Constipation and rectal bleeding

Patient

Q: I have been suffering from chronic constipation for years, in the past year i have only been able to go after taking lots of laxatives going up to 14 days without a bm, now there is blood from that area even when im not trying to go. what is this? what should i do? Im 28years old, i have talked to my dr. about it and i cant get them to help.

Doctor

A:   Bleeding from the back passage in association with chronic constipation may indicate bleeding from the rectum or anus. This bleeding is most commonly due to the presence of haemorrhoids, secondary to constipation. Things that may improve your constipation include: increased exercise, including walking; increased fluid intake in the form of water; and increased fibre in the diet and fibre supplementation. Sources of dietary fibre include fruits and dried fruits especially prunes, root vegetables, especially in the skin, and legumes, cereals high in fibre, wheat and corn bran, oats, nuts and seeds and whole grain bread. Soluble fibre supplements and prebiotics are available in most pharmacies, which may improve symptoms in addition to diet. Other causes of bleeding from the back passage in someone of your age may include: fissures or cracks in the lining of the rectum; colitis (inflammation of the colon); polyps (slow-growing overgrowth on the surface of the colon); inflammatory bowel disease; angiodysplasia (vascular abnormality that causes bleeding from the large bowel). If all the above measures fail to improve your symptoms, I advise consulting your family doctor for a detailed history of the bleeding and a physical examination.

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