Symptoms of Rectal Bleeding and Digestive Issues - Gastroenterology and Hepatology

Q: Symptoms of Rectal Bleeding and Digestive Issues

Hello Mr. <br>Hsiao-Lin： It is recommended that you consult with a specialist in colorectal and anal disorders for examination. <br>Director Cai Jin-ji of the Department of Hepatobiliary and Gastroenterology at Nantou Hospital.

Black, hard stools with granules, mucus, and food remnants; straining at the anus causes bleeding, followed by symptoms of fever?

Hello, I am a computer programmer who spends most of my time sitting in a chair.
I usually drink over 3000cc of water daily, but my exercise routine is irregular, with at least three sessions a week.
I have poor health habits and rarely see a doctor, but I want to change that.
I have no prior experience visiting a major hospital, so I would like to ask a few questions here.
I typically have a bowel movement every morning, but occasionally I go every other day.
My anus seems to be prone to injury; if I exert too much force, I experience a slight stinging pain.
In the past, I have occasionally experienced small cuts from bowel movements that resulted in minor bleeding.
However, last year, I had a more significant bleeding episode, where blood would drip, occurring once a month from March to June.
Each time, I experienced fever and headaches on the night after the bleeding, which lasted for a day or two before resolving.
After June, this stopped, and I did not seek medical attention.
Currently, about two weeks ago, I suddenly noticed that my stools became thin, black, hard, granular, and contained mucus and food remnants, as described in the title.
I also experienced a burning sensation and felt unable to fully evacuate my bowels, leading to prolonged sitting on the toilet for over 30 minutes.
Afterward, I felt the urge to go again a few hours later, with the same symptoms.
That day, I visited the toilet about three times, but due to the hardness and granularity, I was cautious not to exert too much force for fear of bleeding again.
However, it seems I still sustained an injury, as I experienced pain and dripping blood.
After the bowel movement, the bleeding stopped, but I later had a slight fever, and the headache was more pronounced, lasting for two days.
This condition persisted for two days, after which my stools gradually became softer or more like a paste, still containing mucus.
I assumed it was a symptom of gastroenteritis, so I switched to a lighter diet, eating noodles and porridge, but I still did not see a doctor.
Three days ago, my stools became formed and larger (about 2 cm in diameter) and harder, similar to before, so I resumed my previous diet.
However, today, while having a bowel movement, I initially had normal stools, but then I passed thin, long, black stools with a burning sensation, again with hard granules and food remnants.
This time, the stools were drier and more difficult to pass, resulting in injury and bleeding again.
Therefore, I would like to clarify the following:
1.
Possible conditions related to the anus or rectum.
2.
Possible gastrointestinal conditions.

Xiao Lin, 20~29 year old female. Ask Date: 2021/10/03

Dr. Cai Jinji reply Gastroenterology and Hepatology

Hello Mr.
Hsiao-Lin: It is recommended that you consult with a specialist in colorectal and anal disorders for examination.
Director Cai Jin-ji of the Department of Hepatobiliary and Gastroenterology at Nantou Hospital.

Reply Date: 2021/10/03

More Info

Based on your detailed description of symptoms, it seems you are experiencing a combination of rectal bleeding, changes in bowel habits, and discomfort during bowel movements. These symptoms can be indicative of several underlying conditions, and it’s essential to approach them with a thorough understanding and appropriate medical guidance.

Possible Conditions
1. Hemorrhoids: One of the most common causes of rectal bleeding, especially in individuals who sit for prolonged periods, is hemorrhoids. These are swollen veins in the lower rectum or anus that can cause pain, itching, and bleeding during bowel movements. Given your sedentary lifestyle, this could be a significant factor.

2. Anal Fissures: You mentioned experiencing pain and bleeding after bowel movements, which could suggest anal fissures. These are small tears in the lining of the anus, often caused by passing hard stools. The pain can be sharp and may lead to a fear of bowel movements, exacerbating the problem.

3. Diverticular Disease: The presence of hard, pellet-like stools and changes in bowel habits could also indicate diverticular disease, where small pouches form in the colon wall and can become inflamed or infected, leading to symptoms like bleeding and abdominal pain.

4. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause changes in bowel habits, abdominal pain, and rectal bleeding. The presence of mucus and food remnants in your stool could suggest an inflammatory process.

5. Colorectal Polyps or Cancer: Although less common, especially in younger individuals, persistent changes in bowel habits and rectal bleeding warrant consideration of colorectal polyps or cancer. This is particularly important if there is a family history of colorectal disease.

Recommended Actions
1. Consult a Healthcare Professional: Given the complexity and potential seriousness of your symptoms, it is crucial to consult a healthcare provider, preferably a gastroenterologist or a colorectal surgeon. They can perform a thorough evaluation, including a physical examination and possibly a colonoscopy, to visualize the colon and rectum directly.

2. Dietary Adjustments: While you have already started eating lighter foods, it’s essential to maintain a high-fiber diet to help soften stools and promote regular bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying well-hydrated is also vital.

3. Avoid Straining: Since you have experienced pain and bleeding, it’s important to avoid straining during bowel movements. If you feel the urge to go, try to respond promptly rather than holding it in, which can lead to harder stools.

4. Warm Sitz Baths: Taking warm sitz baths can help soothe anal discomfort and promote healing if you have fissures or hemorrhoids.

5. Over-the-Counter Treatments: There are various over-the-counter treatments available for hemorrhoids and anal fissures, including topical creams and suppositories that can provide relief.

6. Monitor Symptoms: Keep a diary of your bowel habits, including the consistency of your stools, any pain or bleeding, and dietary intake. This information can be invaluable for your healthcare provider in diagnosing your condition.

Conclusion
Your symptoms are concerning and warrant a professional evaluation to rule out serious conditions. While lifestyle changes can significantly impact your digestive health, they should be complemented by medical advice tailored to your specific situation. Early intervention can lead to better outcomes, so I encourage you to seek medical attention as soon as possible.

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