Blood Streaks After Bowel Movements: Anal Tears - Gastroenterology and Hepatology

There is no blood in the stool, but there are traces of blood when wiping?

Last week, I experienced a tearing sensation in my anus due to excessive wiping after bowel movements, which happened about three times in a row.
Since the first injury, I have tried to reduce the force I use when wiping, but I still ended up injuring myself.
I can't figure out what the problem is, as I have been wiping as I usually do.
After my anus healed, I started noticing occasional blood streaks after wiping for a few days following bowel movements.
This has continued for three days now, and I am unsure what the issue might be.
Therefore, I am reaching out for advice.
Thank you, doctor, for taking the time to respond.
I also want to express my gratitude for the high-quality services that you provide to us, the general public, at a lower cost.
Thank you for your dedication and efforts.

Chenchen, 10~19 year old female. Ask Date: 2015/09/30

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, finding blood stains when wiping can commonly indicate anal fissures or hemorrhoids.
It is advised not to strain during bowel movements.
If the condition is severe, please consult a specialist in colorectal surgery.
This is a response from Dr.
Lin Ming-Hui, attending physician of the Gastroenterology Department at Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/09/30

More Info

Experiencing blood streaks after bowel movements can be concerning, and it often indicates an underlying issue that needs to be addressed. Based on your description, it sounds like you may be dealing with anal fissures, which are small tears in the lining of the anus. These can occur due to various reasons, including straining during bowel movements, passing hard stools, or excessive wiping, as you mentioned.

When you wipe too vigorously, it can irritate the sensitive skin around the anus, leading to tears. The fact that you have experienced this multiple times suggests that the area may still be healing, and any additional trauma could exacerbate the situation. The presence of blood streaks after bowel movements, especially if it is bright red, typically indicates that the bleeding is coming from the lower part of the gastrointestinal tract, such as the rectum or anus, rather than from higher up in the digestive system.

Here are some steps you can take to manage and prevent further irritation:
1. Gentle Wiping: As you've already started doing, continue to be gentle when wiping. Consider using moist wipes or a bidet to clean the area without the friction that dry toilet paper can cause.

2. Increase Fiber Intake: A diet high in fiber can help soften stools and make bowel movements easier. Foods like fruits, vegetables, whole grains, and legumes are excellent sources of fiber. Additionally, staying well-hydrated by drinking plenty of water can also help.

3. Avoid Straining: If you feel the urge to go, try not to delay it. Straining can worsen fissures and lead to further bleeding. If you find that you are having difficulty passing stools, consider using a stool softener or a fiber supplement.

4. Warm Baths: Taking warm baths can help soothe the area and promote healing. Soaking in warm water for about 10-15 minutes can relieve discomfort and improve blood flow to the area.

5. Topical Treatments: Over-the-counter creams or ointments that contain hydrocortisone or other soothing ingredients can help reduce inflammation and promote healing. However, consult with a healthcare provider before using any medication.

6. Consult a Healthcare Provider: If the bleeding persists, worsens, or is accompanied by severe pain, it is essential to seek medical advice. A healthcare provider can perform a thorough examination to rule out other potential causes of bleeding, such as hemorrhoids, polyps, or more serious conditions.

7. Follow-Up Care: If you have been diagnosed with anal fissures, follow your healthcare provider's recommendations for treatment and follow-up care. They may suggest additional interventions if conservative measures do not lead to improvement.

In summary, while anal fissures are common and often heal with proper care, persistent symptoms warrant a professional evaluation to ensure there are no other underlying issues. Taking steps to prevent further irritation and promoting healing through dietary changes and gentle hygiene practices can significantly improve your situation. If you have any concerns or if symptoms do not improve, do not hesitate to reach out to a healthcare professional for further guidance.

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