Rectal Bleeding and Pain: Causes and Solutions

Blood in the stool accompanied by a tearing sensation?

On March 2nd, after seeing a doctor for a cold, I had a bowel movement when I got home.
Then on March 6th, I experienced constipation and had to strain hard to pass a stool, which resulted in bleeding.
In the following days, I felt the urge to have a bowel movement but could not, and when I did manage to go, the stool was hard and small, resembling rabbit pellets, and there was bleeding.
The pain in my anus has persisted, and as of today, March 13th, the bleeding has increased.
What should I do, doctor?

Lin, 10~19 year old female. Ask Date: 2016/03/13

Dr. Ke Fangxu reply Surgery

This situation is likely indicative 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 the toilet.
Warm sitz baths may also help alleviate symptoms.
You can purchase over-the-counter hemorrhoid 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: 2016/03/13

More Info

Rectal bleeding and pain can be concerning symptoms, and it's important to understand the potential causes and appropriate solutions. Based on your description, it seems that you have been experiencing constipation, straining during bowel movements, and subsequent rectal bleeding and pain. These symptoms can often be interrelated and may indicate a few underlying issues.

One common cause of rectal bleeding, especially after straining, is the development of hemorrhoids. Hemorrhoids are swollen blood vessels in the rectal area that can become inflamed and bleed, particularly when there is increased pressure from straining during bowel movements. This can lead to pain, discomfort, and visible blood during or after a bowel movement. Another possibility is an anal fissure, which is a small tear in the lining of the anus that can occur due to passing hard stools. This can also cause significant pain and bleeding.

Given that you have been experiencing constipation, it is crucial to address this issue first. Constipation can lead to straining, which exacerbates the risk of hemorrhoids and fissures. Here are some recommendations to help alleviate your symptoms:
1. Increase Fiber Intake: Aim to consume a diet rich in fiber, including fruits, vegetables, whole grains, and legumes. Fiber helps to soften stools and promote regular bowel movements. You may also consider a fiber supplement if you're unable to get enough from your diet.

2. Stay Hydrated: Drinking plenty of water is essential for preventing constipation. Aim for at least 8-10 glasses of water a day, and consider warm liquids, which can sometimes stimulate bowel movements.

3. Regular Exercise: Engaging in regular physical activity can help stimulate digestion and promote regular bowel movements. Even simple activities like walking can be beneficial.

4. Avoid Straining: When you feel the urge to have a bowel movement, try to go to the bathroom without delay. If you're having difficulty, avoid straining, as this can worsen hemorrhoids and fissures.

5. Over-the-Counter Remedies: If you're experiencing significant discomfort, over-the-counter topical treatments for hemorrhoids may provide relief. Additionally, stool softeners or mild laxatives can help ease constipation, but it's best to consult with a healthcare provider before starting any medication.

6. Warm Sitz Baths: Taking warm baths can help soothe the anal area and relieve pain associated with hemorrhoids or fissures. Soaking for 10-15 minutes several times a day can be beneficial.

7. Consult a Healthcare Provider: Since you mentioned that the bleeding has been significant and persistent, it is crucial to consult a healthcare provider. They can perform a thorough examination to determine the exact cause of your symptoms and recommend appropriate treatment. They may suggest further diagnostic tests, such as a colonoscopy, especially if there are concerns about other potential causes of rectal bleeding.

In summary, while hemorrhoids and anal fissures are common causes of rectal bleeding and pain, it is essential to address the underlying issue of constipation and seek medical advice for persistent symptoms. Early intervention can help prevent complications and improve your overall gastrointestinal health. If you experience severe pain, significant bleeding, or any other concerning symptoms, do not hesitate to seek immediate medical attention.

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