Rectal Bleeding: Causes and Solutions for Your Symptoms

Bowel movements are smooth, but there is frequent bleeding from the anus?

Hello, Dr.
Ke: I generally consume a moderate amount of fruits and vegetables, about 2 to 3 bowls a day.
I have regular bowel movements every day, usually completed within 10 minutes.
However, occasionally I experience a tearing sensation when passing stool, and I notice fresh blood on the toilet paper when wiping.
Additionally, I feel pain around the anal area when it comes into contact with water.
This has been a recurring issue since high school.
Since last month, I have frequently experienced bleeding from the anus during bowel movements, but the blood does not mix with the stool, and the amount is usually a few drops, sometimes more.
What could be the issue? I would like to try increasing my water intake as a way to improve this.

Cheng, 20~29 year old female. Ask Date: 2015/06/13

Dr. Ke Fangxu reply Surgery

Minor bleeding accompanied by anal pain is often due to anal fissures.
It is recommended to improve bowel habits and increase the intake of fruits and vegetables.
Drinking plenty of water during the hot summer months can also be beneficial.
If these measures are ineffective, you may consult a physician for a prescription of topical medications for treatment.

Reply Date: 2015/06/13

More Info

Rectal bleeding can be a concerning symptom, and it is important to understand the potential causes and appropriate solutions. Based on your description, it seems that you are experiencing bright red blood on the toilet paper after bowel movements, along with a tearing sensation and pain when the area comes into contact with water. This symptom has been ongoing since high school but has become more frequent over the past month.

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 pain, itching, and bleeding during bowel movements. The blood is usually bright red and may appear on the toilet paper or in the toilet bowl.

2. Anal Fissures: An anal fissure is a small tear in the lining of the anus, often caused by passing hard stools. This can lead to sharp pain during bowel movements and may result in bleeding. The blood is typically bright red and may be seen on the toilet paper.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can sometimes lead to diverticulitis, causing inflammation and bleeding. However, this is less common in younger individuals.

4. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause rectal bleeding, along with other symptoms such as abdominal pain, diarrhea, and weight loss.

5. Polyps or Colorectal Cancer: While less common in younger individuals, polyps can develop in the colon and rectum, and some can become cancerous over time. Bleeding may occur, and it is important to rule this out, especially if you have a family history of colorectal cancer.

Recommended Solutions
1. Increase Fluid and Fiber Intake: Since you mentioned considering increasing your water intake, this is a good start. Staying hydrated helps soften stools, making them easier to pass. Additionally, increasing your fiber intake through fruits, vegetables, and whole grains can help prevent constipation and reduce straining during bowel movements.

2. Avoid Straining: Straining during bowel movements can exacerbate hemorrhoids and fissures. If you feel the urge to go, try to respond promptly rather than waiting, as delaying can lead to harder stools.

3. Warm Sitz Baths: Taking warm sitz baths can help soothe the anal area and promote healing if you have hemorrhoids or fissures. Soaking for 10-15 minutes a few times a day can provide relief.

4. Over-the-Counter Treatments: There are various over-the-counter creams and ointments available for hemorrhoids that can help reduce inflammation and discomfort. However, consult with a healthcare professional before starting any treatment.

5. Consult a Healthcare Provider: Given that you have been experiencing this issue for an extended period, it is crucial to consult a healthcare provider for a thorough evaluation. They may recommend a physical examination, possibly including a digital rectal exam or colonoscopy, to determine the exact cause of your bleeding.

When to Seek Immediate Medical Attention
If you experience significant bleeding (more than a few drops), severe pain, changes in bowel habits, or any other concerning symptoms, it is essential to seek medical attention promptly. These could be signs of a more serious condition that requires immediate intervention.

In summary, while occasional rectal bleeding can be due to benign causes like hemorrhoids or fissures, persistent symptoms warrant a thorough evaluation by a healthcare professional to rule out any serious underlying conditions. Taking proactive steps to improve your diet and hydration can help, but professional guidance is key to addressing your symptoms effectively.

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