Rectal Bleeding: Causes and When to Seek Help

Frequent bleeding during bowel movements?

Hello, doctor.
During one bowel movement, my stool was quite dry and hard, which seemed to have scraped the mucosa or aggravated my hemorrhoids.
Since that painful incident, I haven't experienced pain again, but I have been noticing blood during bowel movements, even with softer stools.
It feels somewhat like it's irritating the hemorrhoids.
I've had similar experiences in the past, but they usually resolved within a few days.
This time is different; I've been staying up late studying for an exam, which has affected my overall well-being, and the bleeding has increased compared to before.
This has led to feelings of fatigue and dizziness, similar to anemia, but I am certain that the bleeding is from an injury to my rectum and not from within my intestines.
This issue has been troubling me lately.
I hope to receive your advice.
Thank you.

Huan, 10~19 year old female. Ask Date: 2022/06/30

Dr. Chen Ronghong reply Surgery

Hello Huan, based on your description, both anal fissures and hemorrhoids are possible.
If even soft stools cause bleeding, you should be cautious about whether you are straining too much while wiping after a bowel movement.
If you frequently have hard stools, it is important to increase your water intake and dietary fiber.
Generally, minor bleeding from the anal area is not enough to cause anemia, but if you experience dizziness, you should be aware of other potential health issues.
Additionally, you can prepare a basin of warm water and soak for 10 minutes during your daily bath, or more simply, use a handheld showerhead to rinse with warm water, which can improve blood circulation around the anal area.
If bleeding persists, it is advisable to seek medical evaluation.

Reply Date: 2022/06/30

More Info

Rectal bleeding can be a concerning symptom, and it is important to understand its potential causes and when to seek medical help. Based on your description, it seems that you may be experiencing bleeding due to a few possible reasons, such as hemorrhoids or anal fissures, especially since you mentioned having hard stools that could have caused trauma to the rectal mucosa.

Common Causes of Rectal Bleeding
1. Hemorrhoids: These are swollen veins in the lower rectum or anus that can cause bleeding during bowel movements. They can be internal or external and may cause discomfort, itching, or pain.

2. Anal Fissures: A fissure is a small tear in the lining of the anus, often caused by passing hard stools. This can lead to sharp pain during and after bowel movements, along with bleeding.

3. Diverticular Disease: This condition involves the formation of small pouches in the colon wall, which can sometimes bleed.

4. Colorectal Polyps or Cancer: While less common, polyps can bleed, and colorectal cancer is a serious condition that can present with rectal bleeding.

5. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can lead to rectal bleeding due to inflammation in the gastrointestinal tract.

When to Seek Medical Help
Given your symptoms, it is crucial to monitor the situation closely. Here are some guidelines on when to seek medical attention:
- Persistent Bleeding: If the bleeding continues for more than a few days or worsens, it is essential to consult a healthcare provider.

- Increased Blood Volume: If you notice a significant increase in the amount of blood, especially if it is bright red or mixed with stool, this warrants immediate medical evaluation.

- Signs of Anemia: Symptoms such as dizziness, fatigue, or weakness could indicate that you are losing too much blood, leading to anemia. If you experience these symptoms, seek medical attention promptly.

- Severe Pain: If you experience severe pain that does not improve, it is important to get evaluated.

- Changes in Bowel Habits: If you notice changes in your bowel habits, such as diarrhea or constipation, along with bleeding, it is advisable to consult a doctor.

Recommendations for Management
1. Dietary Changes: Increasing your fiber intake can help soften stools and reduce straining during bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes.

2. Hydration: Drinking plenty of fluids can also help prevent constipation.

3. Over-the-Counter Treatments: If hemorrhoids are the issue, topical treatments or suppositories may provide relief. For fissures, sitz baths can help soothe the area.

4. Avoid Straining: Try to avoid straining during bowel movements, as this can exacerbate the problem.

5. Rest and Stress Management: Since you mentioned that you have been under stress due to studying, it is important to find ways to manage stress, as it can impact your overall health.

6. Consult a Specialist: If the bleeding persists or if you have concerns about the underlying cause, consider seeing a gastroenterologist for a thorough evaluation. They may recommend diagnostic tests, such as a colonoscopy, to rule out more serious conditions.

In conclusion, while rectal bleeding can often be attributed to benign causes like hemorrhoids or fissures, it is essential to monitor your symptoms and seek medical advice if they persist or worsen. Taking proactive steps in managing your diet and stress levels can also contribute to your overall well-being.

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