Rectal Bleeding: Causes and Prevention Tips for Teens - Surgery

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Rectal bleeding


I am very frightened and scared.
Hello, doctor.
Yesterday, after having a bowel movement, I noticed some bleeding (a drop of bright red blood, not attached to the stool).
There was a little blood when I wiped the inside of my anus with toilet paper, and the bleeding stopped after the bowel movement.
I felt a slight protrusion at the anus during the bowel movement, which is not usual for me.
There was no pain during the bowel movement, and my stool was not hard.
Aside from a history of anal fissures due to constipation when I was younger, I haven't had any bleeding for a long time, even when my stool was harder than this time.
I tend to push quite hard to completely empty my bowels; could that be the reason? However, I sometimes do this and don’t experience bleeding.
Can you please advise me on how to avoid bleeding? Thank you for your guidance, I really appreciate it.

You Li Zhong, 10~19 year old female. Ask Date: 2005/05/21

Dr. Wang Qichao reply Surgery


Hello! Based on your description, the likelihood of hemorrhoidal bleeding seems to be higher.
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 lifelong regrets.
Sincerely, Dr.
Wang Qi-Chao, Department of Surgery, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2005/05/21

More Info


Rectal bleeding, especially in teenagers, can be a concerning symptom that warrants attention. It's understandable to feel anxious about this experience, but it's important to approach it with a clear understanding of potential causes and preventive measures.

Based on your description, the presence of bright red blood after a bowel movement, particularly if it appears on the toilet paper or inside the anal area, could be indicative of several conditions. The most common causes of rectal bleeding in young individuals include hemorrhoids, anal fissures, and less commonly, conditions like diverticulosis or inflammatory bowel disease. Given that you mentioned a slight protrusion during bowel movements, this could suggest the presence of hemorrhoids, which are swollen veins in the rectal area that can bleed, especially after straining.

Straining during bowel movements is a significant factor that can lead to both hemorrhoids and anal fissures. When you exert pressure to pass stool, it can cause small tears in the anal lining (fissures) or exacerbate existing hemorrhoids. The fact that you mentioned you sometimes strain to ensure complete evacuation could indeed be contributing to your symptoms. However, it’s also possible that other factors, such as diet, hydration, and bowel habits, play a role.

To prevent rectal bleeding, consider the following tips:
1. Dietary Adjustments: Ensure that your diet is rich in fiber. Foods such as fruits, vegetables, whole grains, and legumes can help soften your stool and promote regular bowel movements. Aim for at least 25-30 grams of fiber per day.

2. Hydration: Drink plenty of water throughout the day. Staying well-hydrated helps to keep your stool soft and easier to pass.

3. Regular Bowel Habits: Try to establish a routine for bowel movements. Don’t rush or strain; allow your body to naturally signal when it’s time to go. If you feel the urge, respond to it promptly rather than holding it in.

4. Avoid Straining: If you find yourself straining during bowel movements, consider using a footstool to elevate your feet while sitting on the toilet. This position can help align your rectum for easier passage of stool.

5. Physical Activity: Regular exercise can help stimulate bowel function and prevent constipation.

6. Over-the-Counter Remedies: If you experience occasional constipation, consider using a stool softener or a fiber supplement, but consult with a healthcare provider before starting any new medication.

If you continue to experience rectal bleeding, or if the bleeding worsens, becomes more frequent, or is accompanied by other symptoms such as pain, changes in bowel habits, or weight loss, it is crucial to seek medical attention. A healthcare professional can perform a thorough evaluation, which may include a physical examination and possibly further diagnostic tests to determine the underlying cause of your symptoms.

In summary, while rectal bleeding can be alarming, many cases are due to benign conditions that can be managed with lifestyle changes. By focusing on a high-fiber diet, adequate hydration, and mindful bowel habits, you can significantly reduce the risk of recurrence. However, always prioritize your health and consult with a healthcare provider for personalized advice and treatment options.

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