Postpartum rectal bleeding after bowel movements is a common problem, and it’s worth checking in with your provider about. The most common rectal bleeding causes are hemorrhoids or constipation. Sitting in a sitz bath, holding ice to the area, and using an over-the-counter hemorrhoid medicine or pain reliever are some rectal bleeding treatments. To prevent constipation, add extra fiber into your diet, drink lots of water, and exercise often. And get medical help right away if you have heavy rectal bleeding.
IN THIS ARTICLE
- What is rectal bleeding?
- Why does rectal bleeding occur postpartum?
- How is rectal bleeding treated?
- When should I call the doctor about postpartum rectal bleeding?
- Are there any ways to prevent rectal bleeding postpartum?
What is rectal bleeding?
The rectum is the bottom part of your intestine that connects to your anus. If you’re bleeding from the rectum, you might see blood on the toilet paper when you wipe, or in the toilet bowl. Don’t panic. Most of the time, bleeding down there isn’t as scary as it looks.
Looking at the color of the blood can tell you where it came from. Bright red blood is usually from the lower part of your colon. Dark red or maroon blood starts higher up in your colon or small intestine. Dark stools could be a sign of bleeding higher up in your GI tract.
You might see just a few drops of blood on the toilet paper, or a larger amount from heavy rectal bleeding. Rectal bleeding can be a one-time thing, or it might happen every time you wipe.
It’s always a little unnerving to see blood when you use the toilet. Most causes of postpartum rectum bleeding aren’t serious, but it’s still worth checking out this symptom with your doctor, especially if the bleeding is heavy or it doesn’t go away.
Why does rectal bleeding occur postpartum?
There are a few possible causes for rectal bleeding in the postpartum period. One of the most common is hemorrhoids – swollen veins in and around the rectum. About 40 percent of women get hemorrhoids in their last trimester of pregnancy and the first few days after giving birth.
You’re more likely to get these swollen veins if you were constipated during pregnancy, you gave birth to a large baby, or you strained a lot during the delivery.
And speaking of constipation, it’s another common affliction during pregnancy and after delivery. Straining during bowel movements or passing hard stools – a common scenario if you are constipated – can make these swollen veins bleed.
Passing hard stools can also cause cracks in the skin of the anus. These are called anal fissures, and they can be quite painful, particularly during and just after a bowel movement.
Though these are by far the most likely culprits during pregnancy and after you give birth, inflammatory bowel disease (IBD), aka Crohn’s disease or ulcerative colitis, can also cause rectal bleeding. Less often, bleeding is a sign of polyps, non-cancerous, pre-cancerous, or cancerous growths in the intestines. Polyps should always be investigated and treated by your healthcare provider.
How is rectal bleeding treated?
Here are some rectal bleeding treatments to help you manage hemorrhoids and anal fissures.
Take a sitz bath. Several times a day, immerse your bottom in warm water for about 10 to 15 minutes. You can use a portable basin that fits in the toilet, or simply fill your bathtub with a few inches of warm water. (Don’t add any soaps or bubble baths.)
Most hospitals will give you the portable basin for a sitz bath during your postpartum stay if you ask, and you can bring it home with you. Otherwise, you can buy one at the drug store. Relaxing your anal muscles during the soak will help maximize blood flow – and healing – in the area, and may make bowel movements less painful.
To find these muscles, simply contract the same muscles you use to stop urinating or having a bowel movement and then relax them, like you do during Kegel exercises. Do this a few times while you’re taking a sitz bath.
Use an ice pack. An ice pack or cold compresses soaked in witch hazel can relieve hemorrhoids. If warmth feels better, use a heating pad. Try alternating hot and cold treatments: Start with an ice pack followed by a warm sitz bath.
Buy soft toilet paper. Use white unscented toilet tissue, which is less irritating than colored or scented varieties. Moistening the tissue can help, too. Or use baby wipes or moist towelettes soaked in witch hazel instead.
Treat hemorrhoids. Ask your healthcare provider to recommend a hemorrhoid cream or suppository. (Note: If you’ve had an episiotomy or tear that extends into your rectum, it’s especially important not to put anything – including suppositories – into your rectum until your healthcare provider gives you the okay.) Most hemorrhoid medicines are meant to be used short-term only (a week or less). See your doctor if your symptoms don’t improve in that time.
Take a pain reliever. For temporary relief, you can take acetaminophen or ibuprofen, even if you’re breastfeeding, in the recommended amount. (Avoid aspirin or products containing aspirin if you’re nursing.) If the pain continues, talk to your midwife or doctor. Keep in mind that opioid-containing pain relievers such as Percocet and Vicodin can cause constipation after delivery, so you may want to avoid them after the first few days postpartum, and be sure, if you are taking them, to drink lots of water and add a fiber supplement or an osmotic laxative.
When should I call the doctor about postpartum rectal bleeding?
Most of the time, rectal bleeding isn’t anything serious. Bleeding caused by hemorrhoids usually stops on its own, especially if you make changes to keep prevent constipation.
But because you have no way of knowing what’s going on, it’s always a good idea to check in with your doctor. They can tell you whether you should come into the office, and if you need any tests.
Also call if:
- You’re having more or fewer bowel movements than usual
- Your poop has changed color or texture
- You feel tired or weak
- You have belly pain
If you bleed often, there’s a lot of blood, or your stool is a dark or tarry color, call for an appointment right away. Those could be signs of a more serious condition. If the problem is severe or you have anal fissures that aren’t healing, your caregiver might refer you to a specialist for treatment.
Are there any ways to prevent rectal bleeding postpartum?
It’s not uncommon for your bowels to be a bit sluggish in the days after you give birth. Since constipation can both bring about and irritate hemorrhoids and anal fissures, staying regular can help.
Here are some tips for preventing and easing constipation:
- Try to eat high-fiber foods such as cereals, whole-grain breads, beans, and fresh fruits and vegetables every day. If that alone doesn’t do the trick, you might add a couple of tablespoons of unprocessed wheat bran to your cereal in the morning. (You may want to start with a smaller amount of bran and gradually increase the amount to avoid becoming gassy.)
- Bump up your daily water servings. A glass of fruit juice each day, especially prune juice, can also be helpful.
- Exercise regularly. Walking, swimming, and yoga can all help ease constipation and leave you feeling more fit and healthy.
- An osmotic laxative can do wonders for getting you back on a regular bowel routine.
- Listen to your body. Try to go to the bathroom whenever you feel the urge, even if your bottom is tender and it’s uncomfortable to go. Waiting will only make the problem worse.
- Ask your healthcare provider about taking an over-the-counter fiber supplement, stool softener, or mild laxative.
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