DEAR DR. GOTT: I am an 18-year-old male and would like to know if I have a problem or if it is normal. Personally, I think it is a problem. For a while I have been bleeding from my anus. Sometimes it will stop and start but it only occurs when I use the bathroom.
I haven’t told anybody or seen a doctor about it because I am scared. I hope you have an answer or some suggestions. Thank you.
DEAR READER: There are a number of causes for rectal bleeding, to include hemorrhoids, colon polyps, diarrhea, anal fissures (tears in the anal skin), ulcerative and ischemic colitis, Crohn’s disease, proctitis, cancer, and more.
Because you indicate you only have the problem when you have a bowel movement, my guess is that hemorrhoids would be the likely suspect, which are simply inflamed, swollen veins in the anus and lower rectum. They can be internal and located inside the rectum, or external and develop under the skin of the anus and protrude through. Common causes include straining during evacuation, chronic constipation or diarrhea, obesity, engage in anal intercourse, and sitting for extended periods of time on a toilet seat. Signs include bright red blood on toilet tissue or actual drops of blood in the bowl, a small lump or lumps near the anus, itching, and pain in the anal region. Unfortunately, you don’t indicate if your rectal bleed is accompanied by or has followed a change in bowel habits, or if your stool may be dark maroon or even the color of tar. This might certainly lead to a physician considering other possible causes for the bleeding.
I cannot pinpoint the exact cause of your problem because I am unable to examine you but clearly someone has to. Therefore, I urge you to make an appointment with your physician who will initially make a simple visual examination of your rectum. If indeed you are suffering from external hemorrhoids, he or she can make the diagnosis easily and quickly. If my guess is correct, it is likely a simple over-the-counter suppository, pad or ointment might be recommended by your physician for control. If questions remain, the doctor can proceed with other more sophisticated testing to determine the cause of your symptoms. I do not want to concern you needlessly. As with many procedures, I recommend you keep things simple and proceed from there if there is reason to do so.
You are young. Most people don’t develop hemorrhoids until they are in their 50s. Therefore, do yourself a favor and let a doctor examine you. There is nothing to be embarrassed about or ashamed of. Many causes for rectal bleeding are easy to control so work with him or her and hopefully you can put your concerns to rest and enjoy your life.
Readers who would like related information can order my Health Report “Constipation and Diarrhea” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the report title when writing or print out an order form from my website www.AskDrGottMD.com.