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When to Call for Rectal Bleeding

Care Advice

Mild Rectal Bleeding

1. What You Should Know:
   • Rectal bleeding is never normal. However, it is not always serious.
   • Sometimes bleeding can be very mild. There may be just a few drops of blood in the stool or blood on the toilet paper. Often this is from hemorrhoids (piles) or a small scratch from a hard stool.
   • You can treat very mild rectal bleeding from hemorrhoids, anal fissure, or constipation at home.
   • Here is some care advice that should help.
2. Warm SITZ Baths Twice a Day:
   • Sit in warm bath water for 20 minutes 2 times each day. This helps clean and heal the rectal area.
   • If you want, you can add ¼ cup (80 grams) of table salt or baking soda to each tub of water. Stir the water until it dissolves.
   • This is also called a Sitz bath.
3. Stool Softener for Hard Bowel Movements:
   • If you have hard stools, stool softeners can help soften the stool. This can help decrease rectal pain when passing stool.
   • Docusate (Colace) is a stool softener that you can get over-the-counter.
4. Call Back If:
   • Bleeding increases
   • Bleeding lasts more than 3 days
   • Bleeding is off and on for weeks or months
   • You think you need to be seen
   • You get worse

Constipation

1. What You Should Know:
   • Trouble passing a stool, hard stools, and infrequent stools are signs of constipation.
   • Healthy living habits can help treat and prevent constipation. Healthy habits include eating a diet high in fiber and regular exercise.
   • You can treat mild constipation at home.
   • Here is some care advice that should help.
2. Eat a High Fiber Diet:
   • Slowly increase the amount of fiber in your diet. This will help soften your stools. Fiber works by holding more water in your stools.
   • Eat more fresh fruit and vegetables. They are great sources of natural fiber. This includes peas, prunes, citrus, apples, beans, and corn.
   • Eat more foods made from whole grains. Foods made from whole grains also have fiber. Examples are bran flakes, bran muffins, graham crackers, oatmeal, brown rice, and whole wheat bread. Popcorn is also a good source of fiber.
3. Liquids:
   • Drinking enough liquids is important to keep your stools soft.
   • Drink 6-8 glasses of water a day. Caution: certain medical problems require fluid restriction.
   • Prune juice is a natural laxative.
   • Avoid alcohol.
4. Exercise:
   • Staying active is always a healthy choice.
   • Regular exercise decreases constipation.
   • Even a daily walk for 15 minutes helps.
5. Call Your Doctor If:
   • Constipation lasts more than 2 weeks after using Care Advice
   • Stomach swelling, vomiting or fever occur
   • Constant or increasing stomach pain
   • You think you need to be seen
   • You get worse

Over-the-Counter (OTC) Medicines for Constipation

1. Step-By-Step: A step-by-step approach to using OTC medicines for constipation is best.
2. Step 1 - Use a Fiber Laxative Every Day:
   • You can take a fiber laxative every day instead of eating more fiber.
   • An example of a fiber laxative is psyllium (Metamucil). You can buy this at the store without a prescription.
   • Fiber can help soften your stools. Fiber works by holding more water in your stools. Be patient. Sometimes this takes 1 to 2 weeks to work.
   • Osmotic Laxatives, as needed: You can take milk of magnesia or polyethylene glycol (PEG, Miralax). This type of medicine helps pull water into your intestines. This softens the stools.
   • Read the instructions and warnings on the package insert for all medicines you take.
3. Step 2 - Add a Stool Softener:
   • For stools that are more firm or hard, try an over-the-counter stool softener. An example is docusate(Colace, Surfak).
   • These medicines soften stools and make them easier to pass. You can buy them at the store.
   • They may take 1 to 2 days to start working.
   • Read the instructions and warnings on the package insert for all medicines you take.
4. Step 3 - Use an Osmotic Laxative if Needed:
   • If needed, you can try an osmotic laxative to treat occasional constipation. Examples are polyethylene glycol(PEG and Miralax) and milk of magnesia. You can buy these at the store without a prescription. Another option is to try a glycerine rectal suppository.
   • These medicines help pull water into your intestines. This softens the stools. They often start working in 1 to 2 days. Glycerine suppositories often work within an hour or less.
   • Do not use laxatives for more than 2 weeks unless your doctor instructs you to do this.
   • Caution: do not use milk of magnesia if you have kidney disease.
   • Caution: if you are pregnant, talk to your doctor before using these laxatives.
   • Read the instructions and warnings on the package insert for all medicines you take.
5. Step 4 - Add a Stimulant Laxative:
   • If the constipation does not get better with the Care Advice in the above 3 steps, add a stimulant laxative. Use only if needed.
   • Try bisacodyl(Dulcolax) tablets. You can buy these at the store without a prescription.
   • These laxatives often work in 6 to 12 hours. Another option is Senna. This is a mild, plant-based laxative.
   • Do not use laxatives for more than 2 weeks unless your doctor instructs you to do this.
   • Caution: do not use stimulant laxatives if you are pregnant.
   • Read the instructions and warnings on the package insert for all medicines you take.
6. Call Your Doctor If:
   • Constipation lasts more than 2 weeks after using Care Advice
   • Stomach swelling, vomiting or fever occur
   • Constant or increasing stomach pain
   • You think you need to be seen
   • You get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.