Rectal Bleeding: Causes, Treatments, and When to Seek Surgery

I'm sorry, but I need more information to assist

I have been experiencing bleeding during bowel movements for the past week and it is painful.
However, upon self-examination, I did not notice any protrusions, so it doesn't seem like hemorrhoids.
Some people suggested it might be anal fissures.
Do anal fissures require surgery? Will it be painful or troublesome? Will it heal on its own?

Hey~, 10~19 year old female. Ask Date: 2004/07/20

Dr. Wang Qichao reply Surgery

Hello! Based on your description, the likelihood of hemorrhoidal bleeding seems to be quite high.
However, it is important to understand that rectal bleeding is a warning sign that warrants further examination.
While hemorrhoidal bleeding is the most common cause, a portion of cases may be due to tumors or intestinal inflammation.
Therefore, my personal recommendation is to schedule an appointment for evaluation to determine the underlying cause, to avoid any regrets later on.
Sincerely, Dr.
Wang Qichao, Department of Surgery, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2004/07/20

More Info

Rectal bleeding can be a concerning symptom, and understanding its causes, treatments, and when to seek surgical intervention is crucial for your health. Based on your description of experiencing blood during bowel movements for the past week or two, along with pain, it is important to consider several potential causes.

Causes of Rectal Bleeding
1. Hemorrhoids: These are swollen veins in the rectum or anus that can cause bleeding, especially during bowel movements. They can be internal (inside the rectum) or external (under the skin around the anus). Symptoms often include pain, itching, and discomfort.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain and bleeding during bowel movements.

3. Diverticular Disease: This condition involves the formation of small pouches in the colon wall, which can become inflamed or infected, leading to bleeding.

4. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause inflammation in the digestive tract, resulting in rectal bleeding.

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

Treatments
The treatment for rectal bleeding largely depends on the underlying cause:
- For Hemorrhoids: Conservative treatments include dietary changes (increasing fiber intake), topical treatments, and sitz baths. In more severe cases, procedures like rubber band ligation or surgical removal may be necessary.

- For Anal Fissures: Increasing fiber intake, staying hydrated, and using topical anesthetics or nitroglycerin ointment can help. If conservative measures fail, surgical options may be considered.

- For Diverticular Disease: Treatment may involve antibiotics and dietary modifications. In severe cases, surgery may be required.

- For IBD: Medications to reduce inflammation and manage symptoms are typically used. Surgery may be necessary for severe cases or complications.

- For Polyps or Cancer: Polyps can often be removed during a colonoscopy, and cancer treatment may involve surgery, chemotherapy, or radiation, depending on the stage.

When to Seek Surgery
Surgery is typically considered when:
- There is significant bleeding that does not stop.

- There is severe pain that is not manageable with medication.

- There are signs of infection (fever, increased pain, swelling).

- There is a suspicion of cancer or if polyps are found during a colonoscopy.

Conclusion
Given your symptoms of rectal bleeding and pain, it is essential to consult a healthcare provider for a thorough evaluation. They may perform a physical examination and possibly recommend a colonoscopy to determine the exact cause of your symptoms. Early diagnosis and treatment are key to managing any underlying conditions effectively.

If you are experiencing severe pain, significant blood loss, or any other alarming symptoms, do not hesitate to seek immediate medical attention. Remember, while some causes of rectal bleeding are benign, others can be serious, and it is always better to err on the side of caution when it comes to your health.

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