Rectal Bleeding: Causes and When to Seek Help - Gastroenterology and Hepatology

Q: Rectal Bleeding: Causes and When to Seek Help

Hello： Long-standing poor bowel habits can lead to hard stools, resulting in anal laxity. <br>If there is persistent bleeding, please consult a colorectal surgeon. <br>A diet rich in fiber, with plenty of fruits and vegetables, and low in fried and irritating foods is recommended

Rectal bleeding

I personally dislike having bowel movements because it takes a long time for me to pass stool.
I usually wait until my stomach feels uncomfortable before going, and I often hold it in until I can't anymore.
Last week, I experienced gastrointestinal discomfort.
Initially, I couldn't pass anything, so I took some intestinal health tablets for a few days.
On a certain day last week, when I felt more of an urge, I tried to go, but my stool was likely too hard.
After finishing, I experienced severe pain in my anus that lasted all night.
When I wiped after the bowel movement, I noticed a bit of blood on the toilet paper, but the color of the stool appeared normal.
At that time, I thought the bleeding was due to straining too hard.
My gastrointestinal discomfort persisted after the bowel movement.
However, I did have another bowel movement this week, and today I went again.
I didn't pass much, but there was still a bit of blood on the toilet paper, and the stool color remains normal.
I would like to ask the doctor if this is normal.

yu, 20~29 year old female. Ask Date: 2012/07/21

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello: Long-standing poor bowel habits can lead to hard stools, resulting in anal laxity.
If there is persistent bleeding, please consult a colorectal surgeon.
A diet rich in fiber, with plenty of fruits and vegetables, and low in fried and irritating foods is recommended.
Ensure adequate hydration and maintain sufficient physical activity.
Wishing you good health.
Sincerely, Dr.
Chi-Feng Chen, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2012/07/21

More Info

Rectal bleeding can be a concerning symptom, and it's important to understand its potential causes and when to seek medical help. Based on your description, it seems that your bowel movements have been difficult, leading to hard stools and pain during defecation. This can often result in small tears in the anal area, known as anal fissures, which can cause bleeding.

Causes of Rectal Bleeding
1. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can be quite painful and may result in bright red blood on the toilet paper or in the stool.

2. Hemorrhoids: Swollen blood vessels in the rectal area can also cause bleeding. Hemorrhoids can be internal or external and may cause discomfort, itching, 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. Gastrointestinal Conditions: Conditions such as inflammatory bowel disease (IBD), colorectal polyps, or even colorectal cancer can cause rectal bleeding, although these are less common in younger individuals.

5. Infections: Certain infections can lead to inflammation and bleeding in the gastrointestinal tract.

When to Seek Help
While occasional rectal bleeding, especially after hard stools, can be benign, there are specific situations where you should seek medical attention:
- Persistent Bleeding: If you notice blood in your stool or on toilet paper consistently over several days, it’s important to consult a healthcare provider.

- Severe Pain: If the pain during bowel movements is severe and does not improve, it may indicate a more serious issue.

- Changes in Bowel Habits: Any significant changes in your bowel habits, such as diarrhea or constipation lasting more than a few days, should be evaluated.

- Other Symptoms: If you experience additional symptoms such as weight loss, fever, or changes in appetite, these warrant immediate medical attention.

Recommendations for Management
1. Dietary Changes: Increasing your fiber intake can help soften stools and make bowel movements easier. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Additionally, staying well-hydrated is crucial.

2. Stool Softeners: Over-the-counter stool softeners can help ease the passage of stools and reduce the risk of fissures.

3. Warm Baths: Soaking in a warm bath can help relieve pain and promote healing of anal fissures.

4. Avoid Straining: Try to avoid straining during bowel movements. If you feel the urge to go, it’s best to respond promptly rather than waiting.

5. Consult a Healthcare Provider: If the bleeding continues or worsens, or if you have concerns about your symptoms, it’s essential to see a healthcare provider. They may recommend further evaluation, such as a physical examination or imaging studies, to determine the underlying cause of the bleeding.

In summary, while occasional rectal bleeding after hard stools can be due to benign causes like anal fissures or hemorrhoids, persistent or severe symptoms should not be ignored. Making dietary changes, staying hydrated, and seeking medical advice when necessary can help manage your symptoms and prevent further complications.

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