Rectal Bleeding: Causes, Symptoms, and When to See a Doctor - Surgery

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Rectal bleeding?


Around March, I developed an anal fissure due to hard stools, which led to the formation of a skin tag at the anal opening.
The doctor mentioned that the fissure caused the hemorrhoids to become more pronounced.
I experienced significant pain and bleeding after bowel movements.
I consulted a doctor and used suppositories and stool softeners.
On April 30, I underwent a fecal occult blood test, which returned normal results.

By mid-June, I started having daily bowel movements accompanied by abdominal pain.
Initially, there was no blood in the stool, but as I was about to finish, bleeding began, resulting in blood in the toilet.
However, there was no pain associated with this bleeding.
I have scheduled a colonoscopy, but it won't be until mid-July.
It seems like I might have colitis, and the waiting period is quite difficult.
Should I see a doctor again? I understand that a colonoscopy is necessary to clarify the issue.

Jinmen A-Zhe, 30~39 year old female. Ask Date: 2022/06/28

Dr. Yu Mingchang reply Surgery


Hello: The issue is not significant; just wait for the colonoscopy.

Reply Date: 2022/06/28

More Info


Rectal bleeding can be a concerning symptom, and understanding its causes, symptoms, and when to seek medical attention is crucial for proper management. Based on your description, it seems that you have experienced a series of gastrointestinal issues, including anal fissures and potential hemorrhoids, which have led to rectal bleeding. Let's break down the possible causes and when it is essential to consult a healthcare provider.


Causes of Rectal Bleeding
1. Anal Fissures: As you mentioned, hard stools can cause tears in the anal canal, leading to pain and bleeding during bowel movements. This is often accompanied by sharp pain and can result in the formation of hemorrhoids due to the straining.

2. Hemorrhoids: Swollen veins in the rectal area can cause bleeding, especially during bowel movements. They may be internal or external, and while they can be painful, they often do not cause significant discomfort unless thrombosed.

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

4. Colorectal Polyps or Cancer: While less common, polyps can bleed, and colorectal cancer can present with rectal bleeding, especially in older adults or those with risk factors.

5. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause inflammation in the intestines, leading to bleeding, diarrhea, and abdominal pain.

6. Infections: Gastrointestinal infections can lead to inflammation and bleeding, often accompanied by diarrhea.


Symptoms to Watch For
- Amount of Blood: If you notice a significant amount of blood, especially if it fills the toilet bowl or is mixed with stool, this warrants immediate medical attention.

- Associated Symptoms: Abdominal pain, changes in bowel habits, weight loss, or fever accompanying rectal bleeding should prompt a visit to the doctor.

- Duration: If bleeding persists or recurs over several days, it is essential to seek medical advice.


When to See a Doctor
Given your situation, where you have experienced rectal bleeding that has escalated to dripping blood without pain, it is advisable to consult a healthcare provider sooner rather than later. While you have already undergone a colonoscopy, which is a critical diagnostic tool, the symptoms you describe suggest that further evaluation may be necessary, especially if the bleeding continues or worsens.


Diagnostic Steps
1. Colonoscopy: As you mentioned, a colonoscopy is the gold standard for evaluating the colon and rectum. It allows for direct visualization and potential biopsy of any abnormal areas.

2. Imaging Studies: Depending on your symptoms, your doctor may recommend imaging studies such as a CT scan to assess for diverticulitis or other structural issues.

3. Laboratory Tests: Blood tests can help evaluate for anemia due to blood loss and assess overall health.


Conclusion
In summary, rectal bleeding can arise from various causes, ranging from benign conditions like hemorrhoids and anal fissures to more serious issues like colorectal cancer. Given your ongoing symptoms and the potential for significant blood loss, it is crucial to follow up with your healthcare provider. They may recommend additional diagnostic tests or treatments based on your current condition. Remember, early intervention can lead to better outcomes, so do not hesitate to seek medical advice.

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