Rectal Bleeding: Causes, Symptoms, and Solutions

Rectal bleeding

Hello Doctor: Previously, I experienced some pain in the anal area during bowel movements, but it went away.
However, in the past two to three days, I have started to feel pain in the anal area again during bowel movements, and I noticed bright red blood around the stool.
After wiping with toilet paper a few times, the bleeding stopped, but today I found an unknown object while wiping, which felt somewhat soft.
I was startled and haven't seen a doctor yet.
I have researched related issues online, and it mentioned that it could be caused by straining during bowel movements.
However, I would like to confirm if this is correct and how to resolve it.
Thank you, Doctor, for helping me understand my symptoms!

Liao, 20~29 year old female. Ask Date: 2015/10/02

Dr. Ke Fangxu reply Surgery

If you really want to confirm what the issue is, the only way is to have a physician conduct a personal examination.
Online consultations can only make the most likely inferences based on the information you provide, but without a physical examination, it is impossible to provide a definitive diagnosis.
Based on your description, the likelihood of an anal fissure seems higher, which is commonly associated with painful bowel movements and slight bleeding.
Typically, there is a history of constipation or diarrhea.
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, it will only treat the symptoms and not the root cause, potentially leading to chronic anal fissures that recur.
As for the unidentified object you mentioned, the information provided is limited to "somewhat soft," making it impossible to determine what it might be.

Reply Date: 2015/10/02

More Info

Rectal bleeding can be a concerning symptom, and understanding its causes, symptoms, and potential solutions is crucial for effective management. Based on your description, it appears that you are experiencing rectal pain and the presence of bright red blood on toilet paper after bowel movements. Additionally, you mentioned noticing an unknown soft object, which understandably has caused you some alarm.

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, especially during bowel movements. The blood is typically bright red, indicating that it is fresh.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain during and after bowel movements, along with bleeding.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can sometimes lead to diverticulitis, where these pouches become inflamed or infected, causing bleeding.

4. Infections or Inflammatory Conditions: Conditions such as inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, can also cause rectal bleeding.

5. Polyps or Colorectal Cancer: While less common, polyps (growths on the colon lining) or colorectal cancer can also present with rectal bleeding, especially in older adults or those with a family history of such conditions.

Symptoms to Watch For
- Bright red blood on toilet paper or in the toilet bowl
- Pain during bowel movements
- Changes in bowel habits (diarrhea, constipation)
- Abdominal pain or discomfort
- Unexplained weight loss or fatigue

Solutions and Recommendations
1. Seek Medical Attention: Given your symptoms, it is essential to consult a healthcare professional, preferably a gastroenterologist or a colorectal surgeon. They can perform a thorough examination, which may include a digital rectal exam, anoscopy, or colonoscopy to determine the exact cause of your bleeding.

2. Dietary Adjustments: Increasing fiber intake can help soften stools and reduce straining during bowel movements, which may alleviate symptoms related to hemorrhoids or anal fissures. Foods rich in fiber include fruits, vegetables, whole grains, and legumes.

3. Hydration: Drinking plenty of water is crucial to prevent constipation and promote regular bowel movements.

4. Topical Treatments: Over-the-counter creams or ointments can provide relief from hemorrhoids or anal fissures. These may contain hydrocortisone or witch hazel to reduce inflammation and discomfort.

5. Warm Sitz Baths: Soaking in warm water can help soothe anal pain and promote healing of fissures or hemorrhoids.

6. Avoid Straining: When using the bathroom, try to relax and avoid straining, as this can exacerbate bleeding and pain.

7. Monitor Symptoms: Keep track of your symptoms, including the frequency and amount of bleeding, any changes in bowel habits, and the presence of pain. This information will be valuable for your healthcare provider.

Conclusion
While rectal bleeding can often be attributed to benign causes such as hemorrhoids or anal fissures, it is essential to rule out more serious conditions. Your symptoms warrant a professional evaluation to ensure appropriate diagnosis and treatment. In the meantime, implementing dietary changes and self-care measures can help manage your symptoms. Remember, early intervention is key to preventing complications and promoting overall digestive health.

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