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Had blood in stool. Observed small tear in anus. Suggest treatment? - Online Doctor Chats

Date : 04-Jun-2013
User rating for this question
Very Good Posted in: Digestion and Bowels
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2308 Questions
User:Good morning doctor
Doctor:How can I help you?
User:Yesterday while my bowel movement I saw blood in stool
User:It happened today also
User:What I observed is a small tear in anus at corner
User:This happened to me 2 weeks back and again it happened yesterday and today
User:Stool is not hard
User:My bowell movements are fine
User:When it happened last time, doctor asked me to get an ultrasound done, it came back fine
User:I visited my family doctor and he said it could be because of haemoroids
User:I am getting worried because of this
User:Its not small amount of blood
User:Are you there?
Doctor:I am sorry,
Doctor:May I know if a per rectal examination was done or now?
Doctor:*whether a per rectal examination was done or not?
User:I can see the tear clearly though
User:Its like head of very small nail
Doctor:Do you have pain while passing stool?
Doctor:Is there any swelling or lump felt at the anal region?
Doctor:May I know your age and do you have any other medical problems?
User:I could not see any
User:age is 32
User:I have gastric problems
Doctor:May I know the colour of blood - was it like a pure blood or black stained stool?
User:Its pure blood
Doctor:Let me brief you.
User:It does not come with the first stool comes out
User:It happens when big chunk is coming out
Doctor:Ok, let me explain.
Doctor:2 most common cause of anal bleeding is fissure (trauma/cut to the anal mucosa)and hemorrhoids.
Doctor:Unfortunately both these conditions are painful condition and invariably patients complain of pain / difficulty while passing stool.
Doctor:Again these episodes are precipitated by constipation and hard stool.
Doctor:That being said, it is confirmed by per rectal examination and sigmoidoscopy.
User:I dont have pain however some times I get little pinching
User:Even when the bleeding happening, I feel little pinch feeling but not so pain
Doctor:If there is some stinging sensation perhaps there may be minor injuries caused by ? forceful expulsion
Doctor:But ultrasound definitely is not the investigation of choice here.
Doctor:What you need is a per rectal examination with or without scopy.
Doctor:This will confirm whether or not you have those tears.
Doctor:Though the investigations are needed to confirm the condition, in my opinion
Doctor:you need to wait and observe for a few days.
User:Do you mean to say, there may be more tears apart from the one I am seeing
Doctor:1. Take warm sitz bath for a few days if the stinging sensation is discomforting.
Doctor:2. Wait and observe how your symptoms are progressing in the next few days. Most minor tears heal by itself.
Doctor:Only those where the symptoms persist or worsen say after 5-7 days can be evaluated.
Doctor:3. Take a diet containing plenty of fibres. Consume plenty of banana to soften stool.
Doctor:And drink plenty of fluids.
Doctor:I expect you to be alright with these measures.
Doctor:if symptoms persist / worsen in the next few days, consult a surgeon for examination.
User:As I said, I can clearly see blood from the tear I observed and it stops on its own
User:BTW, I have pin worms as well
Doctor:Do not worry, minor tears heal by itself.
User:Another thing I observed is, last week I am out of station and I did not see any blood
Doctor:Worm infestation are other cause of bloody stool.
User:I drove my car to office and last week when I did not drive, no blood is observed
Doctor:That would be my 3rd possibility if fissure/tears are ruled out by per rectal examination and sigmoidoscopy.
Doctor:It is extremely difficult to differentiate between blood caused by worm infestation and fissures.
Doctor:since you mentioned that there is a stingy sensation in the anus while passing stool, I would rate minor fissures as the cause more than the worms.
Doctor:Both of these can be treated and we can wait for a few more days before starting any treatment.
Doctor:The measures that i mentioned should take care of minor fissures.
Doctor:A surgeon can help you if you the symptoms persist / worsens.
Doctor:Hope it is clear to you.
User:Do you think this is worrysome?
Doctor:Do you have any queries?
Doctor:Your current symptoms are not worrisome.
Doctor:*hemorrhoids too are graded based on the symptoms; and only the last grades are very troublesome where surgical treatments would be needed.
Doctor:So do not worry.
Doctor:Use sitz baths and dietary modifications.
Doctor:Have you followed?
Doctor:Do you have any other query?
User:thats it, thank you
Doctor:you are welcome.
Doctor:Thanks for consulting me.
Doctor:Bye for now.
User:thank you
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