Blood in Stool: Painful Bowel Movements and Causes

Blood in the stool?

Yesterday afternoon, I experienced severe pain before having a bowel movement.
It wasn't abdominal pain; it felt like a cramping pain, and I couldn't pinpoint where it was coming from.
After I had a bowel movement, there was some bleeding.
The stool was somewhat constipated in shape, but later that evening, I had another bowel movement without any bleeding.
The next day, there was also no bleeding.
I typically have bowel movements once or twice a week.
Last week, during a bowel movement, I experienced excruciating pain and noticed a small amount of blood, but it wasn't as much as this week.
I usually drink over 2500 milliliters of water daily.

yu, 10~19 year old female. Ask Date: 2020/04/11

Dr. Ke Fangxu reply Surgery

Based on your description, it seems more like the typical symptoms of an anal fissure, which include pain during bowel movements accompanied by slight bleeding.
The common cause is often constipation.
The fundamental treatment is to improve bowel habits, along with warm sitz baths.
Warm sitz baths can help alleviate pain, maintain cleanliness, and promote blood circulation.
You can also purchase hemorrhoid suppositories over the counter for use.
If symptoms persist without improvement, it is advisable to consult a physician for further evaluation.

Reply Date: 2020/04/11

More Info

Experiencing blood in your stool, especially accompanied by painful bowel movements, can be concerning and warrants a thorough understanding of potential causes and appropriate actions to take. Based on your description, it seems that you are experiencing significant discomfort during bowel movements, which may be associated with constipation, and you have noticed blood in your stool on multiple occasions.

Possible Causes
1. Hemorrhoids: One of the most common causes of blood in the stool, especially if the blood is bright red, is hemorrhoids. These are swollen veins in the lower rectum or anus that can cause pain and bleeding during bowel movements.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain during and after bowel movements, and bleeding may occur.

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

4. Inflammatory Bowel Disease (IBD): Conditions such as Crohn's disease or ulcerative colitis can cause inflammation in the gastrointestinal tract, leading to symptoms like abdominal pain, diarrhea, and blood in the stool.

5. Colon Polyps or Cancer: While less common, polyps or colorectal cancer can also present with blood in the stool, especially in older adults or those with a family history of colorectal cancer.

6. Infections: Certain infections can cause gastrointestinal symptoms, including diarrhea and blood in the stool.

Recommended Actions
1. Consult a Healthcare Provider: Given the symptoms you are experiencing, it is crucial to consult a healthcare provider for a thorough evaluation. They may recommend a physical examination, a review of your medical history, and possibly diagnostic tests such as a colonoscopy or imaging studies to determine the underlying cause.

2. Dietary Adjustments: While you mentioned drinking over 2500 ml of water daily, it may also be beneficial to increase your intake of dietary fiber. Foods rich in fiber, such as fruits, vegetables, whole grains, and legumes, can help soften stool and promote regular bowel movements. Consider consulting a nutritionist for personalized dietary advice.

3. Over-the-Counter Remedies: If constipation is a significant issue, over-the-counter laxatives or stool softeners may provide relief. However, these should be used sparingly and under the guidance of a healthcare provider.

4. Avoid Straining: Straining during bowel movements can exacerbate hemorrhoids and anal fissures. If you feel the urge to go, try to respond promptly rather than delaying.

5. Monitor Symptoms: Keep a record of your bowel habits, including the frequency, consistency, and any associated pain or bleeding. This information can be valuable for your healthcare provider in diagnosing the issue.

6. Follow-Up: If you experience worsening symptoms, such as increased pain, persistent bleeding, or changes in bowel habits, seek medical attention promptly.

Conclusion
Blood in the stool and painful bowel movements can stem from various causes, ranging from benign conditions like hemorrhoids to more serious issues like IBD or cancer. It is essential to seek medical evaluation to determine the exact cause and receive appropriate treatment. In the meantime, focus on dietary changes, hydration, and avoiding straining during bowel movements to help alleviate your symptoms. Remember, early intervention can lead to better outcomes, so do not hesitate to reach out to a healthcare professional.

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