Rectal Bleeding: Is It Hemorrhoids or Something More Serious?

There was bleeding during bowel movements, but it has since stopped?

(There has been a history of constipation, with bowel movements occurring only 1-2 times a week.) On Monday, during a bowel movement, I noticed fresh blood while wiping, and there was some pain in the anal area, which I thought might be due to hemorrhoids, so I didn't pay much attention to it.
(I had not experienced any bleeding during bowel movements before.) On Tuesday, I continued to have bowel movements, but both passing gas and having a bowel movement were painful, and the bleeding started to increase.
On Wednesday, I had bowel movements as usual, with pain during gas and bowel movements, but it was somewhat better, and the bleeding continued to increase.
On Thursday, I had a bowel movement, but the bleeding was unusually heavy, and I noticed something that looked like a blood clot (only one large piece), resembling a clot formed during heavier menstrual bleeding.
Additionally, the blood loss was more significant this time.
The stool shape resembled a black-and-white yin-yang symbol, being short, round, and with a tail.
On Friday, I had a bowel movement as usual, with no bleeding and less pain; the stool became longer and varied in width, resembling my previous stool shape.
On Saturday, I had a bowel movement as usual, with no bleeding, less pain, and it was very smooth.
Q&A:
1.
Is this hemorrhoids or something else?
2.
Since there was one day with something resembling a blood clot, could it be colon cancer?
3.
But since there was no bleeding afterward, can colon cancer have periods of no bleeding?
4.
Should I seek medical attention promptly?

Xiao Fang, 20~29 year old female. Ask Date: 2015/06/06

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, based on the symptoms, it may be severe hemorrhoidal bleeding.
It is recommended to consult a colorectal surgeon.
Wishing you safety and health.
Sincerely, Dr.
Chi-Feng Chen, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/06/06

More Info

Understanding rectal bleeding can be quite concerning, especially when it presents with symptoms such as pain and the presence of blood. Based on the symptoms you've described, it is essential to consider several potential causes, including hemorrhoids, anal fissures, and more serious conditions like colorectal cancer.

1. Is it hemorrhoids?
Hemorrhoids are swollen veins in the lower rectum and anus that can cause bleeding, especially during bowel movements. The fact that you experienced pain and bright red blood on the toilet paper after a bowel movement suggests that hemorrhoids could be a likely cause. The blood is typically bright red, indicating that it is coming from the lower gastrointestinal tract, which aligns with your symptoms. The presence of blood clots could also occur with hemorrhoids, especially if there is significant straining during bowel movements.

2. Could it be something more serious, like colorectal cancer?
While hemorrhoids are a common cause of rectal bleeding, the presence of blood clots and changes in bowel habits can raise concerns about more serious conditions, including colorectal cancer. However, colorectal cancer typically presents with other symptoms such as changes in bowel habits (persistent diarrhea or constipation), unexplained weight loss, and abdominal discomfort. The fact that your bleeding resolved and you experienced a return to normal bowel movements is reassuring, but it does not completely rule out the possibility of a serious condition.

3. Can colorectal cancer have periods of no bleeding?
Yes, colorectal cancer can have periods of bleeding and non-bleeding. Some patients may experience intermittent bleeding, while others may have continuous symptoms. The variability in symptoms can make it challenging to diagnose without proper medical evaluation.

4. Should you seek medical attention?
Given your symptoms, it is advisable to seek medical attention. A healthcare provider can perform a thorough evaluation, which may include a physical examination, a digital rectal exam, and possibly a colonoscopy to visualize the colon and rectum. This is particularly important if you have a history of constipation, as straining can lead to conditions like hemorrhoids or fissures, but it can also exacerbate underlying issues.

In addition to seeking medical advice, consider the following recommendations:
- Dietary Changes: Increasing fiber intake can help alleviate constipation and reduce straining during bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying hydrated is also crucial.

- Over-the-Counter Treatments: If hemorrhoids are suspected, over-the-counter creams or suppositories may provide relief. However, these should not replace a visit to a healthcare provider.

- Avoid Straining: Try to avoid straining during bowel movements, as this can worsen hemorrhoids and lead to further complications.

In summary, while your symptoms may suggest hemorrhoids, it is essential to rule out more serious conditions through a medical evaluation. Early diagnosis and treatment can significantly improve outcomes and alleviate your concerns. Don't hesitate to reach out to a healthcare professional for guidance and support.

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