Blood on Toilet Paper: Causes and When to See a Doctor

There is blood when wiping after a bowel movement?

A couple of days ago, I had diarrhea (watery), and today, because I was outside without access to a restroom, I held in the urge to go for about fifteen minutes.
After I finished and wiped, I noticed fresh red blood on the toilet paper, but there hasn't been any bleeding since.
What could this be? Do I need to see a doctor?

Niming, 10~19 year old female. Ask Date: 2015/07/25

Dr. Ke Fangxu reply Surgery

It is possible that holding in bowel movements for too long has caused mild rectal bleeding.
If there is no pain or ongoing bleeding, it is generally not a cause for concern.
However, if the rectal bleeding persists and is accompanied by pain, it may indicate an anal fissure.
It is recommended to take warm sitz baths, and if symptoms do not improve, medical attention should be sought.

Reply Date: 2015/07/25

More Info

When you notice blood on toilet paper after a bowel movement, it can understandably cause concern. The presence of bright red blood typically indicates that the bleeding is coming from the lower part of the gastrointestinal tract, such as the rectum or anus. There are several potential causes for this symptom, and while some may be benign, others may require medical attention.

One common cause of bright red blood on toilet paper is hemorrhoids. Hemorrhoids are swollen blood vessels in the rectal area that can become inflamed or irritated, often due to straining during bowel movements, constipation, or prolonged sitting. If you recently experienced diarrhea, as you mentioned, the subsequent straining during a bowel movement could have exacerbated any existing hemorrhoids, leading to bleeding.

Another possibility is anal fissures, which are small tears in the lining of the anus that can occur due to passing hard stools or straining. These fissures can cause sharp pain and bleeding during and after bowel movements, and the blood is usually bright red.

In some cases, the blood may be a sign of more serious conditions, such as diverticular disease, inflammatory bowel disease (IBD), or even colorectal polyps or cancer, especially if the bleeding is recurrent or accompanied by other symptoms like abdominal pain, changes in bowel habits, or weight loss.

Given that you experienced diarrhea recently and then noticed blood, it may be related to the strain or irritation caused by your bowel movements. However, it is essential to monitor your symptoms closely. If the bleeding persists, increases in volume, or is accompanied by other concerning symptoms (such as severe pain, fever, or changes in bowel habits), it is crucial to seek medical attention promptly.

In general, if you notice blood in your stool or on toilet paper, it is advisable to consult a healthcare professional, especially if it is a new symptom or if you have any underlying health conditions. A doctor may perform a physical examination, ask about your medical history, and possibly recommend further tests, such as a colonoscopy, to determine the cause of the bleeding.

In summary, while bright red blood on toilet paper can often be attributed to benign causes like hemorrhoids or anal fissures, it is essential to remain vigilant and consult a healthcare provider if the symptom persists or worsens. Early evaluation can help rule out more serious conditions and ensure appropriate management.

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