Blood in Stool: Causes and Concerns After Straining

Q: Blood in Stool: Causes and Concerns After Straining

Hello： Based on what you described, it does sound like internal hemorrhoid bleeding. <br>Internal hemorrhoids are typically painless, and fresh blood may cover the surface of the stool, while the stool itself remains normal in color. <br>If you have a history of hemorrhoids, it i

Rectal bleeding

Two days ago, I had difficulty eating due to a tooth extraction, which made it hard for me to have a bowel movement.
I spent an hour in the bathroom and eventually managed to pass a stool, but I had to strain a lot, and since the stool was quite large, I experienced some bleeding from the anus that day.
The next day, my bowel movement was much easier and took only two minutes, but I noticed fresh blood on the toilet paper and a small amount of blood at the end of the stool.
Today (two days later), my bowel movement was similar to yesterday's, and I have not experienced any pain during either bowel movement; they have been smooth.
I would like to know what this situation might indicate.
(I had surgery to remove hemorrhoids last year; is it possible that new hemorrhoids have developed?)

A-Yun, 20~29 year old female. Ask Date: 2022/01/24

Dr. Lin Wufu reply Internal Medicine

Hello: Based on what you described, it does sound like internal hemorrhoid bleeding.
Internal hemorrhoids are typically painless, and fresh blood may cover the surface of the stool, while the stool itself remains normal in color.
If you have a history of hemorrhoids, it is advisable to schedule an appointment with a colorectal surgeon for an examination to confirm whether there is a recurrence.

Reply Date: 2022/01/24

More Info

When it comes to the presence of blood in the stool, especially following a period of straining during bowel movements, there are several potential causes and concerns that should be addressed. Based on your description, it appears that the bleeding may be related to the straining you experienced during your recent bowel movements, particularly after having difficulty due to your dental procedure.

Straining during bowel movements can lead to several issues, including:
1. Hemorrhoids: Since you mentioned a history of hemorrhoid surgery, it is possible that you may have developed new hemorrhoids or that the existing ones have become irritated. Hemorrhoids can bleed, especially after straining, and the blood is typically bright red, indicating that it is fresh.

2. Anal Fissures: Straining can also cause small tears in the lining of the anus, known as anal fissures. These can be quite painful and may cause bleeding, especially during bowel movements. The blood from fissures is usually bright red and may be seen on the toilet paper or on the stool itself.

3. Other Causes: While less common, other causes of blood in the stool can include diverticular disease, polyps, or more serious conditions such as inflammatory bowel disease (IBD) or colorectal cancer. However, these are less likely given your recent history of straining and the absence of other symptoms.

Given that you have experienced blood in your stool after a period of significant straining, it is essential to monitor the situation closely. Here are some recommendations:
- Hydration and Diet: Ensure you are drinking plenty of water and consuming a high-fiber diet to help soften your stool and reduce the need for straining. Foods rich in fiber include fruits, vegetables, whole grains, and legumes.

- Avoid Straining: If you feel the urge to have a bowel movement, try to go when your body signals you rather than waiting. This can help prevent the need for straining.

- Warm Baths: Taking warm baths can help soothe the anal area and may provide relief if you are experiencing discomfort.

- Topical Treatments: Over-the-counter creams or ointments designed for hemorrhoids can help alleviate symptoms if hemorrhoids are the cause of your bleeding.

- Consult a Healthcare Provider: If the bleeding persists, increases in severity, or is accompanied by other symptoms such as pain, changes in bowel habits, or significant discomfort, it is crucial to consult a healthcare professional. They may recommend a physical examination or further diagnostic tests, such as a colonoscopy, to rule out any serious underlying conditions.

In summary, while the bleeding you are experiencing may be related to straining and could be due to hemorrhoids or anal fissures, it is essential to monitor your symptoms and seek medical advice if the situation does not improve or worsens. Taking proactive steps to manage your bowel health can help prevent future occurrences.

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