Rectal Bleeding: Causes and When to Seek Help

Bleeding from the anus after wiping following a bowel movement?

Recently, I noticed blood (bright red) on the toilet paper after having a bowel movement.
Initially, there were just one or two drops, but over the course of two weeks, the amount of blood has increased to about the size of a fifty-cent coin, and there is some mild pain during bowel movements.

Ning, 10~19 year old female. Ask Date: 2016/03/11

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 over-the-counter hemorrhoidal suppositories 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: 2016/03/11

More Info

Rectal bleeding can be a concerning symptom, and it is essential to understand its potential causes and when to seek medical help. The presence of fresh blood on toilet paper or in the stool can arise from various conditions, some of which may require immediate attention.

Common Causes of Rectal Bleeding
1. Hemorrhoids: One of the most common causes of rectal bleeding, hemorrhoids are swollen veins in the lower rectum or anus. They can cause bright red blood during bowel movements, often accompanied by pain or discomfort.

2. Anal Fissures: These are small tears in the lining of the anus, usually caused by passing hard stools. They can lead to sharp pain during bowel movements and may result in bleeding.

3. Diverticular Disease: Diverticulosis involves the formation of small pouches in the colon wall, which can become inflamed or infected (diverticulitis), leading to bleeding.

4. Colorectal Polyps: These are growths on the inner lining of the colon or rectum. While many polyps are benign, some can develop into cancer over time and may cause bleeding.

5. Colorectal Cancer: This is a more serious cause of rectal bleeding, especially in individuals over 50 or those with a family history of colorectal cancer. Blood in the stool, changes in bowel habits, and unexplained weight loss are concerning symptoms.

6. Gastrointestinal Infections: Certain infections can cause inflammation and bleeding in the gastrointestinal tract, leading to rectal bleeding.

7. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause inflammation of the digestive tract, resulting in bleeding.

When to Seek Medical Help
Given your symptoms of increasing blood on toilet paper and some pain during bowel movements, it is crucial to consult a healthcare professional. You should seek medical attention if you experience:
- Significant or persistent bleeding: If the bleeding increases or does not stop, it is essential to seek immediate care.

- Severe pain: Intense pain accompanying the bleeding may indicate a more serious condition.

- Changes in bowel habits: Any significant changes, such as diarrhea or constipation, especially if accompanied by blood, should be evaluated.

- Unexplained weight loss: If you notice weight loss without trying, it could be a sign of a more serious underlying condition.

- Symptoms of anemia: Fatigue, weakness, or dizziness may indicate significant blood loss.

Diagnostic Approach
When you visit a healthcare provider, they will likely perform a thorough history and physical examination. Depending on your symptoms, they may recommend further tests, such as:
- Digital Rectal Exam (DRE): This can help identify hemorrhoids or fissures.

- Colonoscopy: A more comprehensive examination of the colon to identify polyps, diverticula, or cancer.

- Blood tests: To check for anemia or other underlying conditions.

Conclusion
While rectal bleeding can often be attributed to benign conditions like hemorrhoids or anal fissures, it is essential to take it seriously, especially as the amount of blood increases. Early diagnosis and treatment are crucial in managing any underlying issues effectively. If you have not already done so, please schedule an appointment with a healthcare provider to discuss your symptoms and receive appropriate care.

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