Rectal Bleeding

[unusual]

I am a 26 yr old female.  Fairly healthy, no major health concerns.  I am 5'4 137lbs.  I don't excerise reguarly, but will tend to excercise just to burn a quick few pounds.  I don't eat regular meals.  I do not have any sort of eating disorders. I do not endulge in any sexual anal activities.  Two mths ago I was drinking dietary shakes and was passing soft bowel movements about 3 times a day for about 5 days. After I stopped drinking the diet shakes, I had a hard solid bowel movement. I felt myself straining to pass this bowel.At that time I noticed the bright red bleeding dripping from my anal. I thought maybe I strained too hard. But then about a couple of weeks ago and again this morning the bright red blood reappeared. The blood drips from my anal while passing the bowel and shortly after passing the bowel. The blood is bright red on the toliet paper.  I noticed that if I flexed by anal by squeezing my buttock and relaxing then the blood would creep out the anal.  I saw the prior responses list stating that this may be a possible fissure or hemorrhoids, but I really need to know.  I do plan to see a physician soon, but second opinions always can help make me feel at ease.  I will tend to hold a bowel movement until I feel like taking the trip to the restroom.  Sometimes it's difficult for me to pass the bowel and I feel that I am needing to strain (these are usually hard bowels).  But for some reason, the strained bowel movements do not have blood in them.  It is the soft bowels that flow right out of the anal that usually have the bright red blood. Not sure if this has anything to do with the rectal bleeding, but currently my right lower waste(just above my high hip area) and lower back along the spine are in pain.  It could be from general lifting and working. But if this all helps, please let me know what could possibile be wrong with me!!!

[Kevin Pho, MD]

Hello - thanks for asking your question.

There are many causes for rectal bleeding.  Of course, the cause that everybody is wary of is cancer.  It is unlikely in someone as young as you.  However, you definitely need to be evaluated by your personal physician.

Hemorrhoids is the most common cause of rectal bleed under the age of 50.  Painless bleeding is usually associated with a bowel movement. Bright red blood typically coats the stool at the end of defecation. Blood may also drip into the toilet or stain toilet paper.  Hemorrhoidal bleeding is almost always painless. Thus, bleeding associated with painful defecation should prompt investigation for other causes such as anorectal fissures.

Clinical trials have demonstrated that adding fiber to the diet through supplementation commercially available fiber preparations may significantly reduce bleeding episodes associated with hemorrhoidal disease.

Other less likely causes you should consider is an anal fissure, diverticulosis, colon cancer or polyps, inflammatory bowel disease and infectious colitis or gastroenteritis.  

Evaluation should be performed with an anoscopy and/or endoscopy.  

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.

Thanks,
Kevin, M.D.

[surgeon]

given your age and your description of the bleeding, it is almost certainly from hemorrhoids, and since it't not a long-term problem, would likely respond to regulating your stools with adequate fiber. However, new onset bleeding needs a definite answer; keep your appointment with your doctor.

[wishingyouwell]

the pain in  lower right side, and your back concerns me if i were you when you see your doctor hopefuly it is a gastro/specialest.which is who you need to go to on digestive concerns! i would ask them to do a colonoscopy to rule out more serious colon and lower digestive probs .it is always better to be safe than sorry when you have bleeding acompanied with pain in the area you discribed, i had colon surgery and one of the major problems was the severe pain in the back ,left and right side .this is not to say this is your problem only it is better to make sure.god bless, wishing you well

[conceredwife10]

My husband is 36 years old and seems to have the same problem as "unusual" described.  However, his bleeding can be very heavy at times.  He had a colonoscopy three years ago and nothing was found. He has bowl movements regularly, but they are almost always soft/runny stools and bleeding seems to only occur when he has a bowl movement. Bleeding may be occaisional, but heavy. He is also an extremly heavy drinker.  Could this in any way have something to do with the rectal bleeding?