Rectal Bleeding: Causes and When to See a Doctor

Rectal bleeding

Hello Doctor, on February 5th, after having a bowel movement, I first noticed that my stool was followed by the passage of red liquid.
Later, when I wiped, I found a lot of bright red liquid, and there was also red liquid in the toilet.
However, I did not feel any tearing in my anus.
What could be the cause of this, and how long should I wait before seeing a doctor? I have never experienced this before.
Thank you.
P.S.
I do not have a regular bowel schedule; I only go when I have stomach pain, but I usually have a very clean bowel movement.

Xiao Lin, 20~29 year old female. Ask Date: 2016/02/05

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 fluid intake should be sufficient.
If bleeding persists, it is advisable to consult a physician for evaluation.

Reply Date: 2016/02/05

More Info

Rectal bleeding can be alarming, and understanding its potential causes is crucial for determining when to seek medical attention. Based on your description, it seems you experienced bright red blood during and after a bowel movement, which can be indicative of several conditions. Here’s a comprehensive overview of possible causes, when to see a doctor, and additional considerations.

Possible Causes of Rectal Bleeding
1. Hemorrhoids: One of the most common causes of bright red blood in the stool is hemorrhoids, which are swollen veins in the rectum or anus. They can cause bleeding during bowel movements, especially if there is straining involved.

2. Anal Fissures: Although you mentioned not feeling a tear, anal fissures can occur and may not always be painful. These are small tears in the lining of the anus that can lead to bleeding.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can lead to diverticulitis, where these pouches become inflamed or infected, potentially causing bleeding.

4. Colorectal Polyps or Cancer: While less common, polyps (growths on the colon lining) or colorectal cancer can cause rectal bleeding. The blood may appear bright red or darker, depending on the location of the bleeding.

5. Gastrointestinal Infections: Certain infections can cause inflammation and bleeding in the gastrointestinal tract, leading to blood in the stool.

6. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause rectal bleeding due to inflammation in the digestive tract.

When to See a Doctor
Given that this is your first experience with rectal bleeding, it is advisable to consult a healthcare professional, especially if:
- The bleeding persists or worsens.

- You experience significant pain, discomfort, or changes in bowel habits.

- You notice other symptoms such as weight loss, fever, or changes in appetite.

- You have a family history of colorectal issues or cancer.

Additional Considerations
- Diet and Hydration: Ensure you are consuming a balanced diet rich in fiber to promote regular bowel movements and prevent straining, which can exacerbate hemorrhoids or fissures. Staying hydrated is also essential.

- Bowel Habits: Since you mentioned irregular bowel habits, it may be beneficial to establish a routine. Regular bowel movements can help reduce the risk of straining and associated bleeding.

- Avoid Straining: If you experience constipation, consider gentle laxatives or stool softeners, but consult with a doctor before starting any new medication.

- Monitoring Symptoms: Keep track of any additional symptoms, such as changes in stool color, consistency, or frequency, as well as any abdominal pain or discomfort.

Conclusion
While occasional rectal bleeding can be benign, it is essential to take it seriously, especially if it is a new symptom for you. Consulting with a healthcare provider will allow for a thorough evaluation, which may include a physical examination, and possibly further diagnostic tests like a colonoscopy, depending on your symptoms and medical history. Early intervention can lead to better outcomes, especially if there are underlying conditions that need to be addressed.

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