Rectal Bleeding: Causes and When to Seek Help

Recently, there has been blood in the stool?

Hello, I would like to ask about an issue I experienced about four or five years ago.
I had a situation where I held in my bowel movement, and when I finally went, there was bleeding (I distinctly felt the stool cutting through the area around the anus).
It took about a week to heal.
Since childhood (as far back as I can remember), I have had irregular bowel habits, having a bowel movement every three to four days.
Seven days ago, I felt some discomfort in my abdomen and had a mild episode of diarrhea (not completely watery), but there was blood in one area on the surface.
When I wiped, there was blood, but it stopped after that.
Today, I had two more bowel movements, both of which had blood as well.
Initially, there was no blood, but it appeared later on.
The last two bowel movements were quite normal in shape, and I didn't have to strain much to pass them.
What could this situation be, doctor? I am currently in college, and I checked the clinic hours at my school hospital, but I can't really fit them into my schedule (unless I take a leave of absence), or I may need to find another clinic.
What should I do?

Xiao Wang, 20~29 year old female. Ask Date: 2015/11/29

Dr. Ke Fangxu reply Surgery

Based on your description, it seems likely that you are experiencing an anal fissure.
Common symptoms include pain during bowel movements accompanied by slight bleeding, often with 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, this will only provide temporary relief and may lead to chronic anal fissures with recurrent episodes.
If you are unable to seek medical attention during the day due to class commitments, most hospitals offer evening outpatient services.
Please carefully review the clinic schedule and seek medical care as soon as possible.

Reply Date: 2015/11/29

More Info

Rectal bleeding can be a concerning symptom, and understanding its causes and when to seek medical help is crucial for your health. Based on your description, it seems that you have experienced rectal bleeding on multiple occasions, particularly after episodes of constipation and straining during bowel movements. This is a common scenario that can lead to several potential causes.

One of the most frequent causes of rectal bleeding, especially in individuals with a history of constipation, is the development of anal fissures. An anal fissure is a small tear in the lining of the anus, which can occur when hard or large stools pass through. This can cause sharp pain during bowel movements and may lead to bright red blood on the toilet paper or in the stool. Given that you mentioned feeling a sensation of being "cut" during bowel movements, this could very well be the case.

Another possibility is hemorrhoids, which are swollen blood vessels in the rectal area. Hemorrhoids can be internal or external, and they often cause bleeding during bowel movements, along with discomfort or itching. The fact that you have had irregular bowel habits (having a bowel movement every three to four days) could contribute to the development of hemorrhoids or fissures, as straining can exacerbate these conditions.

In your case, since you have experienced rectal bleeding again after a period of discomfort and changes in your bowel habits, it is essential to monitor the situation closely. If the bleeding persists, increases in frequency, or is accompanied by other symptoms such as severe pain, changes in bowel habits, or weight loss, it is crucial to seek medical attention. While it may be challenging to find time to visit a healthcare provider due to your university schedule, it is important to prioritize your health. You might consider visiting a local urgent care clinic or a gastroenterologist, as they can often accommodate patients without the need for a long wait.

In terms of management, here are some steps you can take to help alleviate your symptoms and prevent further issues:
1. Increase Fiber Intake: Aim to consume a diet rich in fiber, including fruits, vegetables, whole grains, and legumes. This can help soften your stools and promote regular bowel movements, reducing the risk of straining.

2. Stay Hydrated: Drinking plenty of water is essential for maintaining soft stools. Aim for at least 8-10 glasses of water a day.

3. Regular Bowel Habits: Try to establish a routine for bowel movements. Setting aside time each day, especially after meals, can help train your body to have regular bowel movements.

4. Avoid Straining: If you feel the urge to go, try not to hold it in. If you are having difficulty, consider using over-the-counter stool softeners or fiber supplements after consulting with a healthcare provider.

5. Warm Baths: Taking warm baths can help soothe anal discomfort and promote relaxation, which may help with bowel movements.

6. Over-the-Counter Treatments: If you suspect hemorrhoids, topical treatments or suppositories may provide relief. However, consult with a healthcare provider before starting any new medication.

In conclusion, while occasional rectal bleeding can be benign, it is essential to take it seriously, especially if it recurs. Monitoring your symptoms and seeking medical advice when necessary is key to ensuring your health and well-being. If you find it difficult to visit your university's health services, consider looking for nearby clinics that may offer more flexible hours. Your health is worth the effort.

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