Rectal Discomfort and Bleeding

[Mrfuji]

I have had some pretty annoying sypmtoms now for over 3 years so I am writing to find out what you all think.  I read a few others symptoms similar to mine but was not satisfied that I have anal inconstinence but anyway:
My symptoms are this:

1)After a bowel movement, I have to frequently go back to the bathroom to wipe due to a lot of excess moisture and itching.  Sometimes there is a bit of excess feces but mostly it seems that it is just clear liquid.  Sometimes there are small amounts of blood on the paper only, mainly due to how hard and frequently I have to wipe b/c of the itching and dampness I think.  I notice that when I drink a lot of alcohol the night before, these symptoms are magnified a lot, especially the amount of clear liquid that seems to be there after a bowel movement.  I am not an alcoholic but I drink 1-2 nights a week on average.  This problem is very annoying.  I find myself having to visit the bathroom 4-5 times after a normal bowel movement.  The problem has steadily gotten worse for the last 3 years.

2)This may be unreleated but for the past 4-5 months I have started jogging on a treadmill 3 times a week or so.  I normally run 3 miles or less at a decent clip.  For the past 2-3 months, I have noticed that I have rectal bleeding right afterwards.  Nothing that drips through to my underwear but due to the frequent itching and discomfort from the above described issue, I found that if I wipe with paper right after running, there is a fair amount of bright red blood (probably mixed with sweat, etc) on the paper.  

I never have problems controlling a bowel movement before hand.  It's just afterwards that is the problem.  Please help!

Thank you!

[Haroon]

I have had very similar symptoms to yours (see my posting on this forum dated January 24, 2004).

I went to my doctor and he did a "digital" exam of my rectum as well as inspected the anal/rectal area with a rectal scope.  He said he couldn't find anything wrong and told me to wait and see if the problem goes away on its own.

With my assumption that this situation may be related to a fungal infection, I started taking a non-prescription anti-yeast/anti-fungal treatment starting at the beginning of the year, and have seen some improvement and reduction in the symptoms.  Here are some other practices that I have found helpful.

1.  soaking in warm water in a bath tub.  I found that sitting in a 4-5 inch deep layer of warm water for 20 minutes daily before I go to bed is quite helpful.

2.  Placing a cotton ball against the anus (after thoroughly cleaning as in "1" above) keeps moisture against the skin to a minimum and soaks whatever fluid is being released.  In addtion to the increased comfort, this practice allows you to examine the type and quantity of the discharge that is occuring to better track your progress.

3.  After a bowel movement, stay at the toilet seat for as long as 5 minutes at least, using toilet paper to soak up the liquid that follows the bowel movement.  Use a blotting action rather than wiping action to avoid further irritating the raw skin of the anus.

4.  Watch what you are eating from a cause-effect relationship and adjust your eating habits accordingly.  It is good you noticed the connection to alcohol.  It is known that alcohol exacerbates a yeast infection as does a high sugar intake.

I believe the blood that you are seeing on paper tissue is merely from an over abraded anal area that is alreay raw from the corrosive fluid it is being exposed to on a continual basis.

I totally agree with you that this is not a case of fecal incontinence.  The anus is designed to keep in solids and cannot hold in watery liquids.

I hope you feel better soon.  Please let me know if any of the above makes any sense and if you are able to reach a successful diagnosis of the situation.

[Kevin Pho, MD]

Being 29 years old, the most likely causes would be hemorrhoids or an anal fissure.  Inflammatory bowel disease is also possible.  Cancer and polyps, while still possible, are less likely.  

Any rectal bleeding needs to be evaluated.  I would suggest obtaining an anoscopy - which can evaluate for hemorroids or a fissure, or a flexible sigmoidoscopy.  The sigmoidoscopy is a more thorough test and can also evaluate for inflammatory bowel disease.  

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]

There's no way to diagnose this online: depending on your age and other things you didn't state, it could be as simple as hemorroids; or it could be a fissure (a tear in the surface of the anal opening), or a fistula (a tract from the anal canal to the outside skin near the anus), or inflammatory bowel disease. It could also indicate a tumor; a benign one such as a polyp, or a malignant one such as rectal cancer. Since the only way to be sure is to see a doctor and have an exam, and since the possibilities are many and potentially serious, seeing a doctor is what you need to do.

[Mrfuji]

I forgot to tell you that I'm a 29 year old male!!  Sorry.