Rectal Bleeding: Causes and When to Seek Help - Surgery

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Rectal bleeding


Hello: Currently, I have a bowel movement every two days, and I started noticing blood in my stool about a week ago.
I can see the blood dripping.
I saw a doctor on Friday, and the doctor said I do not have hemorrhoids (a finger examination was performed), but prescribed medication and suppositories for hemorrhoids.
I did not see blood during my bowel movement that same day, but after two days, I started bleeding again.
There are still streaks of blood or clots when I wipe.
Is this considered normal?

Xiao Mei, 20~29 year old female. Ask Date: 2015/12/15

Dr. Ke Fangxu reply Surgery


This situation is likely indicative of a higher possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Warm sitz baths can also help alleviate symptoms.
You should continue using the medication prescribed by your physician.
If there is significant bleeding or if it persists, you should seek medical attention again.

Reply Date: 2015/12/15

More Info


Rectal bleeding can be a concerning symptom and may arise from various causes. It is essential to understand the potential reasons behind this bleeding and when to seek medical attention.
Firstly, the presence of blood in the stool or on toilet paper can be alarming, and while it may not always indicate a severe condition, it should never be ignored. Common causes of rectal bleeding include hemorrhoids, anal fissures, diverticular disease, inflammatory bowel disease (IBD), and colorectal polyps or cancer. Given that your doctor performed a digital examination and did not find hemorrhoids, it is possible that the bleeding could be due to an anal fissure, which is a small tear in the lining of the anus that can occur due to passing hard stools. This condition is often accompanied by sharp pain during bowel movements and can lead to bleeding.

The fact that you experienced a cessation of bleeding after starting the medication suggests that the treatment may have been effective in addressing the underlying issue, at least temporarily. However, the recurrence of bleeding after two days raises concerns that the initial cause may not have been fully resolved. It is also important to note that while topical treatments can help with symptoms, they do not address underlying issues that may require further investigation.

In your case, the use of hemorrhoid medication and suppositories may have provided symptomatic relief, but if the bleeding persists, it is crucial to follow up with your healthcare provider. Persistent rectal bleeding, especially if it is accompanied by other symptoms such as abdominal pain, changes in bowel habits, weight loss, or fatigue, warrants further evaluation. Your doctor may recommend additional diagnostic tests such as a colonoscopy, which allows for direct visualization of the colon and rectum, and can help identify any abnormalities such as polyps, inflammation, or tumors.

It is also essential to consider dietary factors that may contribute to your symptoms. A diet low in fiber can lead to constipation and hard stools, which can exacerbate anal fissures and lead to bleeding. Increasing your fiber intake through fruits, vegetables, whole grains, and adequate hydration can help promote regular bowel movements and reduce the risk of further injury to the anal area.

In summary, while occasional rectal bleeding may not always indicate a severe condition, it is essential to monitor the situation closely. If the bleeding continues or worsens, or if you experience additional concerning symptoms, it is vital to seek further medical evaluation. Early diagnosis and treatment can help prevent complications and ensure that any underlying conditions are appropriately addressed. Always feel empowered to communicate openly with your healthcare provider about your symptoms and concerns, as they can provide the best guidance tailored to your specific situation.

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