Rectal Symptoms: What Does a Small Red Spot Mean?

Regarding issues related to feces?

Hello, doctor.
I have a habit of observing my stool.
A few days ago, my bowel movement was smooth, with normal thickness and a golden color.
After finishing, there were no issues with the color when I wiped.
However, about half an hour later, I felt like I hadn't wiped clean (I've been experiencing anal itching frequently lately), so I wiped again and noticed a very small reddish spot on the toilet paper.
It was really tiny (about one-fifth the size of a sesame seed), and I had to use a pin to pick it off the paper to examine it.
I'm unsure if it was blood, food residue, or something else (regarding red food, I had consumed food containing crushed chili flakes two days prior).
There was only that one small spot on the paper, and since then, I haven't seen anything on the paper during bowel movements over the past two days (the stool itself has been normal in consistency, color, and thickness, approximately 2 cm in diameter and about 10 cm in length).
I would like to know what this might indicate.
Regarding my medical history, I was diagnosed with internal hemorrhoids about 20 years ago after experiencing pain while wiping and seeing blood on the toilet paper.
About 9 years ago, I underwent a rigid sigmoidoscopy, during which the doctor noted the hemorrhoids were quite prominent, and I received outpatient treatment (I recall it involved an injection, and I felt quite uncomfortable for a day afterward).
Since then, I have occasionally noticed slight blood on the paper after straining too much during bowel movements or wiping excessively (often after diarrhea), but the stool itself has not had blood.
This happens about once or twice a year, so the frequency is not high.

Sam, 30~39 year old female. Ask Date: 2023/06/26

Dr. Ke Fangxu reply Surgery

Abnormal stool color is often caused by food residues, with common culprits including carrots, dragon fruit, tomatoes, and pumpkin.
It is advisable to temporarily avoid dark-colored foods.
If there is no improvement, a fecal occult blood test can be performed to check for bleeding.
Alternatively, you may consult a physician to arrange for a colonoscopy.

Reply Date: 2023/06/26

More Info

When it comes to rectal symptoms, particularly the appearance of a small red spot on toilet paper after wiping, there are several potential explanations. Given your history of hemorrhoids and the recent dietary intake that included spicy foods, it is essential to consider both benign and more serious causes.

Firstly, the small red spot you observed could be a result of minor bleeding from hemorrhoids. Hemorrhoids are swollen veins in the rectal area that can become irritated, especially after straining during bowel movements or excessive wiping. This irritation can lead to small amounts of blood appearing on toilet paper, which is often bright red due to its proximity to the rectum. Since you mentioned a history of hemorrhoids and that you have experienced similar symptoms in the past, this could very well be the cause of the red spot.

Another possibility is that the red spot could be related to anal fissures, which are small tears in the lining of the anus. These can occur due to passing hard stools or straining during bowel movements. Fissures can cause pain and bleeding, but they typically heal on their own with proper care, including maintaining soft stools and avoiding excessive wiping.

The fact that you have not seen any further blood in the days following the initial observation is a positive sign. It suggests that whatever the cause, it may have been a minor issue that has resolved itself. However, if the symptoms persist or worsen, or if you begin to experience additional symptoms such as pain, significant bleeding, or changes in bowel habits, it would be prudent to seek medical attention.

In your case, considering your previous diagnosis of internal hemorrhoids and the recent dietary changes, it is likely that the red spot was a benign occurrence related to hemorrhoidal irritation or a minor fissure. However, it is always wise to monitor your symptoms closely. If you notice any recurring issues or if the symptoms escalate, a visit to a healthcare provider for a thorough examination would be advisable. They may recommend a physical examination or possibly a colonoscopy if there are concerns about other underlying conditions.

In summary, while the small red spot you observed is likely benign, especially given your history, it is essential to remain vigilant about your symptoms. Maintaining a diet high in fiber, staying hydrated, and avoiding excessive straining during bowel movements can help prevent future occurrences. If you have any concerns or if symptoms change, do not hesitate to consult a healthcare professional for further evaluation and guidance.

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