Anal Issues: Causes of Bleeding and Pain - Gastroenterology and Hepatology

Anal issues

A month ago, I noticed blood in my stool, but it went away after a while.
However, two days ago, after having a bowel movement, I experienced pain that lasted all day.
It hurts when I tighten my buttocks.
Later, when I got home and took a shower, I looked in the mirror and found a small swelling around my anus.
It feels swollen to the touch and is painful when pressed.
What could be the cause of this?

Ann, 10~19 year old female. Ask Date: 2015/11/28

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, based on the symptoms, it appears to be hemorrhoids or related conditions.
Please consult with the colorectal surgery department at Taoyuan Hospital, Ministry of Health and Welfare, with attending physician Dr.
Chi-Feng Chen.

Reply Date: 2015/11/28

More Info

Bleeding and pain in the anal area can be concerning symptoms that may arise from various underlying conditions. Based on your description, it sounds like you might be experiencing symptoms related to hemorrhoids, anal fissures, or possibly an infection or other rectal conditions. Let's break down these potential causes and their implications.

1. Hemorrhoids
Hemorrhoids are swollen veins in the lower rectum and anus, similar to varicose veins. They can be internal (inside the rectum) or external (under the skin around the anus). Symptoms of hemorrhoids include:
- Bleeding during bowel movements, which may appear bright red.

- Pain or discomfort, especially when sitting or during bowel movements.

- Swelling or a lump near the anus.

The fact that you noticed a small lump that is painful to touch could indicate an external hemorrhoid. They can become thrombosed (clotted), leading to increased pain and swelling.

2. Anal Fissures
An anal fissure is a small tear in the lining of the anus, often caused by passing hard stools or straining during bowel movements. Symptoms include:
- Sharp pain during and after bowel movements.

- Bright red blood on the stool or toilet paper.

- A visible tear or crack in the skin around the anus.

The pain you described, especially if it is sharp and occurs during bowel movements, could suggest an anal fissure.

3. Infections or Abscesses
Infections in the anal area can lead to abscesses, which are collections of pus that can cause swelling, pain, and sometimes fever. Symptoms might include:
- Severe pain in the anal area.

- Swelling or a lump that feels warm to the touch.

- Possible discharge of pus or blood.

4. Other Conditions
There are other less common conditions that could cause similar symptoms, including:
- Rectal prolapse, where part of the rectum protrudes through the anus.

- Inflammatory bowel disease (IBD), such as Crohn's disease or ulcerative colitis, which can cause rectal bleeding.

- Anal cancer, although this is rare, can present with bleeding and pain.

Recommendations
Given your symptoms, it is crucial to seek medical attention. A healthcare provider can perform a physical examination, which may include a visual inspection of the anal area and possibly a digital rectal exam. They may also recommend further tests, such as a colonoscopy, especially if there are concerns about more serious conditions.

In the meantime, here are some general self-care measures you can take:
- Dietary Changes: Increase fiber intake through fruits, vegetables, and whole grains to soften stools and reduce straining.

- Hydration: Drink plenty of water to help prevent constipation.

- Warm Baths: Soaking in a warm bath can help relieve pain and discomfort.

- Over-the-Counter Treatments: Creams or ointments specifically for hemorrhoids can provide temporary relief.

Conclusion
While your symptoms may be indicative of common conditions like hemorrhoids or anal fissures, it is essential to have a healthcare professional evaluate your situation to rule out more serious issues. Early diagnosis and treatment can significantly improve your comfort and health outcomes. Please do not hesitate to reach out to a healthcare provider for a thorough assessment.

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