Is It Hemorrhoids? Rectal Bleeding and Gastrointestinal Health

Q: Is It Hemorrhoids? Rectal Bleeding and Gastrointestinal Health

Hello, Xiao-Wen： 1. The original symptom is anal fissure bleeding, which is often caused by hard stools. 2. The gastroscopy is unrelated to the rectal bleeding and constipation; however, you may have gastritis or a gastric ulcer. If you continue to experie

Is this hemorrhoids?

Hello Doctor: I previously experienced a tearing sensation in my anus after using the restroom, with bleeding when wiping.
This lasted for 2 to 3 days, and then the tearing sensation would disappear, leaving only blood when wiping.
It would resolve within a week, and this cycle repeated for 1 to 2 years.
However, half a month ago, I again felt a tearing sensation after using the restroom, with blood when wiping.
I thought it would resolve in a couple of days, but it has now been half a month.
My stools are soft, and there is no tearing sensation after using the restroom, but there is still blood when wiping, and sometimes I notice mucus that resembles menstrual blood, even though I am not on my period.
Over the past half month, I have also experienced slight abdominal discomfort and itching around the anus after bowel movements.
Could this be caused by hemorrhoids? I have had digestive issues since childhood, often alternating between diarrhea and constipation, and I frequently suffer from gastroenteritis.
A doctor once suggested an endoscopy, but I have not undergone it due to fear of pain.
I usually see a doctor and take medication for 1 to 2 weeks, after which I feel better.
Is this related to the blood I see when using the restroom? If I need to see a doctor, should I consult a gastroenterologist or a proctologist? Thank you!

Xiao Wen, 20~29 year old female. Ask Date: 2006/07/10

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Xiao-Wen:
1.
The original symptom is anal fissure bleeding, which is often caused by hard stools.

2.
The gastroscopy is unrelated to the rectal bleeding and constipation; however, you may have gastritis or a gastric ulcer.
If you continue to experience upper abdominal discomfort or hunger pangs, a gastroscopy can help confirm the cause.

3.
Anal fissures are typically addressed by a colorectal specialist, while stomach pain should be evaluated by a gastroenterologist.

Changhua Hospital cares about your health,
Chen Shidian

Reply Date: 2006/07/10

More Info

Rectal bleeding can be a concerning symptom, and understanding its potential causes is crucial for appropriate management. Based on your description, it seems you have experienced intermittent rectal bleeding, associated with a tearing sensation and soft stools, along with some abdominal discomfort and itching around the anal area. These symptoms could indeed suggest hemorrhoids, but there are other possibilities that should be considered as well.

Hemorrhoids, which are swollen veins in the lower rectum and anus, can cause bleeding during bowel movements, especially if there is straining involved. The tearing sensation you described may indicate the presence of anal fissures, which are small tears in the lining of the anus that can occur due to passing hard stools or straining. The fact that you have experienced this for a prolonged period, along with the presence of blood when wiping, supports the possibility of hemorrhoids or fissures.

The presence of mucus that resembles menstrual blood, along with your other symptoms, raises additional considerations. While hemorrhoids can cause some mucus discharge, the consistency and color of the mucus you described warrant further investigation. Mucus in the stool can sometimes indicate inflammation in the gastrointestinal tract, which could be due to conditions such as inflammatory bowel disease (IBD), infections, or other gastrointestinal disorders.

Given your history of gastrointestinal issues, including frequent diarrhea and constipation, it is essential to address these underlying problems. Chronic gastrointestinal symptoms can lead to complications such as hemorrhoids and fissures, and managing your bowel habits may help alleviate some of your symptoms.

In terms of seeking medical attention, it would be advisable to consult a specialist who can provide a thorough evaluation. While a gastroenterologist (肝膽腸胃科) can help assess your overall gastrointestinal health and manage conditions related to the stomach and intestines, a colorectal surgeon or proctologist (直腸科) would be more specialized in diagnosing and treating conditions specifically related to the rectum and anus, including hemorrhoids and anal fissures.

When you visit the doctor, it is important to provide a detailed history of your symptoms, including the duration, frequency, and any associated factors such as diet, bowel habits, and any previous treatments you have undergone. This information will help the physician determine the most appropriate diagnostic tests, which may include a physical examination, anoscopy, or even a colonoscopy if deemed necessary.

In the meantime, there are some self-care measures you can take to alleviate your symptoms. Increasing dietary fiber intake, staying hydrated, and avoiding straining during bowel movements can help prevent constipation and reduce the risk of hemorrhoids and fissures. Over-the-counter treatments, such as topical creams or suppositories designed for hemorrhoids, may also provide relief.

In summary, while your symptoms may suggest hemorrhoids or anal fissures, it is essential to rule out other potential causes of rectal bleeding. Consulting with a colorectal specialist would be a prudent step to ensure a comprehensive evaluation and appropriate management of your symptoms.

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