So, yeah, anal bleeding... should I be worried?

August 6, 2011 1:08 PM

[ick filter] Things just get better and better. What do I do about anal bleeding?

So, about two weeks ago (thereabouts) I posted this question about this elimination diet that I'm trying. The pains have all but disappeared (I still get a twinge now and again, but nothing serious), and my bowel movements have been pretty loose (this is important) and I've been feeling... kinda blah. That's nothing new though, I always feel kinda blah (hence the reason for trying this diet).

Cue in two days ago. All of a sudden, I start bleeding from my backside. Now, I've had fissures before, and hemorrhoids and at first I thought, "not again." However those generally only bleed when there's bowel movement and this is pretty much all the time - there's even blood on my underwear. Also, there's no itching or pain this time. Okay, it's not a lot of blood -- like spotting -- and it's bright red, so I'm not overly alarmed. I mean, nothing's dark red or tarry black (just the opposite) so it's nothing to worry about, right?

Anyway, I plan to go to the student health clinic on Monday if it doesn't stop, but this is Saturday and I can't find much on Google about random anal bleeding other than what it might be, which is a number of things from benign to OMG I'm going to die!!! I also found this Askme from a few years ago, but most of the answers are also what it might be. I'm not really asking what it might be; I'm asking if there's anything I should do (I have no idea if there's anything I *can* do since I have no idea what's causing this...) or keep an eye out for between now and the time I can get to the health clinic on Monday.

Yes, yes, I know that no one here is my doctor.

posted by patheral to health & fitness (20 answers total)

I'm not sure if there's any advice besides "go to the doctor immediately," since persistent anal bleeding is not something you should try and wait out. You may have developed thrombocytopenia as a result of some sort of nutrient deficiency. Avoid taking blood-thinning drugs like aspirin until you can see a medical professional, which should be as soon as possible.
posted by Nomyte at 1:19 PM on August 6, 2011 [2 favorites]

I mean, nothing's dark red or tarry black (just the opposite) so it's nothing to worry about, right?

There is no way for anyone here to reassure you on that score. I would go to the ER or at the very least an Urgent Care office. Do not leave this till Monday for the student health services. And seconding Nomyte -- do not take any aspirin, NSAIDs (ibuprofen, naproxen, etc.) or anything else that has blood thinning properties.
posted by scody at 1:30 PM on August 6, 2011

Go to the ER! My immediate IANAD guess is that the persistent diarrhea (for almost a month, right?) has caused some bleeding (which it can) because you are on what seems to be (based on your past question) an extremely unsuitable diet. But there's no way to tell whether this is the case or whether you have, for example, an extremely fast-bleeding ulcer (friend of mine had that and could have died)

Assuming that this immediate situation gets resolved, you need to go to a gastroenterologist and get these "blah feelings" figured out. Seriously, an "elimination" diet to fix something as nebulous as "inflammation" is not what you need. If you have celiac or IBD, there are specific diets targeted toward those conditions
posted by Frowner at 1:41 PM on August 6, 2011 [3 favorites]

Your student health should have after-hours services. Go.
posted by Stewriffic at 1:47 PM on August 6, 2011

Bright red means artery. Get to the ER pronto.
posted by brujita at 1:58 PM on August 6, 2011

2nding Frowner. ER, now.
posted by StrikeTheViol at 2:34 PM on August 6, 2011

Worry. ER or after-hours clinic.

Seriously.
posted by guster4lovers at 2:38 PM on August 6, 2011

You should get checked out to be on the safe side. I do know that when I cut grains out of my diet and went Paleo, I had some serious indigestion, stomach pains akin to kidney stones, and pretty bad diarrhea. When it was really bad, I ate some bran mixed into yogurt. Better to cheat then get really sick.
posted by Raichle at 3:20 PM on August 6, 2011

Spotting is not an emergency situation. Flowing is. I certainly wouldn't go to the ER, but I might go to a GP next week.
posted by gjc at 3:52 PM on August 6, 2011 [2 favorites]

Bright red means artery. Get to the ER pronto.

Um, no. That's ridiculous. Bright red blood from the anus does *not* necessarily mean you've tapped into an artery. Do you have any medical training, brujita? If not, you might want to rethink the certainty levels in your answers to medical questions. Here's a better response:

The color of blood during rectal bleeding often depends on the location of the bleeding in the gastrointestinal tract. Generally, the closer the bleeding site is to the anus, the brighter red the blood will be. Thus, bleeding from the anus, rectum, and the sigmoid colon tends to be bright red, whereas bleeding from the transverse colon and the right colon tends to be dark red or maroon-colored.

I've had on-and-off, generally mild proctitis (inflammation/ulceration of the rectum and/or colon since my late 20s, and bright red bleeding, while clearly a cause for concern and a definite reason to get to a doctor, is not always an emergency situation that involves tapping into an artery. I'm not telling you what to do, just correcting misinformation in the thread. But yeah, if it was me, I'd be at the clinic Monday morning.
posted by mediareport at 4:05 PM on August 6, 2011 [7 favorites]

Like gjc I very much doubt if this is an emergency situation--assuming it is as you describe--spotting and not a continual bleed. Given your recent history I would assume it is the result of some type of anal trauma. Should the spotting change or be accompanied by pain, extreme fatigue, rapid pulse etc then go to an urgent care center. Otherwise call first thing Mon AM, or after hours and schedule a early appointment. Make sure you are not doing anything to continue to aggravate or irritate it. Good luck and I hope the symptoms are quickly alleviated.
posted by rmhsinc at 4:05 PM on August 6, 2011

I'm sorry if my question was misleading, but I certainly have not had diarrhea for a month. I would have definately gone to a doctor before now if that were the case. I meant to infer that my stools have been soft -- rather than difficult to pass.

I cannot afford another ER visit, I'm still paying off the last one from over a year ago because I have no insurance. There are no urgent care clinics in this town, it's the ER or nothing. And the student health clinic is not open on the weekends. Period. I found that out the hard way. As it is, if I'm not falling down, I take a wait and see attitude. I simply have no choice.

Thanks for the advice about the blood thinners, I'll keep that in mind. I'll also keep an eye out for rapid pulse and unusual pain. I'm always fatigued, it's part and parcel of my every day life -- the heat doesn't help that at all.
posted by patheral at 5:10 PM on August 6, 2011

If you're determined to wait until Monday, can you at least have a friend call/check on you periodically, or maybe sleep over if you don't have a roommate?
posted by Glinn at 5:30 PM on August 6, 2011 [1 favorite]

Thanks, Glinn, I have a roommate who also worries. I've mentioned this to her, and she knows about my other medical issues. She asks me periodically how I am feeling. She's not a doctor, but she's had some medical training. I'm sure if I start to look really bad, she'll call an ambulance (neither of us have a car)
posted by patheral at 5:35 PM on August 6, 2011

Bright red means artery.

Just to expand on this statement, unless you have a bit of experience looking at blood, arterial and venous (or capillary) blood can be hard to distinguish even side by side in sample tubes; spots on tissue or cloth (such as undergarments) are pretty much impossible to distinguish. More to the point, arterial bleeding is vigorous and (usually) pulsatile and doesn't stop unless pressure is continuously held for a long time (the other day in the cath lab it took 45 minutes of pressure on one patient) So this is not arterial bleeding as described, and while worth getting looked at, not an emergency unless other symptoms develop.
posted by TedW at 7:00 PM on August 6, 2011

I would second the opinion that you should talk to a medical doctor as soon as possible about the issue. Until you can do that should stop taking any herbal supplements or vitamins as some of them can interact with blood clotting chemistry. Also some teas as well.

but really go see a Dr. soon.
posted by The Violet Cypher at 7:30 PM on August 6, 2011

Okay, it got worse, as did the abdominal pains, so I did go to the ER. The NP there said that it isn't a hemorrhoid, but it is a fissure and an "irritation" where there used to be a hemorrhoid. She said it probably got worse because it's getting more irritated by the moment. She also said the inside of my anus was tender and irritated. She prescribed cream and suppositories.

AND the abdominal pain is being caused by two things (now that we're in TMI territory)... I'm "full of stool" even though I've been passing stool every day, she said, "obviously not the right stool" whatever that means. She said to add grains back to my diet -- which was on the agenda anyway, so there's that. The upper right quadrant pain I've been experiencing is because there's "a lot of gas" "massive gas" up in that area. She prescribed a laxative, which I'm waiting to work right now, and suggested I start taking fish oil and fiberfill or some other fiber supplement in addition to adding grains back to my diet. She also suggested that I might have IBS -- which has been suggested before...

Anyway, crisis averted. I'm not looking forward to the bill, but now I can at least rest knowing I'm not bleeding to death inside.
posted by patheral at 10:03 PM on August 6, 2011 [1 favorite]

So now stop messing around with random diets on your own and go see your GP on Monday to get this properly diagnosed. I have IBS and I've been studying IBD. Elimination diets aren't something you can do properly at home, at least partially because this is the kind of thing that happens when you don't know what you're doing. You've been lucky this time (as lucky as a highly irritated anus every is anyway), but you need to get it sorted for reals now. Laxatives, additional fibre or oil (even fish oil) can be disastrous for IBS suffers depending on their triggers, so you're well beyond being able to treat this yourself. You probably need to see a gastroenterologist and proper dietician, but at least get started with a GP.
posted by shelleycat at 1:40 AM on August 7, 2011 [2 favorites]

Thank you for the advice, Shelleycat. Once I have a real job and some insurance, I will certainly find a GP and get it all straightened out. The student health clinic, as I mentioned before, is staffed with rather incompetent people so I don't expect much from them. Until then, I will stop messing with stupid diets and concentrate on getting the hell out of this one-horse town.
posted by patheral at 9:25 AM on August 7, 2011

Goddamn, it seems like a quick trip to a colon hydrotherapist would have cleared up the "full of stool" and "massive gas" issues immediately. Next time.
posted by HotPatatta at 9:34 AM on August 13, 2011