Rectal Bleeding: Causes and When to Seek Further Testing

Q: Rectal Bleeding: Causes and When to Seek Further Testing

Hello： Internal hemorrhoids can cause bleeding, and the presence of red spots in the stool is possible. <br>It is recommended to treat the hemorrhoids, and since you have already undergone a colonoscopy, there is no need for further examination. <br>Changhua Hospital cares about

Rectal bleeding

Hello, Dr.
Tsai.
Last week, I experienced bleeding during a bowel movement, and I felt a stretching sensation in my anus.
The blood was bright red on the surface of the stool, and there was a lot of blood on the toilet paper.
The bleeding lasted for about two days and then stopped.
Today, during a bowel movement, I noticed two or three red spots on the stool that looked like fresh blood, but there was no blood on the toilet paper.
The shape of my stool varies; sometimes it is normal, sometimes it is flat, and sometimes it is unformed.
I had a similar issue at the end of March this year and underwent a colonoscopy, which showed everything normal except for internal hemorrhoids.
The doctor said it was due to the internal hemorrhoids and irritable bowel syndrome.
Can internal hemorrhoids cause red spots on the stool? Do I need to undergo further testing? Thank you.

hhoen, 30~39 year old female. Ask Date: 2015/12/09

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: Internal hemorrhoids can cause bleeding, and the presence of red spots in the stool is possible.
It is recommended to treat the hemorrhoids, and since you have already undergone a colonoscopy, there is no need for further examination.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2015/12/09

More Info

Rectal bleeding can be concerning, and understanding its causes is crucial for determining the appropriate course of action. Based on your description, it seems you have experienced fresh red blood on the surface of your stool and on toilet paper, along with some changes in your bowel habits. You mentioned that you previously underwent a colonoscopy, which revealed hemorrhoids (referred to as "internal痣" in your message) and a diagnosis of irritable bowel syndrome (IBS).
Firstly, it's important to clarify that fresh red blood in the stool often indicates bleeding from the lower gastrointestinal tract, which includes the rectum and anus. Common causes of rectal bleeding include hemorrhoids, anal fissures, diverticular disease, and in some cases, more serious conditions such as colorectal polyps or cancer. Given that you have a history of hemorrhoids, it is quite possible that the bleeding you are experiencing is related to this condition. Hemorrhoids can cause bright red blood on the stool or toilet paper, especially during bowel movements when straining occurs.

The fact that you have noticed blood on the surface of your stool and that your stool consistency varies could suggest that your bowel habits are affected by IBS. IBS can lead to changes in stool form, including diarrhea, constipation, or alternating between both. The presence of blood, however, should always be evaluated carefully, especially if it is a new symptom or if it has changed in frequency or appearance.

Regarding your question about whether internal hemorrhoids can cause small red spots on the stool, the answer is yes. Internal hemorrhoids can bleed, and this blood can mix with the stool or appear on the surface. However, it is essential to monitor the situation closely. If the bleeding persists, increases in volume, or is accompanied by other symptoms such as significant abdominal pain, changes in bowel habits, or unexplained weight loss, further evaluation is warranted.

In your case, since you have already had a colonoscopy that showed no serious issues apart from hemorrhoids, it may not be immediately necessary to undergo another invasive procedure unless your symptoms change significantly. However, it is advisable to consult your healthcare provider to discuss your ongoing symptoms. They may recommend a physical examination or possibly a repeat colonoscopy if they feel it is warranted based on your current symptoms.

In summary, while your symptoms may be related to hemorrhoids and IBS, it is essential to remain vigilant. Keep track of any changes in your bleeding pattern, stool consistency, and any accompanying symptoms. If you have concerns or if the bleeding continues, do not hesitate to seek further medical advice. Your health is paramount, and ensuring that any potential issues are addressed promptly is crucial.

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