Blood on Toilet Paper After Bowel Movement: What You Should Know

Blood on toilet paper after a bowel movement?

Yesterday, when I went to the bathroom, I had to exert more effort, and I felt that my anus was stretched more than usual.
After the bowel movement, the stool appeared harder and larger.
When I wiped, I noticed blood on the toilet paper, but after about two wipes, there was no more blood.
I also inserted the toilet paper slightly into the anus and saw a bit of blood, with a drop coming out.
The stool itself did not have blood in it, but when I tightened my anus, there was a little blood.
After wiping, there was no more blood.
Later, I felt a slight burning sensation around the anus.
I just had another bowel movement, and the stool was yellow with no blood present.
What should I pay attention to after this?

Yan, 40~49 year old female. Ask Date: 2023/07/31

Dr. Ke Fangxu reply Surgery

Based on your description, it seems more like the typical symptoms of an anal fissure, which include pain during bowel movements accompanied by slight bleeding.
The pain often lasts for several days, sometimes exceeding a week.
The common causes are usually constipation or diarrhea.
The fundamental treatment is to improve bowel habits, along with warm sitz baths.
Warm sitz baths can help alleviate pain, maintain cleanliness, and promote blood circulation.
You can also purchase hemorrhoid suppositories at the pharmacy for relief.
If symptoms persist without improvement, it is advisable to consult a physician for further evaluation.

Reply Date: 2023/07/31

More Info

Experiencing blood on toilet paper after a bowel movement can be concerning, and it's important to understand the potential causes and appropriate responses to such symptoms. Based on your description, it seems that you may be dealing with a common issue related to bowel movements, such as hemorrhoids or anal fissures, especially considering the hard and larger stool you mentioned.

Potential Causes
1. Hemorrhoids: These are swollen veins in the lower rectum and anus that can cause discomfort, pain, and bleeding during bowel movements. Straining during a bowel movement, as you described, can exacerbate this condition, leading to bleeding.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard or large stools. The tearing can lead to sharp pain and bleeding, especially when wiping or during bowel movements.

3. Other Conditions: While less common, other gastrointestinal issues could also cause rectal bleeding, including diverticulosis, inflammatory bowel disease, or even more serious conditions like colorectal cancer. However, these are less likely given your age and the nature of your symptoms.

What to Do Next
1. Monitor Symptoms: Keep an eye on your symptoms. If the bleeding persists, increases in volume, or is accompanied by other symptoms such as severe pain, changes in bowel habits, or unexplained weight loss, it is crucial to seek medical attention.

2. Dietary Adjustments: To prevent hard stools, consider increasing your fiber intake through fruits, vegetables, and whole grains. Staying well-hydrated is also essential, as it helps soften the stool and makes bowel movements easier.

3. Avoid Straining: When using the bathroom, try to relax and avoid straining. If you feel the urge to go, respond to it promptly rather than holding it in, as this can lead to harder stools.

4. Proper Hygiene: After a bowel movement, gentle cleaning is important. Using moist wipes or a bidet can help reduce irritation compared to dry toilet paper. If you notice blood, avoid excessive wiping, as this can worsen any existing irritation.

5. Over-the-Counter Treatments: If you suspect hemorrhoids, over-the-counter creams or suppositories may provide relief. For anal fissures, topical anesthetics or hydrocortisone creams can help reduce pain and inflammation.

6. Consult a Healthcare Provider: If you continue to experience bleeding or if your symptoms worsen, it is advisable to consult a healthcare provider. They may recommend a physical examination or further diagnostic tests, such as a colonoscopy, to rule out any serious conditions.

Conclusion
In summary, while occasional blood on toilet paper can be alarming, it is often related to benign conditions like hemorrhoids or anal fissures, especially if the bleeding is minimal and resolves quickly. However, it is essential to monitor your symptoms and make lifestyle changes to prevent recurrence. If you have any concerns or if the symptoms persist, do not hesitate to seek medical advice for a thorough evaluation and appropriate management. Your health is paramount, and addressing these symptoms early can lead to better outcomes.

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