Sudden Changes in Bowel Habits and Rectal Bleeding - Gastroenterology and Hepatology

Changes in bowel habits. Large amounts of bleeding from the anus?

Hello Dr.
Chen,
I have two questions I would like to ask, hoping you can clarify and provide treatment methods and guidance.
1) I have always had normal bowel movements, typically once a day, occasionally twice (unless I have diarrhea).
However, for the past month, I have frequently felt the urge to defecate but have been unable to do so.
Sometimes it takes 2 to 3 days before I can have a bowel movement.
Three weeks ago, I had a cold and took medication for three days; I am unsure if this has had any effect.
In the past week, I have often felt the urge to defecate but have struggled to do so while sitting on the toilet.
Although I can eventually pass stool after prolonged sitting and straining, the process is quite painful, and the stool is hard and round.
I am worried this may be "constipation." My lifestyle and diet are normal; I enjoy exercising, drinking tea, and soup, and I sweat easily due to well-developed sweat glands.
(However, my bowel movements have always been normal before.) This sudden change in bowel habits has left me surprised and anxious, so I am reaching out for your advice.
2) My wife has had a history of constipation for several years, during which she also experienced minor hemorrhoids.
Over the past few years, she has developed a routine of drinking a glass of warm water every morning and has been consistently exercising, which has improved her constipation to a normal state.
However, on the night of the Mid-Autumn Festival, she suddenly experienced significant rectal bleeding, with blood dripping, which caused her great distress.
Due to the Mid-Autumn holiday, it was inconvenient to seek medical attention, so she endured it and applied some medication that slightly stopped the bleeding.
However, she has since felt the need to use the restroom frequently, going 5 to 7 times a day, with only a small amount each time.
Additionally, straining during bowel movements has caused bleeding, leading to slight swelling of the hemorrhoids.

Could you please explain the reason for this sudden bleeding? Can smaller hemorrhoids be treated with medication? Is surgery necessary?
I sincerely hope you can provide clarification and guidance on these issues.
Thank you very much!

Suǒ Shàng, 60~69 year old female. Ask Date: 2013/09/25

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello,
1.
Taking medication for a cold can easily lead to increased heat and constipation; some cough medications may also have an impact.
Please consume more fruits and vegetables and drink plenty of water.
If symptoms persist, medical attention is necessary.

2.
Rectal bleeding is most commonly associated with hemorrhoids.
Please consult a colorectal specialist for evaluation.

Wishing you good health,
Dr.
Chi-Feng Chen, Taoyuan Hospital

Reply Date: 2013/09/25

More Info

Understanding sudden changes in bowel habits and rectal bleeding can be concerning, especially when they deviate from what is typically normal for an individual. Let's address your two questions in detail.

1. Changes in Bowel Habits: You mentioned that you have experienced a sudden change in your bowel habits, specifically difficulty in passing stools, which are hard and round. This could indeed indicate constipation. Constipation can be caused by various factors, including dietary changes, dehydration, lack of physical activity, or even stress. You mentioned that you were sick three weeks ago and took medication, which could have contributed to changes in your gastrointestinal function. Some medications can lead to constipation as a side effect.
To manage constipation, consider increasing your fiber intake through fruits, vegetables, and whole grains. Drinking plenty of fluids, especially water, is crucial as it helps soften the stool. Regular physical activity can also stimulate bowel movements. If these lifestyle changes do not improve your symptoms, it may be beneficial to consult a healthcare professional for further evaluation and potential treatment options, which may include over-the-counter laxatives or other medications.

2. Rectal Bleeding and Hemorrhoids: Your wife’s experience of sudden rectal bleeding, especially after a period of constipation, is not uncommon. Hemorrhoids, which are swollen veins in the rectal area, can become aggravated by straining during bowel movements, leading to bleeding. The fact that she has a history of hemorrhoids and has experienced a significant increase in bowel movements with bleeding suggests that her hemorrhoids may have become inflamed or thrombosed (a clot has formed within the hemorrhoid).

The treatment for hemorrhoids can often be managed with conservative measures, including topical treatments, sitz baths, and dietary changes to prevent constipation. In many cases, small hemorrhoids can be treated effectively without the need for surgical intervention. However, if the bleeding persists, becomes more severe, or if there are other concerning symptoms (such as significant pain, changes in bowel habits, or weight loss), it is essential to seek medical attention. A healthcare provider can perform a thorough examination and may recommend procedures such as rubber band ligation or sclerotherapy for more severe cases.

In summary, both your concerns highlight the importance of monitoring changes in bowel habits and any associated symptoms like rectal bleeding. While lifestyle modifications can often help manage these issues, it is crucial to consult a healthcare professional if symptoms persist or worsen. Regular check-ups and open communication with a doctor can help ensure that any underlying conditions are addressed promptly, providing peace of mind and better health outcomes.

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