Bleeding During Bowel Movements: Causes and Solutions

Bleeding during wiping after a bowel movement?

Hello Doctor: Recently, due to taking antibiotics for a cold, I have been experiencing frequent diarrhea, about five times a day, which has led to significant pain in my anus.
Today, I even noticed some bleeding.
After having a bowel movement, I feel a pulsating sensation in the blood vessels around my anus.
What improvements should I consider?

QQQ, 20~29 year old female. Ask Date: 2020/04/29

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 causes are often constipation or diarrhea.
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 over-the-counter hemorrhoid suppositories for use.
If the symptoms persist without improvement, it is advisable to consult a physician for further evaluation.

Reply Date: 2020/04/29

More Info

Bleeding during bowel movements can be alarming, and it's essential to understand the potential causes and appropriate solutions. Based on your description, it seems that your recent experience with diarrhea, possibly due to antibiotic use, has led to irritation and inflammation around the anal area, which can result in bleeding. Here’s a comprehensive overview of possible causes and recommended actions.

Possible Causes of Bleeding During Bowel Movements
1. Hemorrhoids: One of the most common causes of rectal bleeding is hemorrhoids, which are swollen veins in the lower rectum or anus. They can become inflamed due to straining during bowel movements, especially if you are experiencing diarrhea or constipation.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools or straining. Given your recent diarrhea, the frequent bowel movements can lead to irritation and fissures, resulting in bleeding.

3. Infections or Inflammatory Conditions: Conditions such as inflammatory bowel disease (IBD), including Crohn's disease or ulcerative colitis, can cause bleeding. Antibiotics can disrupt the normal gut flora, leading to gastrointestinal issues.

4. Diverticular Disease: Diverticulitis, which occurs when diverticula (small pouches that can form in the walls of the colon) become inflamed or infected, can also lead to bleeding.

5. Other Causes: Less commonly, bleeding can be caused by colorectal polyps or cancer, especially if there are other concerning symptoms like weight loss or changes in bowel habits.

Recommended Solutions
1. Increase Fiber Intake: To help regulate your bowel movements, consider increasing your dietary fiber. This can help form softer stools and reduce straining. Foods rich in fiber include fruits, vegetables, whole grains, and legumes.

2. Stay Hydrated: Ensure you are drinking plenty of fluids, especially water, to help prevent dehydration and support healthy bowel function.

3. Avoid Straining: When you feel the urge to go, try not to delay. Straining can exacerbate hemorrhoids and fissures. If you experience pain, consider using a stool softener or a mild laxative after consulting with a healthcare provider.

4. Warm Sitz Baths: Taking warm sitz baths can help soothe the anal area and promote healing if you have fissures or hemorrhoids. Soaking for 10-15 minutes several times a day can provide relief.

5. Topical Treatments: Over-the-counter creams or ointments designed for hemorrhoids can help reduce inflammation and discomfort. These may contain hydrocortisone or witch hazel.

6. Monitor Symptoms: Keep track of your symptoms, including the frequency and amount of bleeding, as well as any other changes in your bowel habits. If bleeding persists or worsens, or if you experience severe pain, it’s crucial to seek medical attention.

7. Consult a Healthcare Provider: Given your symptoms, especially the bleeding and pain, it’s advisable to consult a healthcare professional. They may recommend a physical examination, and if necessary, further investigations such as a colonoscopy to rule out more serious conditions.

Conclusion
While occasional bleeding during bowel movements can be due to benign causes like hemorrhoids or anal fissures, it’s essential to pay attention to your body and seek medical advice if symptoms persist. Maintaining a healthy diet, staying hydrated, and practicing good bowel habits can significantly improve your condition. If you have any concerns or if your symptoms escalate, do not hesitate to reach out to a healthcare provider for a thorough evaluation and tailored treatment plan.

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