Rectal Bleeding: When to Worry and What to Do - Surgery

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When it comes to rectal bleeding, it can understandably cause concern, especially when you notice blood on toilet paper. In your case, you've already taken the right steps by consulting with a colorectal surgeon and undergoing a digital rectal exam and anoscopy, which have indicated the presence of hemorrhoids. Hemorrhoids are a common cause of rectal bleeding and can lead to minor bleeding, especially during bowel movements.

The fact that your stool remains normal in color and consistency is a positive sign. Normal bowel movements typically indicate that there is no significant obstruction or serious underlying gastrointestinal issue. Additionally, the blood being present only on the toilet paper and not in the toilet bowl further suggests that the bleeding is likely superficial, which aligns with the diagnosis of hemorrhoids.

It's also important to consider other factors that might contribute to rectal bleeding. For instance, you mentioned that your menstrual period is approaching, and you noticed blood when wiping after vaginal wiping. This could indeed be a source of confusion, as menstrual blood can sometimes be mistaken for rectal bleeding, especially if you are wiping in the same area.
Given that both your colorectal and gynecological evaluations have not revealed any serious issues, it is reasonable to conclude that your bleeding is likely related to the hemorrhoids and possibly some menstrual blood. However, it is essential to monitor your symptoms closely. If you experience any of the following, you should seek medical attention promptly:
1. Increased Amount of Bleeding: If the bleeding becomes heavier or if you notice blood in your stool.

2. Changes in Bowel Habits: Such as persistent diarrhea or constipation.

3. Severe Pain: If you experience significant pain during bowel movements or at rest.

4. Signs of Infection: Such as fever, chills, or increased swelling around the anal area.

5. Persistent Symptoms: If the bleeding continues for an extended period or worsens despite treatment.

In terms of management, your doctor may recommend lifestyle changes such as increasing fiber intake, staying hydrated, and avoiding straining during bowel movements. Over-the-counter treatments for hemorrhoids, such as topical creams or suppositories, can also provide relief.
If your symptoms do not improve with conservative management, further evaluation may be warranted. This could include additional imaging studies or procedures to rule out other potential causes of bleeding, such as anal fissures or more serious conditions.

In summary, based on your current evaluations and the information provided, it appears that your rectal bleeding is likely related to hemorrhoids and possibly some menstrual blood. As long as your symptoms remain stable and you follow up with your healthcare providers as needed, there is no immediate cause for alarm. However, always trust your instincts and seek medical advice if you feel something is not right.