Can Traditional Chinese Medicine Cause Rectal Bleeding?

Can traditional Chinese medicine cause me to have bloody stools?

Dear Doctor, I have a hard lump near my anus, and a colorectal surgeon diagnosed it as an anal fistula.
Currently, I am relying on traditional Chinese medicine.
My TCM doctor mentioned that this is just a minor issue and that surgery is not necessary.
The prescribed herbs are: Xianfang Huoming Decoction 4g, Yizi Decoction 1.4g, Wuwei Xiaodu Powder 2g, Huangqin 1g, Mudanpi 1g, Lianqiao 1g, Jinyinhua 1g, Ruxiang 0.5g, and Moyi 0.5g.
So far, it has been effective, and the lump has decreased in size.
However, after taking the herbs for two weeks, I suddenly noticed blood in my stool yesterday morning, which is concerning because the color is dark red.
Therefore, I went back to see the colorectal surgeon, and during the examination with the anoscope, I saw that the internal hemorrhoids were bleeding and swollen.
My diet is healthy; I do not smoke or drink alcohol, I sleep at least 6 hours, and I rarely eat fried or barbecued food, only about two or three times a month.
I avoid processed foods like sausages or meatballs.
There is no family history of colorectal cancer.
I am wondering if the traditional Chinese medicine could be causing the bleeding.
I started taking antibiotics yesterday, spaced one hour apart from the herbal medicine.
This morning, I looked for blood in my stool for a long time and found only a little, much less than yesterday.
My ID number is A12935425.
Although the lump from the anal fistula has shrunk, I would like to ask the doctor: could the herbal medicine be causing the bleeding? I do not feel uncomfortable, and my stool is soft and moist.
My weight is 85 kg, and I drink about 3000 ml of water daily.
There has been no sudden weight loss, fever, or abdominal pain.
Another question is: could the fistula potentially infect my colon? Is there a possibility that if left untreated, it could lead to colorectal cancer? If I intentionally fast to give my colon a rest, would that be advisable? Since I am taking antibiotics, which can kill both good and bad bacteria, can I take probiotics?

Chen Bo-Yu, 30~39 year old female. Ask Date: 2024/04/14

Dr. Hu Guozheng reply Gastroenterology and Hepatology

We recommend that you visit the colorectal surgery outpatient clinic for evaluation by a specialist.
Thank you.

Reply Date: 2024/04/14

More Info

The question of whether Traditional Chinese Medicine (TCM) can cause rectal bleeding is complex and requires a nuanced understanding of both TCM practices and the potential side effects of herbal treatments. In your case, you have been diagnosed with an anal fistula and are currently undergoing treatment with a combination of herbal remedies. You have also experienced rectal bleeding, which has understandably raised concerns about the safety and efficacy of the TCM approach.

Firstly, it is essential to recognize that TCM employs a holistic approach to health, focusing on balancing the body's energies (Qi) and addressing underlying imbalances. The herbs you mentioned, such as Xianfang Huoming Decoction and Wuwei Xiaodu Powder, are commonly used in TCM to promote healing and reduce inflammation. However, like any form of medicine, herbal treatments can have side effects, and individual responses can vary significantly.

The occurrence of dark red blood in your stool could be attributed to several factors. While it is possible that certain herbs may have a blood-thinning effect or irritate the gastrointestinal tract, it is crucial to consider other potential causes of rectal bleeding. For instance, the presence of internal hemorrhoids, which you mentioned were observed during a rectal examination, can lead to bleeding, especially if there is increased pressure during bowel movements. Additionally, if the anal fistula is inflamed or infected, it could also contribute to bleeding.

Given your situation, it is advisable to consult with a healthcare professional who specializes in gastrointestinal issues or colorectal surgery. They can conduct a thorough evaluation to determine the exact cause of the bleeding and whether it is related to the herbal treatment or another underlying condition. It is also important to communicate openly with your TCM practitioner about your symptoms, as they may need to adjust your herbal regimen based on your current health status.

Regarding your concerns about the potential for the fistula to lead to more severe conditions, such as colorectal cancer, it is essential to understand that while anal fistulas can lead to complications if left untreated, they do not directly cause cancer. However, chronic inflammation and irritation in the anal region can increase the risk of other complications, so timely intervention is crucial.

As for dietary considerations, fasting or significantly altering your diet can have varying effects on your digestive health. While some individuals may find relief from symptoms through dietary changes, it is essential to approach this cautiously and ideally under the guidance of a healthcare professional. Staying hydrated and maintaining a balanced diet rich in fiber can help support bowel health and prevent constipation, which is particularly important if you are experiencing rectal bleeding.

Lastly, regarding the use of probiotics, they can be beneficial for gut health, especially after a course of antibiotics, which can disrupt the balance of gut flora. However, it is advisable to discuss this with your healthcare provider to ensure that it aligns with your overall treatment plan.

In summary, while TCM can be a valuable component of your treatment, it is crucial to monitor your symptoms closely and maintain open communication with both your TCM practitioner and your conventional healthcare providers. This collaborative approach will help ensure that you receive comprehensive care tailored to your specific needs.

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