemorrhoids or fissures, it is crucial to rule out serious conditions. Colorectal cancer can present with changes in bowel habits, rectal bleeding, and abdominal pain, particularly in individuals over the age of 50 or those with a family history of colorectal cancer.

Recommendations
1. Consult a Healthcare Provider: It is essential to consult a healthcare provider for a thorough evaluation. They may recommend a physical examination, including a digital rectal exam, and possibly a colonoscopy to visualize the colon and rectum directly. This will help rule out any serious conditions.

2. Dietary Changes: Increasing fiber intake can help soften stools and promote regular bowel movements. Aim for a diet rich in fruits, vegetables, whole grains, and adequate hydration. This can help alleviate constipation and reduce the strain during bowel movements.

3. Over-the-Counter Treatments: Depending on the diagnosis, over-the-counter treatments such as stool softeners, fiber supplements, or topical treatments for hemorrhoids may provide relief.

4. Avoid Straining: Straining during bowel movements can worsen hemorrhoids and fissures. If you feel the urge to go, try to respond promptly rather than delaying, which can lead to harder stools.

5. Monitor Symptoms: Keep track of your symptoms, including the frequency of bowel movements, the consistency of stools, and any changes in pain or bleeding. This information can be valuable for your healthcare provider.

Conclusion
While your symptoms may be indicative of common conditions such as hemorrhoids or anal fissures, it is crucial to seek medical attention to rule out more serious issues, including colorectal cancer. Early diagnosis and treatment can significantly improve outcomes and quality of life. Please prioritize scheduling an appointment with your healthcare provider to discuss your symptoms in detail.

Similar Q&A

Understanding Painful Bowel Movements: When to Seek Medical Attention

Hello doctor, I have been experiencing sharp pain and bleeding during bowel movements recently. I would like to know if this could be a sign of a serious illness. Additionally, I have been feeling some gastrointestinal discomfort and have had slight difficulty breathing. I'm...

Dr. Ke Fangxu reply Surgery
Based on your description, it seems to be an anal fissure. The typical symptoms include pain during bowel movements accompanied by slight bleeding. The primary cause of anal fissures is usually hard stools; however, diarrhea, frequent bowel movements, or prolonged straining can a...

Understanding Painful Bowel Movements: Causes and Concerns

Hello doctor, I would like to ask you about something. For the past two days, I have experienced significant pain in my rectum during bowel movements. The first time I wiped, there was bleeding, but the second time there wasn't. I'm wondering if this could be due to not...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Painful bowel movements accompanied by bleeding are most commonly caused by hemorrhoids or anal fissures. It is advisable to pay attention to hydration and fiber intake, and to develop good bowel habits. If there is frequent pain or bleeding at the anal area, it is recommended to...

Understanding Bowel Issues: Causes and Solutions for Discomfort

Hello Dr. Lin, for the past four days, I have been experiencing a sensation of incomplete bowel evacuation. My usual frequency of 1-2 bowel movements has increased to about 3-4 times a day, with each bowel movement producing less stool than usual. About two hours after a bowel mo...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello: Abnormal bowel movements may be caused by factors such as recent dietary changes, gastrointestinal inflammation, or irritable bowel syndrome. It is advisable to pay attention to your diet and avoid spicy, overly acidic, overly sweet, greasy foods, and those containing caff...

Understanding Anal Pain During Bowel Movements: Causes and Solutions

Current Condition: Since around the age of 20, I have experienced a slight stabbing pain during bowel movements, located at the 12 o'clock position, which has gradually worsened over the years. In recent years, the pain has become sharp, akin to being cut with a knife (clenc...

Dr. Ke Fangxu reply Surgery
1. Cannot be ruled out. 2. A personal examination is necessary to make a determination; online consultations may not be conclusive. 3. It is likely not primarily related to body size. 4. First, consider whether surgery can truly address your concerns; if the surgery exacerbates t...