Rectal Bleeding: Causes and When to Seek Help

Q: Rectal Bleeding: Causes and When to Seek Help

Hello： Your symptoms seem more like an anal fissure, so there is no need to worry too much. <br>It is recommended to consult a colorectal specialist for an anoscopy, which can provide an immediate diagnosis of the underlying cause!

Bowel movement and rectal bleeding issues?

For the past few months, after bowel movements, I have repeatedly noticed blood on the toilet paper, although it is not a large amount—at most the size of a thumbnail, and most of the time just small dots, about the size of sesame seeds.
Sometimes it disappears for 4-5 days, then reappears, continuing this cycle.
My stools are generally of normal size, with only occasional instances, about once a month, where they are as thick as a thumb, but they usually return to being about two fingers wide.
I have bowel movements 2 to 3 times a day.
Sometimes, after a bowel movement, I experience a slight stinging sensation in the anal area that lasts for about 2 minutes.
Today, I felt a slight sting when I tightened my anal muscles, and I also feel like there is something at the anal opening.
I looked online and am really scared that it could be rectal cancer or anal cancer...
Could you please help me understand what this situation might be? I am constantly worried about whether it is cancer.
No close relatives have had colon cancer; my grandfather is a survivor of stomach cancer, and my mother is a survivor of breast cancer.
I had a fecal occult blood test at the end of May, which was negative, and no blood was detected at that time (I did not have any bleeding issues then).

Jiao lü de ren, 20~29 year old female. Ask Date: 2021/09/25

Dr. Chen Mingzhi reply Surgery

Hello: Your symptoms seem more like an anal fissure, so there is no need to worry too much.
It is recommended to consult a colorectal specialist for an anoscopy, which can provide an immediate diagnosis of the underlying cause!

Reply Date: 2021/09/25

More Info

Rectal bleeding can be a concerning symptom, and your description suggests that you are experiencing intermittent bleeding after bowel movements. The blood you see on toilet paper, although small in quantity, can understandably cause anxiety, especially with fears of serious conditions like colorectal or anal cancer. However, it is essential to consider various potential causes and when to seek medical help.

Possible Causes of Rectal Bleeding
1. Hemorrhoids: One of the most common causes of rectal bleeding, especially if the blood is bright red and appears on the toilet paper or on the surface of the stool. Hemorrhoids can be internal or external and may cause discomfort or pain 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, along with bleeding.

3. Diverticular Disease: Diverticulosis, the presence of small pouches in the colon wall, can sometimes lead to diverticulitis, which may cause bleeding.

4. Polyps: Benign growths in the colon can sometimes bleed. While most polyps are not cancerous, some can develop into cancer over time.

5. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause rectal bleeding, along with other symptoms like abdominal pain and diarrhea.

6. Colorectal Cancer: While your family history does not indicate a high risk, it is still a possibility that should be ruled out, especially if symptoms persist or worsen.

When to Seek Medical Help
Given your symptoms and the fact that you have experienced intermittent bleeding, it is advisable to consult a healthcare professional. You should seek medical attention if:
- The bleeding increases in frequency or volume.

- You experience significant pain or discomfort.

- You notice changes in your bowel habits, such as persistent diarrhea or constipation.

- You have any other concerning symptoms, such as weight loss, fatigue, or changes in appetite.

Recommended Steps
1. Consult a Gastroenterologist: A specialist in digestive disorders can provide a thorough evaluation. They may recommend a colonoscopy, which allows for direct visualization of the colon and rectum, and can help identify any abnormalities.

2. Keep a Symptom Diary: Documenting when the bleeding occurs, its frequency, and any associated symptoms can provide valuable information to your doctor.

3. Dietary Adjustments: Increasing fiber intake can help prevent constipation and reduce straining during bowel movements, which may alleviate symptoms related to hemorrhoids or fissures.

4. Hydration: Ensure you are drinking enough fluids to help maintain soft stools.

5. Avoid Straining: If you experience constipation, consider using stool softeners or mild laxatives as recommended by your healthcare provider.

Conclusion
While the intermittent rectal bleeding you are experiencing may be due to benign causes such as hemorrhoids or anal fissures, it is crucial to have a thorough evaluation to rule out more serious conditions. Your negative fecal occult blood test is reassuring, but persistent symptoms warrant further investigation. Remember, early detection and treatment are key to managing any potential issues effectively. Don't hesitate to reach out to a healthcare professional for guidance and support.

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