Blood on Toilet Paper After Bowel Movement: Is It Hemorrhoids?

Blood on toilet paper after a bowel movement?

Recently, due to the hot weather and excessive sweating with insufficient water intake, I have been experiencing difficulty in bowel movements.
My stools are hard and pellet-like, and when I exert a lot of effort, I sometimes pass a larger stool.
Occasionally, I notice blood on the toilet paper after wiping (only twice).
After bowel movements, my anus feels swollen, but it returns to normal after a while.
I usually enjoy running, averaging about 40-50 kilometers a week.
Today, my stool was coffee-colored, but the front part was hard and black.
After cleaning up, I did see blood on the toilet paper, but subsequent wiping did not show any blood.
Could this be hemorrhoids?

Zhang Zhiwei, 40~49 year old female. Ask Date: 2021/06/29

Dr. Ke Fangxu reply Surgery

This situation likely indicates a higher possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a major concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Increasing dietary fiber intake can also be beneficial.
Warm sitz baths may help alleviate symptoms, and over-the-counter hemorrhoidal suppositories can be used.
It is best to avoid taking stool softeners indiscriminately.
If bleeding persists, it is advisable to consult a physician.
If necessary, a colonoscopy can also be arranged.

Reply Date: 2021/06/29

More Info

Seeing blood on toilet paper after a bowel movement can understandably cause concern, and it’s important to consider various potential causes. Based on your description, it sounds like you may be experiencing symptoms consistent with hemorrhoids, particularly given the hard stools and the straining you mentioned.
Hemorrhoids are swollen veins in the lower rectum or anus that can cause discomfort, bleeding, and sometimes a feeling of fullness or swelling. They can be classified as either internal or external. Internal hemorrhoids are usually painless but can bleed, while external hemorrhoids can be painful and may cause swelling or irritation. The fact that you have noticed blood only occasionally and that it coincides with hard stools suggests that straining during bowel movements could be contributing to the issue.

The color of the blood you observed is also significant. Bright red blood typically indicates that the source of the bleeding is near the anus, which aligns with hemorrhoids or anal fissures (small tears in the lining of the anus). On the other hand, darker blood or black stools can indicate bleeding higher up in the gastrointestinal tract, which may require further investigation.

Your mention of experiencing hard, pellet-like stools suggests that you may be dealing with constipation. This can be exacerbated by inadequate fluid intake, especially in hot weather when you may be sweating more and not replenishing fluids adequately. Hard stools can lead to straining during bowel movements, which can, in turn, lead to the development of hemorrhoids or anal fissures.
To address your symptoms, consider the following recommendations:
1. Increase Fluid Intake: Aim to drink plenty of water throughout the day. Proper hydration can help soften your stools and make them easier to pass.

2. Dietary Adjustments: Incorporate more fiber into your diet through fruits, vegetables, whole grains, and legumes. Fiber helps to bulk up stools and can prevent constipation.

3. Regular Bowel Habits: Try to establish a regular schedule for bowel movements and avoid straining. If you feel the urge to go, don’t delay.

4. Physical Activity: While you are already active with running, ensure that you are also incorporating exercises that promote core strength and pelvic floor health, which can aid in bowel function.

5. Over-the-Counter Treatments: If you suspect hemorrhoids, topical treatments or suppositories may provide relief from discomfort and help with healing.

6. Consult a Healthcare Provider: If the bleeding persists, increases in frequency, or if you experience significant pain, it’s important to consult a healthcare provider. They may recommend a physical examination or further diagnostic tests, such as a colonoscopy, to rule out other potential issues.

In summary, while your symptoms may suggest hemorrhoids, it is crucial to monitor your condition and make lifestyle adjustments to alleviate constipation. If symptoms persist or worsen, seeking medical advice is the best course of action to ensure proper diagnosis and treatment.

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