Occasionally experiencing blood on toilet paper is quite common. This sign, which in itself is of little concern, is typical of various pathologies, some of which are very serious.
- anal fissures : these small cuts of the anal mucosa are the most frequent cause of blood on toilet paper. In this case the hemorrhage is very contained and more than real drops of blood, thin streaks of bright red color are observed that are attenuated with the various passages of the toilet paper. Anal fissures, which normally cause acute anal pain during defecation and intimate hygiene, can be prevented and defeated by careful intimate hygiene, and by regularizing intestinal activity in the event of diarrhea or constipation
- hemorrhoids : they are dilatations of the homonymous submucosal veins at the level of the anus and the terminal part of the rectum. In this case the bleeding tends to be more abundant and the blood on the toilet paper creates real spots; sometimes you can even observe a blood drip in the internal walls of the WC or a blood varnish on the last faeces emitted. Hemorrhoidal hemorrhage is usually painless, but in the event of severity it can be associated with the loss of mucus, irritation, pain and itching
- polyps or colorectal carcinomas : in this case the blood is mixed with the faeces, unfortunately often not visible to the naked eye and without associated symptoms (for this reason, in the colorectal cancer screening, after 50 years the so-called search for occult blood in the stool). In the case of large polyps, the feces take on a ribbon-like appearance and the persistence of the evacuative stimulus is common even after defecation. The presence of abdominal pain not very intense, anemia, lack of appetite, fatigue, fatigue, dyspnea, weight loss, with blood in toilet paper, diarrhea and constipation can lead to suspect colorectal cancer
- ulcerative colitis : chronic inflammatory disease of the intestine, often characterized by the emission of diarrheal feces with traces of mucus and blood; more rare is the finding of blood in the stool in a person suffering from Crohn's disease
- diverticular disease : the small sacks (diverticula), which especially in old age form along the intestinal walls of some subjects, can become inflamed and rarely cause abundant sudden bleeding in the absence of pain, even with emissions of clots but often without emission of feces
- peptic ulcer : the ulcerations of the gastric and duodenal mucosa determine hemorrhages that occur - among other things - with the emission of digested blood in the faeces (melena), characterized by a particularly dark color and a tarry consistency
- foodborne diseases : food-borne diseases (salmonella, escherichia coli, shigella ...) are typically accompanied by abdominal pains and cramps with violent diarrheal discharges, sometimes mixed with blood and mucus (an expression of damage to the intestinal mucosa)
- venereal diseases : such as gonorrhea, chlamydia, genital herpes, syphilis, trichomoniasis contracted through unprotected sexual intercourse of a mainly anal nature
- iatrogenic bleeding : radiation therapy in the treatment of pelvic tumors, abuse of laxative drugs such as bisacodyl, or antidiarrheal, and prolonged antibiotic therapies, especially with lincomycin and clindamycin, can cause rectal bleeding.
PLEASE NOTE: it is a good rule that any perceived rectal bleeding, even if it is minor and limited to the presence of blood in the toilet paper, is brought to the attention of your doctor, especially in cases of age over 45 or familiarity with polyps and colorectal cancers.
