Hi there,
I am a 17 year old girl.
I am in reasonable health, i have no major medical problems. I am slightly overweight at 70kgs.
Recently i have noticed small amounts of blood on the toilet paper after passing stool.
I must admit, lately i have been passing stool more often than usual, sometimes more than once a day but usually everyday. In the past about 11 months ago i had Yersinia from food poisoning if that is relevant.
I am just wanting to know what this is and how i can treat it?

Answered by: Maria/MD Heath Forum Team

Bleeding and change in bowel habits should prompt you to consult your doctor. Passage of red colored stools generally indicates bleeding from the lower part of the gastrointestinal tract like the colon, rectum and anus. It is important to consult a physician for physical examination and tests to rule out potentially serious diseases. Blood on the toilet paper after passage of stool may be experienced by patients with anal fissure and hemorrhoids. Anal fissure is a small tear in the anal mucosa. Its other symptoms include pain during bowel movement, constipation and blood on the outside of the stool. In addition to health history taking, your doctor will also perform physical examination and it will include inspection of the anal area to confirm the diagnosis of anal fissure. Sometimes the tear is clearly visible, but there are also cases that would require the use of anoscope to visualize the anal canal. Your doctor may also examine the rectum and the lower part of the colon by using a device called prostoscope to rule out other possible disorders. Another way to check on the lining of the rectum is by using a thin, flexible tube that has lighted camera within its tip, this instrument is called sigmoidoscope, this allows physicians to get a magnified view the lining of the rectum on a television screen.

Constipation and prolonged diarrhea are known possible causes of anal fissure.The location of the fissure can be a telltale sign whether the fissure is a symptom of another disease. A fissure found at the side of opening of the anus, for example, may actually indicate another disorder, such as inflammatory bowel disease. Intervention will depend on the doctor’s assessment and severity of the symptoms. There are cases when anal fissures heal without any medical intervention, some also respond to non-surgical treatment. Creams or suppositories that contain corticosteroid may be prescribed by the doctor to address symptoms of inflammation. Generally, surgical intervention may be required for patients who do not respond to medicines.

If a person has hemorrhoids, there may bright spots of blood on toilet paper after a bowel movement. Hemorrhoids is a condition referring to swelling of the veins surrounding the anus or rectum. It has 2 basic types: internal hemorrhoids and external hemorrhoids. The classification depends on the location of the affected veins. The most common symptom of internal hemorrhoids is bright red blood covering the stool, it can also be on the toilet paper after a bowel movement, or in the toilet bowl. There are cases when the hemorrhoid protrudes through the anus and it becomes painful and irritated, this condition is called protruding hemorrhoid. Symptoms of external hemorrhoids include painful swelling or a hard lump around the anus from formation of blood clots. During physical examination, the doctor will look for inflamed blood vessels. Rectal examination by gloved lubricated finger will also be done to feel for any abnormalities in the rectum. Just like in anal fissures, further diagnostic tests like use of protoscope and sigmoidoscope may also be considered to find out whether there are other diseases that predispose the symptoms. Treatment plan will be based on the severity of the condition, it may include measures such as changes in diet as well as bowel habits. Prolonged bleeding and severe pain due to prolapsed hemorrhoid may require surgery.

Talk to your doctor about your symptoms. The information obtained from your health history and physical examination result will allow the doctor to determine whether further testing will be requested. Thereafter, you will be informed of suitable measures for your condition.

Tags: anal fissure, bleeding, hemorrhoids, Inflammatory bowel disease