Blood in Stool: Causes and Solutions for Constipation

Blood in the stool?

Hello Doctor: I have been experiencing constipation for a long time.
Recently, before using the restroom, I have been feeling a cramping pain in my abdomen, similar to the sensation of needing to have diarrhea, but the stool is hard.
When I wipe, there is some blood on the toilet paper, not much, but upon closer inspection, I can see bright red blood on the surface of the stool, which is also a small amount.
After using the restroom, I feel like there is something stuck at the anal opening.
Additionally, my diet and daily routine have always been irregular.
Could you please explain what might be happening? Thank you, Doctor.

TT, 20~29 year old female. Ask Date: 2016/01/10

Dr. Ke Fangxu reply Surgery

This situation likely indicates 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.
You may also consider purchasing over-the-counter hemorrhoidal suppositories for use.
However, if bleeding persists, it is best to consult a physician.
Young women often experience habitual constipation issues.
If you are already aware of dietary and lifestyle problems, you should prioritize correcting these abnormal habits; otherwise, it would be counterproductive.

Reply Date: 2016/01/10

More Info

Hello,
Thank you for your question regarding the presence of blood in your stool, particularly in the context of constipation. This is a concern that should be taken seriously, and I appreciate your proactive approach in seeking medical advice.

Based on your description, it sounds like you are experiencing a combination of constipation and possibly hemorrhoids or anal fissures. The hard stools you mentioned can cause straining during bowel movements, which may lead to small tears in the lining of the anus (anal fissures) or the development of hemorrhoids. Both conditions can result in bright red blood on the surface of the stool or on the toilet paper after wiping.

Causes of Blood in Stool with Constipation:
1. Anal Fissures: These are small tears in the lining of the anus that can occur due to passing hard stools. They can cause sharp pain during bowel movements and may result in bleeding.

2. Hemorrhoids: Swollen blood vessels in the rectal area can become irritated and bleed, especially when straining to pass hard stools. The blood is usually bright red and may be seen on the toilet paper or in the toilet bowl.

3. Diverticular Disease: Although less common, diverticulosis can lead to diverticulitis, which may cause bleeding. However, this is usually accompanied by other symptoms such as abdominal pain and fever.

4. Other Gastrointestinal Issues: While less likely given your symptoms, other conditions such as inflammatory bowel disease (IBD) or colorectal polyps can also cause blood in the stool.

Solutions and Recommendations:
1. Dietary Changes: One of the most effective ways to alleviate constipation is to increase your fiber intake. Foods high in fiber include fruits, vegetables, whole grains, and legumes. Aim for at least 25-30 grams of fiber per day. Additionally, ensure you are drinking plenty of water to help soften your stools.

2. Regular Exercise: Physical activity can help stimulate bowel movements. Aim for at least 30 minutes of moderate exercise most days of the week.

3. Over-the-Counter Remedies: You may consider using stool softeners or mild laxatives to help ease your bowel movements. However, these should be used sparingly and not as a long-term solution.

4. Avoid Straining: When you feel the urge to go, try not to delay it. Straining can worsen hemorrhoids and lead to fissures. If you find it difficult to pass stools, try to relax and take your time.

5. Consult a Healthcare Provider: Since you are experiencing blood in your stool, it is important to consult with a healthcare provider for a thorough evaluation. They may recommend a physical examination, and possibly a colonoscopy, to rule out any serious conditions.

6. Manage Stress: Stress can impact your digestive health. Consider incorporating stress-reducing activities such as yoga, meditation, or deep-breathing exercises into your routine.

Conclusion:
In summary, the presence of blood in your stool, especially in the context of constipation, is often related to anal fissures or hemorrhoids due to straining. However, it is crucial to consult a healthcare professional to ensure that there are no underlying serious conditions. By making dietary changes, increasing physical activity, and managing stress, you can improve your bowel health and reduce the likelihood of future issues. Please take care of yourself, and do not hesitate to seek medical attention for your symptoms.

Best wishes for your health!

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