"Is Having Blood on the Paper After Bowel Movement a Sign of Danger?"

Generally, there is no major risk associated with blood on toilet paper after bowel movements, but further examination is required to determine the cause of the bleeding. It is possible that there are perianal diseases such as hemorrhoids, rectal polyps, anal fissures, etc. Hemorrhoids can be classified as internal or external, and rectal examination can be used to confirm the diagnosis by palpating the hemorrhoidal nucleus. Mild hemorrhoids can be treated with medication, while severe cases may require surgical intervention.

1. Bleeding from Internal Hemorrhoids

Firstly, if there is no blood in the stool but blood is present on the paper, this is often indicative of bleeding from internal hemorrhoids. Generally, when the stool is expelled, it should not contain blood unless the stool is particularly dry. However, after bowel movements, due to increased abdominal pressure, the mucosal lining of internal hemorrhoids can be prolapsed and, as a result of friction with the stool, can be damaged and scratched. This can result in clear and visible blood stains on the paper when wiping. The blood is usually bright red and fresh, not old or dark.

2. Anal Fissures or Other Inflammation

Additionally, the presence of blood can also be indicative of anal fissures or other inflammatory conditions, which can be accompanied by pain. In rare cases, such as patients with malignancies like anal canal cancer or rectal cancer, the blood on the paper may appear old and dark, not fresh, and may even be accompanied by a foul odor and necrotic debris. This situation should be taken seriously, and further examination is necessary to avoid delaying diagnosis and treatment.

3. Anal Canal Inflammation and Anal Fistula

It is a common occurrence for there to be no blood in the stool but blood on the toilet paper, which often indicates a disease affecting the anal canal. The anal canal has a dentate line, which is the skin of the anal area and is mainly composed of squamous epithelium. If there is blood only on the paper, it may indicate a lesion near or outside the dentate line, such as anal canal inflammation or anal fistula. If there is frequent blood in the stool, it is advisable to consider undergoing colonoscopy.