#HLWDK Daily Health Tips: Anal Bleeding

Q: Hello! Doc my friend is having a condition of bleeding from anus. She visited a doctor and they said it’s constipation but after a month the bleeding started

A: Hello! Thanks for writing in.

The first question I have for you is whether the blood is bright red or altered (almost brownish/black)? If it’s bright red, it is likely coming from the anus or somewhere close by. If it’s altered blood, it’s likely coming from higher up in the digestive system eg bleeding from a peptic ulcer. You should see your doctor immediately, if you experience this.

Common causes of bright red bleeding include:

·      Anal fissure

·      Piles (haemorrhoids)

·      Cancer of the rectum or colon

·      Gastro-enteritis: infection of the stomach and intestines

·      Inflammatory bowel diseas

·      Anti-coagulant drugs

You cannot make the diagnosis of what is serious and what is not. So, I suggest you see your doctor to examine you and make a diagnosis.

I will discuss the first two conditions (anal fissure and piles) below;

Constipation can lead to conditions where the stool is so hard that it causes a tear of the skin lining the anus (anal fissure) leading to blood seen with the stool.

Prevention is focused on ensuring that you have enough fibre in your diet (fruits, vegetables, whole grain), getting at least 30 minutes of exercise daily and drinking at least 8 glasses of water daily. When you have the urge to poo, try not to delay it for too long. Go and try to take your time to do your business!

How can you help this?

§  Include some fibre in your diet. Fruits and vegetables, oatmeal, local rice and other whole grain meals are helpful.

§  Drinking at least 8 glasses of water daily. Remember that this number, 8, is not cast in stone. It’s just a helpful guide. If you’re in a hot area, you’ll probably drink more

§  Get at least 30 minutes of exercise/activity per day or on at least 5 days of the week.

§  If these do not help, you may want to see your doctor for a proper examination as some diseases like Diabetes Mellitus may also cause constipation.

Now for piles…

Piles, known as haemorrhoids in medical lingo are swollen veins in the anal canal. They can be internal, external or both internal and external can co-exist. Internal haemorrhoids occur when veins swell within the rectum and external haemorrhoids are found under the skin around the anus.

These haemorrhoids develop when there is undue pressure in the pelvic and anal area as can occur when people strain to pass faeces (if they have diarrhoea or are constipated), in pregnancy (especially the last 6 months), in obese people, people who eat diets low in fibre and people who practice anal intercourse. When women strain in labour, haemorrhoids can also be made worse. For those who love to visit the toilet with their newspapers and spend ages reading them in there, well, you’ve got breaking news!  Sitting on the toilet seat for prolonged periods can also cause haemorrhoids. As people grow older, the support structures for these veins also grow weaker…naturally 😀

Some internal haemorrhoids can be small veins which stay within the rectum. Usually these internal haemorrhoids, stay inside the anus causing no problems. Other internal haemorrhoids can be big veins that sag and protrude out of the anal canal. Straining would cause their delicate surfaces to bruise and bleed. Sometimes, the straining is sufficient to cause the haemorrhoids to protrude out of the anal canal. This is probably what has been described above in the question. When the haemorrhoids are compressed by anal muscles, the pain is made worse and the pressure can lead to cutting off of blood supply to the haemorrhoids.

External haemorrhoids can clot due to irritation forming a hard, painful lump under the skin around the anus.

People with haemorrhoids will complain of streaks of blood in the stool after stooling, blood on the tissue after cleaning up, anal pain, anal itching or a lump around the anus.

Treatment involves the use of ointments to relieve pain, inflammation and itching. There are other minimally invasive and surgical options available that range from rubber band ligation to surgical removal of the haemorrhoids.
You can also limit the discomfort you have by keeping the anal area clean, using wet wipes (non-perfumed) to clean up after using the loo, sit on a bowl of plain warm water for about 15 minutes about twice or three times per day and also use some pain relief, if in pain.

To prevent this, ensure that your diet has sufficient amounts of fruits and vegetables. Remember that if you take a regular flat plate, half of this should be filled with fruits and vegetables, half of the plate with complex carbohydrates and the last half with proteins.

Limit the time you spend sitting on the toilet seat (read your newspapers elsewhere :D), use the toilet as soon as you feel pressed (that way the fluid in the stool is not absorbed making the stool hard) and then don’t strain when you do go. Drink sufficient quantities of water daily, exercise (to keep everything moving along nicely :D)

Remember though that there are other causes of blood in faeces. That’s why this case has to be checked out in the hospital so that a proper diagnosis can be made.

I hope this helps.

Have a good night y’all 

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