Rectal Bleeding: Causes, Concerns, and Treatment Options

Q: Rectal Bleeding: Causes, Concerns, and Treatment Options

Answer： It is likely just hemorrhoids with mild bleeding. <br>During this period, it is recommended to avoid constipation and shorten the time spent on bowel movements. <br>Increasing dietary fiber intake can also be helpful. <br>Warm sitz baths should aid in alleviating symptoms

Internal hemorrhoidal bleeding

Hello doctor, occasionally I notice mucus in my stool, and sometimes there is a bit of blood in the mucus.
Recently, I had more blood in my stool, so I underwent a colonoscopy.
The doctor said everything was fine, only some hemorrhoids were found.
I asked if they were internal or external hemorrhoids, and he said they were mixed.
I then inquired if the blood in my stool was related to the hemorrhoids, and the doctor replied that it likely was.
After the colonoscopy, I haven't seen blood in my stool for the past few days, but previously, I occasionally felt discomfort in my anus after bowel movements.
Therefore, I bought a hemorrhoid cream and used the applicator to insert the cream into my rectum before bed.
The next morning, my stool had mucus mixed with the cream, and there was some blood in the mucus.
Could this be caused by the cream? I find it very distressing; just seeing blood in my stool or mucus with blood makes me feel anxious, even though the colonoscopy showed no issues.

CC, 40~49 year old female. Ask Date: 2020/03/15

Dr. Ke Fangxu reply Surgery

Answer: It is likely just hemorrhoids with mild bleeding.
During this period, it is recommended to avoid constipation and shorten the time spent on bowel movements.
Increasing dietary fiber intake can also be helpful.
Warm sitz baths should aid in alleviating symptoms.
You can also purchase hemorrhoid suppositories at the pharmacy.
It is best not to take stool softeners indiscriminately.
If bleeding persists, it is advisable to consult a physician for evaluation.

Reply Date: 2020/03/15

More Info

Rectal bleeding can be a concerning symptom, and it’s understandable that you feel anxious about it, especially after experiencing blood in your stool. Based on your description, it seems that you have undergone a colonoscopy, which is a crucial step in diagnosing the underlying causes of rectal bleeding. The fact that your doctor found only hemorrhoids (痔瘡) and no other significant issues is reassuring, but it does not eliminate the need for ongoing observation and management.

Hemorrhoids, whether internal or external, can indeed cause bleeding, especially during bowel movements. The presence of blood mixed with mucus can be attributed to the irritation and inflammation of the hemorrhoids. When you apply topical treatments like the ointment you mentioned, it can sometimes lead to temporary irritation or a reaction that might cause additional mucus production or slight bleeding. This is not uncommon, especially if the ointment is applied directly to the affected area.

Here are some important considerations and recommendations for managing your symptoms and concerns:
1. Monitor Symptoms: Keep a close eye on your symptoms. If the bleeding persists, increases, or is accompanied by other symptoms such as severe pain, changes in bowel habits, or weight loss, you should seek medical attention promptly.

2. Dietary Adjustments: Ensure that you are consuming a high-fiber diet, which can help soften stools and reduce straining during bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying well-hydrated is also essential.

3. Avoid Straining: Straining during bowel movements can exacerbate hemorrhoids and lead to further bleeding. If you feel the urge to go, try not to delay it, and consider using a stool softener if necessary.

4. Topical Treatments: While topical treatments can provide relief, be cautious about overusing them. If you notice that the ointment is causing irritation or worsening your symptoms, it may be worth discussing alternative treatments with your healthcare provider.

5. Follow-Up Care: Since you have already had a colonoscopy, it’s essential to maintain regular follow-up appointments with your healthcare provider. They can monitor your condition and suggest further interventions if necessary.

6. Stress Management: Anxiety about rectal bleeding can create a cycle of stress that may worsen your symptoms. Consider relaxation techniques such as deep breathing, meditation, or gentle exercise to help manage your stress levels.

7. Seek a Second Opinion: If you continue to feel uncertain about your diagnosis or treatment plan, it’s perfectly reasonable to seek a second opinion from another gastroenterologist. They can provide additional insights or alternative treatment options.

In summary, while the presence of blood and mucus can be alarming, it is often manageable with appropriate lifestyle changes and medical care. Since your colonoscopy did not reveal any serious conditions, focusing on symptom management and regular monitoring is key. If you have any further concerns or if your symptoms change, do not hesitate to reach out to your healthcare provider for guidance.

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