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

Blood in the stool?

Hello Doctor, for the past two weeks, I have been experiencing a tearing sensation in my anus during bowel movements.
I purchased over-the-counter suppositories for treating anal fissures and hemorrhoids, which have anti-inflammatory properties, promote blood circulation, and aid in wound healing.
I had used these before when I had similar symptoms, so I decided to continue using them this time.
Previously, when I felt the tearing sensation, I noticed only a small amount of bright red blood on the toilet paper after wiping, and occasionally there would be drops of blood or blood on the stool.
However, this time, while experiencing the tearing sensation during bowel movements, I noticed more blood on the toilet paper and also on the stool, which turned the toilet water slightly red.
Occasionally, there are drops of blood as well.
I usually eat fruits and vegetables and drink plenty of water, but I think I developed a bit of constipation from sitting a lot during the summer, which may have led to the tearing pain in my anus.

Should I continue using the over-the-counter medication? Once I feel better, should I keep using it? (Last time, I felt better after using it for 3-4 days, but this time it has been 4 days and I still haven't improved.) Is it possible that this could be lower gastrointestinal bleeding? Could this be a case of chronic anal fissure that is recurring, or could it be accompanied by hemorrhoids? I have noticed a small skin tag around my anus, but it doesn't hurt or cause any discomfort when I touch it.
Thank you, Doctor.

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

Dr. Ke Fangxu reply Surgery

Lower gastrointestinal bleeding refers to bleeding occurring below the duodenum, which includes bleeding around the anal area.
Based on your description, it seems more likely that you are experiencing an anal fissure, which commonly presents with pain during bowel movements accompanied by slight bleeding.
Typically, there is a history of constipation or diarrhea prior to this condition.
Treatment primarily involves topical ointments and suppositories, along with warm sitz baths to effectively alleviate pain.
However, it is essential to address the underlying bowel movement issues; otherwise, this may only provide temporary relief and could lead to chronic anal fissures with recurrent episodes.
To determine if hemorrhoids are also present, an examination of the anal area is necessary.
If the pain and bleeding persist for more than a week without improvement, it is important to consult a physician for further evaluation.

Reply Date: 2015/09/30

More Info

Rectal bleeding can be a concerning symptom, and understanding its potential causes, treatments, and when to seek medical help is crucial for your health. Based on your description, it seems you are experiencing symptoms consistent with anal fissures and possibly hemorrhoids, both of which can lead to rectal bleeding.

Causes of Rectal Bleeding
1. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools or straining during bowel movements. The tearing sensation you described, along with the presence of blood on toilet paper and in the toilet bowl, suggests that you may have an anal fissure.

2. Hemorrhoids: These are swollen veins in the lower rectum or anus that can cause discomfort, itching, and bleeding. The "small meat bump" you mentioned could be a hemorrhoid, especially if it does not cause pain.

3. Constipation: As you noted, sitting for prolonged periods and experiencing constipation can lead to straining during bowel movements, which can exacerbate both fissures and hemorrhoids.

4. Other Causes: While less common, rectal bleeding can also be caused by conditions such as diverticulosis, inflammatory bowel disease (IBD), or colorectal polyps. If bleeding persists or is accompanied by other symptoms (like significant pain, changes in bowel habits, or weight loss), further evaluation may be necessary.

Treatments
1. Topical Treatments: Over-the-counter creams and suppositories designed for hemorrhoids and fissures can help reduce inflammation, promote healing, and alleviate pain. If you have been using these for four days without improvement, it may be time to reassess their effectiveness.

2. Dietary Changes: Increasing fiber intake through fruits, vegetables, and whole grains can help soften stools and reduce straining. Staying well-hydrated is also essential.

3. Sitz Baths: Soaking in warm water can help soothe the anal area and promote healing.

4. Avoid Straining: If you feel the urge to go, try not to delay it. Straining can worsen fissures and hemorrhoids.

5. Medical Evaluation: If your symptoms do not improve with home treatment, or if you experience significant bleeding, pain, or other concerning symptoms, it is important to consult a healthcare professional. They may perform a physical examination and possibly recommend further tests, such as a colonoscopy, to rule out other conditions.

When to Seek Help
You should seek medical attention if:
- You experience heavy bleeding (more than a small amount on toilet paper).

- The pain is severe or worsening.

- You notice changes in your bowel habits (such as diarrhea or constipation).

- You have other symptoms like fever, weight loss, or abdominal pain.

Conclusion
In summary, while your symptoms may be related to anal fissures or hemorrhoids, it is essential to monitor your condition closely. If over-the-counter treatments do not provide relief, or if your symptoms worsen, please consult a healthcare professional for a thorough evaluation. They can provide a definitive diagnosis and appropriate treatment plan tailored to your needs. Remember, early intervention can prevent complications and promote faster recovery.

Similar Q&A

Understanding Rectal Bleeding: Causes and When to Seek Help

Hello, doctor. My wife has recently been experiencing rectal bleeding. Could you please explain what the situation might be regarding the e-hospital in Taiwan? Thank you.

Dr. Xie Yonghui reply Internal Medicine
Hello, Xiao Zhang: Your spouse has recently experienced rectal bleeding. It is important to first observe the nature of the blood in the stool. If it is black (tarry stool), this indicates upper gastrointestinal bleeding, most commonly caused by peptic ulcers (gastric or duodenal...

Understanding Rectal Bleeding: When to Seek Further Medical Evaluation

Hello doctor, I have been experiencing intermittent rectal bleeding for the past eight months, with about five to ten episodes of bleeding each month. During this time, I have seen three doctors, had two digital rectal examinations, and one colonoscopy. The doctors have all diagn...

Dr. Cai Xingzhi reply Surgery
There are many causes of rectal bleeding. It is important to consult a colorectal surgeon for an accurate diagnosis to ensure appropriate treatment. The causes of blood in the stool include hemorrhoids, anal fissures, anal polyps, and colorectal cancer, among others.

Understanding Rectal Bleeding: Causes and When to Seek Help

Recently, I have been experiencing rectal bleeding that resembles the amount of blood during my menstrual period. This morning, when I tried to use the bathroom, I passed gas and noticed a significant amount of blood as well, but there is no pain. What could be the cause of this?

Dr. Zhang Shuhao reply Surgery
Painless rectal bleeding with a significant amount of bright red blood is often caused by internal hemorrhoids. A consultation for a flexible sigmoidoscopy or anoscopy can be performed to assess the condition of the hemorrhoids and rule out any potential rectal lesions. Regular w...

Understanding Rectal Bleeding: When to Seek Medical Attention

Hello doctor, I have recently experienced rectal bleeding, with the toilet water turning red and obscuring the appearance of my stool. I also feel a sharp pain in my anus during bowel movements, and there is bright red blood and clots on the toilet paper after wiping. Additionall...

Dr. Hu Guozheng reply Gastroenterology and Hepatology
It is recommended to visit the colorectal surgery outpatient clinic. Thank you.