[39F] With blood in stool

Patient Description

A 39-year-old female reports noticing a few drops of bright red blood when wiping after bowel movements for the past two days. The blood appears on the surface of the stool and is not mixed in. She has no history of blood in stool prior to this. She denies experiencing any other symptoms such as changes in bowel habits, abdominal pain, dizziness, lightheadedness, weight loss, or fatigue. She is unaware of her family medical history regarding gastrointestinal diseases and has no pre-existing conditions or chronic illnesses. Additionally, she is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Hemorrhoids: Hemorrhoids are swollen veins in your lower rectum or anus. They are a common cause of bright red blood on the toilet paper. Hemorrhoids can be caused by straining during bowel movements, sitting for long periods, or chronic constipation.

    • Treatment: Over-the-counter creams, ointments, or suppositories can help relieve symptoms. Increasing fiber intake and drinking plenty of water can also help prevent constipation and reduce straining.
  • Anal Fissures: These are small tears in the lining of the anus, which can cause bright red bleeding and pain during bowel movements.

    • Treatment: Keeping the area clean, using stool softeners, and applying topical anesthetics can help. Increasing fiber intake and staying hydrated can also prevent further irritation.
  • Diverticular Disease: Small pouches (diverticula) can form in the walls of the colon and sometimes bleed.

    • Treatment: Mild cases may be managed with a high-fiber diet, but more severe cases may require medical intervention.

What you can do

  1. Increase Fiber Intake: Eating more fruits, vegetables, and whole grains can help soften your stool and reduce straining during bowel movements.
  2. Stay Hydrated: Drink plenty of water to help keep your stool soft.
  3. Over-the-Counter Treatments: Consider using over-the-counter creams or ointments if you suspect hemorrhoids.
  4. Avoid Straining: Try not to strain during bowel movements. If you are constipated, consider using a stool softener.

What you should look out for

Seek medical attention if you experience any of the following:

  • Increased Bleeding: If the amount of blood increases or you start seeing blood mixed with your stool.
  • Severe Pain: If you experience severe pain during bowel movements or persistent pain.
  • Changes in Bowel Habits: If you notice significant changes in your bowel habits, such as persistent diarrhea or constipation.
  • Other Symptoms: If you develop other symptoms like dizziness, lightheadedness, weight loss, or fatigue.

Remember, while these suggestions can help manage your symptoms, it's important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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7 mo ago

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People Also Ask


What are the common causes of bright red blood on toilet paper after a bowel movement?

Common causes of bright red blood on toilet paper after a bowel movement include hemorrhoids, anal fissures, and less commonly, diverticular disease. Hemorrhoids are swollen veins in the rectum or anus, while anal fissures are small tears in the anal lining.


How can I differentiate between hemorrhoids and anal fissures?

Hemorrhoids often cause painless bleeding and may be accompanied by itching or discomfort, while anal fissures typically cause sharp pain during bowel movements and may also bleed. A healthcare provider can help differentiate between the two.


What lifestyle changes can help prevent rectal bleeding?

To prevent rectal bleeding, increase your fiber intake by eating more fruits, vegetables, and whole grains, stay hydrated by drinking plenty of water, avoid straining during bowel movements, and consider using stool softeners if needed.


When should I seek medical attention for rectal bleeding?

You should seek medical attention if you experience increased bleeding, blood mixed with your stool, severe pain during bowel movements, significant changes in bowel habits, or other symptoms like dizziness, weight loss, or fatigue.


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