Rectal Bleeding: Causes, Symptoms, and When to Seek Help

Rectal bleeding

Hello doctor, I have experienced rectal bleeding a few times during bowel movements (each time there was only a small amount of bright red blood on the toilet paper).
At that time, my lifestyle was normal, and my bowel movements were regular.
However, after the holidays, I started experiencing constipation, which has become almost daily.
Even when I do have a bowel movement, it is only a small amount of hard, pellet-like stools, and the color is close to black.
There are also blood stains on the toilet paper.
A few days ago, I noticed some mucous with blood, and sometimes I feel pain in my anus during bowel movements, as if something sharp is scraping against it.
I have a diet that includes a lot of meat, and I do eat some fruits and vegetables, so I am a bit worried about the possibility of cancer.
What symptoms should I be aware of? I apologize for the trouble, and thank you.

Niming, 10~19 year old female. Ask Date: 2016/02/06

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.
Over-the-counter hemorrhoidal suppositories can be used, but laxatives should not be taken indiscriminately.
At this age, increasing dietary fiber and hydration should be sufficient.
Although the risk of developing colorectal cancer at 17 years old is not zero, it is generally very low.
It is advisable to maintain a light diet and a good lifestyle routine.
If symptoms persist without improvement, a physician can prescribe medication.
If there is still no improvement or if there are significant concerns, a colonoscopy can be arranged.

Reply Date: 2016/02/06

More Info

Rectal bleeding can be a concerning symptom, and it’s important to understand its potential causes, associated symptoms, and when to seek medical help. Based on your description, it seems you have experienced rectal bleeding during bowel movements, particularly with fresh red blood on toilet paper and some changes in your bowel habits, including constipation and the presence of dark, pellet-like stools.

Causes of Rectal Bleeding
1. Hemorrhoids: One of the most common causes of rectal bleeding, especially if the blood is bright red and appears on the toilet paper. Hemorrhoids can be internal or external and are often associated with straining during bowel movements, which can occur with constipation.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain during and after bowel movements, along with bright red blood.

3. Diverticular Disease: This includes diverticulosis and diverticulitis, where small pouches form in the colon wall and can become inflamed or bleed.

4. Colorectal Polyps or Cancer: While less common, polyps can bleed, and the presence of blood, especially if it is dark or mixed with mucus, can be a sign of more serious conditions, including colorectal cancer.

5. Gastrointestinal Conditions: Conditions like inflammatory bowel disease (IBD) or infections can also lead to rectal bleeding.

Symptoms to Monitor
- Color of Blood: Bright red blood typically indicates bleeding from the lower gastrointestinal tract, while darker blood may suggest bleeding from higher up in the digestive system.

- Pain: Sharp pain during bowel movements may indicate anal fissures or hemorrhoids, while abdominal pain could suggest other gastrointestinal issues.

- Changes in Bowel Habits: Persistent constipation, diarrhea, or changes in stool consistency and color should be noted.

- Accompanying Symptoms: Weight loss, fatigue, changes in appetite, or any signs of anemia (such as paleness or shortness of breath) should be taken seriously.

When to Seek Help
You should seek medical attention if you experience any of the following:
- Persistent Bleeding: If the bleeding continues or worsens.

- Severe Pain: If you have significant pain that does not improve.

- Changes in Bowel Habits: If you notice a significant change in your bowel habits that lasts more than a few days.

- Other Symptoms: If you experience weight loss, fever, or signs of anemia.

Recommendations for Recovery
1. Dietary Changes: Increase your intake of fiber-rich foods (fruits, vegetables, whole grains) to help soften stools and promote regular bowel movements. Staying hydrated is also crucial.

2. Regular Exercise: Physical activity can help stimulate bowel function and reduce constipation.

3. Avoid Straining: When using the bathroom, try not to strain, as this can exacerbate hemorrhoids and fissures.

4. Over-the-Counter Remedies: Stool softeners or fiber supplements can be helpful if you are experiencing constipation.

5. Consult a Healthcare Provider: Given your symptoms and concerns about colorectal cancer, it would be wise to consult a healthcare provider for a thorough evaluation. They may recommend a physical examination, possibly including a digital rectal exam or a colonoscopy, to determine the cause of your bleeding.

In conclusion, while rectal bleeding can be caused by various conditions, many of which are benign, it is essential to monitor your symptoms closely and seek medical advice to rule out any serious underlying issues. Early intervention can lead to better outcomes and peace of mind.

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