Rectal Bleeding: Causes and When to Seek Help

Blood in the stool during bowel movements?

In recent days, I have been drinking less water and often feel dizzy at night.
When I lie down to sleep, it feels like the world is spinning.
If I sit up from bed, the dizziness intensifies, and it usually takes about 10 minutes for the dizziness to subside.
My bowel movements are normal, and I don't feel anything unusual; however, there is blood when I wipe my anus, but I don't experience any pain.
I have had this issue before, but the amount of bleeding was less and the duration was shorter.
Now the bleeding has increased; what could be the reason?

Taipei Ren, 10~19 year old female. Ask Date: 2008/10/16

Dr. Hou Yongji reply Surgery

1.
Based on your description, a definitive diagnosis cannot be made.
It is recommended to first have a blood test to check for anemia.
If anemia is not present, please consult an otolaryngologist or a neurologist for the treatment of dizziness.
2.
If anemia is present, please seek evaluation and treatment from a colorectal surgeon.
Thank you.

Reply Date: 2008/10/16

More Info

Rectal bleeding can be a concerning symptom, and understanding its causes is crucial for determining when to seek medical help. Based on your description, it seems you are experiencing rectal bleeding without accompanying pain, which can sometimes indicate a less severe issue, but it is essential to approach this symptom with caution.

Possible Causes of Rectal Bleeding
1. Hemorrhoids: One of the most common causes of rectal bleeding is hemorrhoids, which are swollen veins in the lower rectum or anus. They can cause bright red blood during bowel movements, especially if there is straining involved. Given that you mentioned the bleeding occurs when wiping, this could be a likely cause.

2. Anal Fissures: These are small tears in the lining of the anus, often resulting from passing hard stools. While they typically cause pain, some individuals may experience bleeding without significant discomfort.

3. Diverticular Disease: Diverticulosis, a condition where small pouches form in the colon wall, can lead to diverticulitis, which may cause bleeding. This is usually accompanied by other symptoms like abdominal pain or changes in bowel habits.

4. Colorectal Polyps or Cancer: While less common, polyps or colorectal cancer can cause rectal bleeding. This is especially a concern if the bleeding is persistent and increasing in volume.

5. Gastrointestinal Conditions: Conditions such as inflammatory bowel disease (IBD), including Crohn's disease or ulcerative colitis, can lead to rectal bleeding. These conditions often present with other symptoms like diarrhea, abdominal pain, or weight loss.

When to Seek Medical Help
Given that you have noticed an increase in the volume of blood and that it has persisted longer than in the past, it is advisable to consult a healthcare professional. You should seek immediate medical attention if you experience:
- Significant or persistent rectal bleeding.

- Blood in your stool that is dark or tarry.

- Accompanying symptoms such as severe abdominal pain, dizziness, or fainting.

- Changes in bowel habits or unexplained weight loss.

Recommendations for Management
1. Hydration: Since you mentioned feeling dizzy and having a reduced fluid intake, it’s important to stay well-hydrated. Dehydration can exacerbate dizziness and may contribute to constipation, which can worsen hemorrhoids or fissures.

2. Dietary Adjustments: Incorporating a high-fiber diet can help prevent constipation and reduce straining during bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes.

3. Avoid Straining: When using the bathroom, try to avoid straining, as this can worsen hemorrhoids and lead to further bleeding.

4. Topical Treatments: Over-the-counter creams or ointments for hemorrhoids may provide relief if that is the underlying cause.

5. Monitoring Symptoms: Keep track of your symptoms, including the amount of bleeding, any changes in bowel habits, and any new symptoms that may arise.

Conclusion
While rectal bleeding can often be attributed to benign causes like hemorrhoids or anal fissures, the increase in bleeding volume and duration you are experiencing warrants a thorough evaluation by a healthcare provider. They may recommend diagnostic tests such as a colonoscopy to rule out more serious conditions. Early intervention can lead to better outcomes, so do not hesitate to seek medical advice.

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