Rectal Bleeding: Causes and Concerns After Injury - Gastroenterology and Hepatology

Rectal bleeding

Doctor, I was injured a couple of days ago and had to stay in bed for several days, which caused my stool to become very hard.
After being discharged and going home, I had a bowel movement, but there were a few drops of blood.
The color of the stool was normal.
Could this be a simple anal fissure? This is the only time I've experienced this.
Will it cause anal laxity?

123 Ren, 20~29 year old female. Ask Date: 2021/05/07

Dr. Chen Shidian reply Gastroenterology and Hepatology

Pain is often associated with anal fissures, while painless bleeding is typically due to internal hemorrhoids, which are unrelated to relaxation.
It is advisable to increase the intake of fruits and vegetables and consider using stool softeners.

Reply Date: 2021/05/07

More Info

Rectal bleeding can be concerning, especially following an injury or a period of immobility. Based on your description, it seems that you experienced hard stools after being bedridden, which can lead to straining during bowel movements. This straining can cause small tears in the lining of the anus, known as anal fissures, which are a common cause of rectal bleeding.
When you mentioned that the blood was only a few drops and that your stool color was normal, it does suggest that the bleeding might be due to a fissure rather than a more serious condition. Anal fissures typically present with sharp pain during bowel movements and may cause slight bleeding. They can occur when stools are hard and require significant effort to pass, which is common after periods of constipation or immobility.

Regarding your concern about anal laxity, it is important to note that a single episode of anal fissure or minor rectal bleeding is unlikely to cause long-term changes in anal tone or function. However, if you experience recurrent fissures or ongoing straining, it could potentially lead to issues such as anal sphincter dysfunction over time.
To help prevent further issues and promote healing, consider the following recommendations:
1. Dietary Changes: Increase your fiber intake to help soften your stools. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Additionally, staying well-hydrated by drinking plenty of water can help prevent constipation.

2. Stool Softeners: Over-the-counter stool softeners can be beneficial if you continue to experience hard stools. These can help make bowel movements easier and reduce the risk of further fissures.

3. Avoid Straining: When you feel the urge to have a bowel movement, try to go as soon as possible. Avoid straining, as this can worsen fissures or lead to new ones.

4. Warm Baths: Taking warm baths can help soothe the anal area and promote relaxation, which may aid in healing.

5. Consult a Healthcare Provider: If you notice persistent bleeding, severe pain, or if the fissure does not heal within a few weeks, it is advisable to consult a healthcare provider. They can assess your condition and recommend appropriate treatments, which may include topical medications or, in rare cases, surgical options for chronic fissures.

In summary, while your symptoms may indicate a simple anal fissure, it is essential to monitor your condition. If you experience any worsening symptoms or have ongoing concerns, seeking medical advice is always a prudent choice. Taking proactive steps to manage your bowel health can help prevent future issues and promote overall well-being.

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