Blood in Stool: When to Seek Medical Attention for Rectal Pain

There is blood in the stool?

Hello, Dr.
Ke: A few days ago, when I went to the bathroom, I experienced difficulty passing a hard stool, which caused some pain and a burning sensation in my anus.
After wiping, I noticed some blood on the toilet paper.
The stool was oval-shaped and in small pieces.
In the following days, I increased my water intake, and bowel movements became easier, but I still experienced some tearing pain.
The stool was thicker and in larger pieces, and I again noticed blood on the toilet paper, which was bright red.
The water in the toilet was also red.
Should I see a doctor, or should I observe for a few more days? Thank you.
P.S.
I go to the bathroom for a bowel movement once a day, but I usually do not go when I feel the urge or pain; I manage to pass stool each time.

Ms. Chen, 20~29 year old female. Ask Date: 2016/02/02

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.
Warm sitz baths may also help alleviate symptoms.
You can purchase hemorrhoidal suppositories at the pharmacy for use.
It is best not to take stool softeners indiscriminately; at this age, increasing dietary fiber and hydration should be sufficient.
If bleeding persists, it is advisable to consult a physician for evaluation.

Reply Date: 2016/02/02

More Info

When it comes to blood in the stool and accompanying rectal pain, it is crucial to take these symptoms seriously. The presence of bright red blood on toilet paper or in the toilet bowl can indicate several potential issues, some of which may require immediate medical attention.
In your case, the symptoms you describe—hard stools, pain during bowel movements, and the presence of fresh red blood—suggest that you may be experiencing anal fissures or hemorrhoids. Anal fissures are small tears in the lining of the anus, often caused by passing hard stools. Hemorrhoids, on the other hand, are swollen veins in the lower rectum or anus that can also cause bleeding and discomfort. Both conditions can lead to pain, burning sensations, and bleeding, especially during bowel movements.

While it is good to hear that you've been drinking more water and that your bowel movements have become easier, the fact that you are still experiencing pain and seeing blood is concerning. Here are some guidelines on when to seek medical attention:
1. Persistent Symptoms: If the bleeding continues for more than a few days, or if you notice an increase in the amount of blood, it is advisable to consult a healthcare professional.
2. Severe Pain: If the pain becomes severe or unbearable, you should seek medical help. This could indicate a more serious condition that needs to be addressed.

3. Changes in Bowel Habits: If you notice any significant changes in your bowel habits, such as diarrhea, constipation, or changes in the consistency of your stool, it is important to get evaluated.

4. Other Symptoms: If you experience additional symptoms such as fever, chills, or unexplained weight loss, these could be signs of a more serious underlying condition, and you should seek medical attention promptly.

5. History of Gastrointestinal Issues: If you have a history of gastrointestinal diseases, such as inflammatory bowel disease (IBD) or colorectal cancer, any new symptoms warrant a visit to your doctor.

In the meantime, here are some self-care measures you can take to alleviate your symptoms:
- Increase Fiber Intake: Eating a diet rich in fiber can help soften your stools and make bowel movements easier. Foods high in fiber include fruits, vegetables, whole grains, and legumes.

- Stay Hydrated: Drinking plenty of fluids, especially water, can help prevent constipation and promote regular bowel movements.

- Warm Baths: Taking warm baths can help soothe anal pain and relax the muscles in the anal area.

- Over-the-Counter Remedies: You may consider using over-the-counter topical treatments for hemorrhoids or fissures, which can provide relief from pain and discomfort.

- Avoid Straining: When using the bathroom, try to avoid straining or sitting for prolonged periods, as this can exacerbate your symptoms.

In conclusion, while your symptoms may be manageable at the moment, it is essential to monitor them closely. If the bleeding continues or worsens, or if you experience any additional concerning symptoms, do not hesitate to seek medical attention. Early intervention can help prevent complications and ensure that any underlying issues are addressed promptly.

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