Causes of rectal bleeding

I am a 23 year old male with no history of colon cancer in my immediate family. I believe my mother's cousin had colon cancer, but that's it. A little over a year ago I began a job where I sit for most of the day and shortly thereafter I got an external hemmoroid. I haven't had one since then but I do notice from time to time that when I use either cheap or rough toilet paper or pass a hard stool I will notice tiny spots of blood on the toliet paper. I don't recall ever noticing blood of any kind in the actual stool itself or the toilet water. I have to be sensitive to that area after a bowel movement in order for it not to bleed. After I use the bathroom and notice specks of bleed on the toliet paper, the area burn a little or even itch to some degree for a while. Whenever it does bleed, it seems like it is seperate from the stool and coming mostly from the sides of the anus. I have not had any noticable change in bowel movements or habits. I did go to the doctor and he did a rectal exam and didn't see any visible hemmoroids (hemorrhoids). He said the only way to see in there was with a colonoscopy, but he said it probably wasn't necessary with my patient history, family history and age. It basically feels very dry down there most of the time. Is there anything that would cause this and how can I correct it? It doesn't happen all the time, but it is irritating when it does. Any suggestions?

[Kevin Pho, MD]

Hemorrhoids would be the most likely cause.  Other possibilities can include an anal fissure, diverticulosis, a polyp and (less likely) cancer.  

You can take a look within the anal canal with an anoscopy.  However, for a more comprehensive evaluation, a flexible sigmoidoscopy or colonoscopy would have to be performed.  

If these are indeed hemorrhoids, you can consider steroid suppositories, Sitz baths and stool softeners as initial treatments.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[jdr1717]

Is it possible for the area around the anus to simply become irritated and thus cause specks of blood on the toilet paper after either a hard stool, diaharea, or excessive wiping?

[scubadude]

Is it physiologicially possible that hemorrhoids, fissures, and diverticulosis are related and or caused by the same condition?

[marri]

I am a 49 year old gal who is training for my first marathon in June. Last Friday I ran my first 18 miles ever. When I came home I had a bowel movement & bright red blood was in the bowl!  Today I ran an easy 3.1 miles and I had quite allot of bright red blood in the bowl after my bowel movement..... I have only begun to notice this in the past few months, which coincides with my longer distance running. (I have for 20+ years ran 5-10 miles with no such 'issues.) Does anyone have any idea's???