Rectal Bleeding: Causes and When to Seek Help - Surgery

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Blood in stool?


Doctor, a few days ago I noticed blood when I had a bowel movement! I found that I would soak my bottom in warm water at night.
It hasn't bled for the past few days, and my stool is light in color! However, sometimes my bottom feels a bit sore! What could be the reason for this?

Xiao Xia, 20~29 year old female. Ask Date: 2016/02/06

Dr. Yu Mingchang reply Surgery


Hello: It is possible that you have an anal fissure.
Please consult the Department of Colorectal Surgery at Changhua Hospital, Ministry of Health and Welfare, for further assistance.

Reply Date: 2016/02/06

More Info


Rectal bleeding can be a concerning symptom, and understanding its potential causes is crucial for determining when to seek medical help. There are several common reasons for rectal bleeding, and the nature of the bleeding can provide important clues about its source.

One of the most common causes of rectal bleeding is hemorrhoids, which are swollen blood vessels in the rectal area. They can cause bright red blood during bowel movements, often accompanied by discomfort or itching. Another common cause is anal fissures, which are small tears in the lining of the anus that can occur due to passing hard stools. These can also lead to bright red bleeding and pain during bowel movements.

Other potential causes of rectal bleeding include diverticular disease, where small pouches form in the colon wall and can become inflamed or bleed; colorectal polyps, which are growths on the colon lining that can bleed; and more serious conditions such as inflammatory bowel disease (IBD), colorectal cancer, or infections. The color of the blood can also provide insights; bright red blood typically indicates a source closer to the anus, while darker blood may suggest bleeding from higher up in the gastrointestinal tract.

In your case, since you mentioned that the bleeding has stopped and you are experiencing some discomfort, it is possible that you may have had a minor issue such as hemorrhoids or an anal fissure. The fact that your stools are lighter in color could be due to dietary changes, hydration levels, or other factors, but it is important to monitor this as well.

Here are some recommendations for managing your symptoms and determining when to seek further medical evaluation:
1. Monitor Symptoms: Keep track of any further episodes of bleeding, the color and consistency of your stools, and any associated symptoms such as pain, itching, or changes in bowel habits.

2. Dietary Changes: Ensure you are consuming a high-fiber diet to prevent constipation, which can exacerbate hemorrhoids and fissures. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying well-hydrated is also essential.

3. Warm Baths: Continuing to soak in warm water can help soothe any discomfort and promote healing if you have an anal fissure or hemorrhoids.

4. Over-the-Counter Treatments: There are various creams and ointments available that can help relieve the symptoms of hemorrhoids or anal fissures. These can provide temporary relief from pain and itching.

5. When to Seek Help: You should seek medical attention if:
- The bleeding resumes or worsens.

- You experience significant pain or discomfort.

- You notice changes in your bowel habits, such as diarrhea or constipation lasting more than a few days.

- You have any other concerning symptoms, such as weight loss, fever, or fatigue.

In summary, while rectal bleeding can often be attributed to benign causes such as hemorrhoids or fissures, it is essential to remain vigilant and seek medical advice if symptoms persist or worsen. A healthcare provider can perform a thorough evaluation, which may include a physical examination and possibly further diagnostic tests, to determine the underlying cause and appropriate treatment.

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