I got bright red blood in rectum but there is no external hemorrhoids. Could it be anal fissure?

Q. Is bleeding rectum without external hemorrhoid dangerous?

Answered by
Dr. Sadaf Mustafa
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Feb 06, 2020 and last reviewed on: Feb 08, 2020

Hello doctor,

Bright red blood is coming from the rectum after using the bathroom. The rectum is also very itchy and no signs of external hemorrhoids. Rectum has been itchy for a while especially when wiping. Every now and again there is a light and spotty bright red blood. There was a little more during my last BM which caused me to be concerned. It may be an anal fissure? I am currently taking Cortizone 10.



Welcome to icliniq.com.

It could be a fissure or internal hemorrhoids or IBD (inflammatory bowel disease). Just to differentiate one from the other if you could help us out by answering these questions:

Does it hurt when you pass stools (BM)? Do you have constipation? How much was the blood? Did you felt dizzy? Do anyone have colon cancer in the family? Do you have any weight loss?

Thank you doctor,

No, it does not hurt when having a BM. There was about a half dollar size of blood on the toilet paper since then I have gone again and there was only about a quarter or so size of spotty bright blood with no constipation or weight loss. No family history of colon cancer and I did not feel dizzy. I am really nervous because of the off chance it could be cancer but I do not have any of the symptoms of it.



Welcome back to icliniq.com.

This is most likely internal hemorrhoids. I would suggest using over the counter hemorrhoidal cream and sitting in warm water for three days. Meanwhile, call your primary care (if you have one) and see if you can get to see a gastroenterologist or a general surgeon for an anoscopy or if you want a colonoscopy. This is just to confirm that you no cancer and have more localized hemorrhoids.

Usually, the ultimate treatment would depend upon the degree of internal hemorrhoids. Now coming to the cancer. The risk of having cancer depends upon age (> 50, weight loss, family history of colon cancer), all of which have been negative for you that we know of. I agree that still we should not take chances but let us treat simple things first and then you can see a gastroenterologist for more local examination if you fail to improve.

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