Rectal Bleeding: Causes, Symptoms, and When to Seek Help

Q: Rectal Bleeding: Causes, Symptoms, and When to Seek Help

Hello： The likelihood of hemorrhoids increases with age. <br>Even after surgery, hemorrhoids may recur. <br>It is recommended to seek surgical treatment from a colorectal specialist. <br>Generally, the possibility of not detecting polyps is low. <br>Wishing you safety and health.

Rectal bleeding

Hello Doctor: During my high school entrance exam period, I experienced rectal bleeding for a while.
When I consulted a doctor, they suggested that it might be due to stress and irregular lifestyle, so I didn't pay much attention to it.
However, even after starting college, the issue persisted.
There would be periods without bleeding, followed by sudden episodes of bleeding.
The blood was bright red and appeared to float on the surface of the water.
Due to my irregular eating habits and lifestyle, I often suffer from constipation.
I initially thought it might be hemorrhoids until recently when the bleeding continued, and I noticed a slippery, mucus-like sensation when wiping.
It felt like blood was dripping when I used the restroom.
After researching online, I learned that it could be polyps or cancer, so I went to the hospital for a check-up.
Although there was a positive fecal occult blood test, the colonoscopy only revealed a benign polyp less than one centimeter in size.
The doctor said there was no significant issue, but mentioned that I had two polyps at the anal opening, suggesting it might be hemorrhoids.
After the examination, my bowel movements returned to normal, but recently I started experiencing rectal bleeding again.
There is no pain or sensation of dripping blood, but there is a small amount of blood when wiping, and a significant amount of blood in the toilet, again appearing to float on the water.
Additionally, there is a layer on top of the blood that I can't identify, whether it's oil or mucus.
What could these symptoms indicate? Is it serious? During the colonoscopy, I did not receive medication to reduce colonic contractions; could this be why other polyps were not detected? I am very concerned about my condition.
Thank you.

Ling, 20~29 year old female. Ask Date: 2014/11/03

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello: The likelihood of hemorrhoids increases with age.
Even after surgery, hemorrhoids may recur.
It is recommended to seek surgical treatment from a colorectal specialist.
Generally, the possibility of not detecting polyps is low.
Wishing you safety and health.
Dr.
Chen Chih-Feng, Gastroenterology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2014/11/03

More Info

Rectal bleeding can be a concerning symptom, and understanding its potential causes, symptoms, and when to seek medical help is crucial for your health. Based on your description, it seems you have been experiencing intermittent rectal bleeding, which has led to significant concern about the underlying causes, including the possibility of hemorrhoids, polyps, or even colorectal cancer.

Causes of Rectal Bleeding
1. Hemorrhoids: These are swollen veins in the lower rectum or anus that can cause bright red blood during bowel movements. They are often associated with straining during bowel movements, constipation, or prolonged sitting.

2. Anal Fissures: Small tears in the lining of the anus can occur due to passing hard stools, leading to pain and bleeding.

3. Polyps: These are growths on the lining of the colon or rectum. While many polyps are benign, some can develop into cancer over time.

4. Colorectal Cancer: This is a more serious cause of rectal bleeding and can present with other symptoms such as changes in bowel habits, weight loss, or abdominal pain.

5. Diverticular Disease: Diverticulosis can lead to diverticulitis, which may cause bleeding.

6. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause inflammation and bleeding in the gastrointestinal tract.

Symptoms to Monitor
- Color of Blood: Bright red blood usually indicates bleeding from the lower gastrointestinal tract, while darker blood may suggest a source higher up in the digestive tract.

- Presence of Mucus: The presence of mucus or a slimy substance along with blood can indicate inflammation or irritation in the rectal area.

- Pain: While you mentioned no pain, any new or worsening pain should be reported to a healthcare provider.

- Changes in Bowel Habits: Any significant changes in your bowel habits, such as diarrhea or constipation, should be noted.

When to Seek Help
You should seek medical attention if you experience:
- Significant or persistent bleeding.

- Blood mixed with stool.

- Severe abdominal pain.

- Changes in bowel habits that last more than a few days.

- Symptoms of anemia, such as fatigue, weakness, or shortness of breath.

Follow-Up and Further Testing
Given that you have already undergone a colonoscopy, and a benign polyp was found, it is reassuring, but it does not rule out other potential issues. If you continue to experience rectal bleeding, it is essential to follow up with your healthcare provider. They may recommend:
- Repeat Colonoscopy: If symptoms persist, a repeat colonoscopy may be necessary to ensure no additional polyps or lesions are present.

- Imaging Studies: In some cases, imaging studies like a CT scan may be warranted to evaluate the gastrointestinal tract further.

- Dietary and Lifestyle Modifications: Since you mentioned issues with constipation, increasing fiber intake, staying hydrated, and regular exercise can help manage bowel health.

Conclusion
While it is understandable to be concerned about rectal bleeding, many causes are benign and manageable. However, ongoing symptoms warrant further investigation. It is crucial to maintain open communication with your healthcare provider and report any new or worsening symptoms. Regular screenings and proactive management of your gastrointestinal health can help prevent more serious complications in the future.

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