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41 years
Today I noticed some rectal bleeding. The blood color is real red and I feel discomfort around my anus. What might be causing it? Should I see a doctor immediately?
May 10, 2015

Dr. Zakia Dimassi Pediatrics
The appearance of fresh (red, bright) blood from the rectum is, in most cases, one of two things:
1- Anal fissure: typically occurs in the scenario of constipation (hard stools), and/or straining, which happens either with constipation or diarrhea. In these cases, the anal mucosa (the lining of the anus) gets injured and is torn. If the affected person has chronic constipation (for example) and thus is exposed to recurrent injury because of hard stools, an anal fissure tends to recur, usually at the same location. The patient notices dripping dripping of fresh blood in the toilet seat or on the toilet paper upon wiping, after passing a bowel movement. Anal fissures are painful and sometimes burn.

2- Internal hemorrhoids: hemorrhoids are diseased blood vessels (veins) in the rectum, the last segment of the large intestine; these veins resemble the varicose veins in the legs: they harbor stagnant blood and often get engorged with blood, so they swell, Passing fresh blood from the rectum WITHOUT pain is the classical textbook description of bleeding from internal (rectal) hemorrhoids

3- External hemorrhoids: these are internal hemorrhoids that have externalized and became outside the colon, around the anal area; when these hemorrhoids get inflamed, they get especially painful (sitting, passing a bowel movement become excruciatingly painful) and may also bleed. They also cause itchiness and discomfort.

In any case, it is advisable that healthy individuals as of the age of 40 years to receive a gastro-intestinal check-up, including a colonoscopy (imaging of the intestines with a scope) as part of the yearly health check-up. Since you have observed rectal bleed, maybe now is a good time to do that check up and make sure everything is alright.