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Postpartum Rectal Bleeding: Causes, Tips And Prevention

Postpartum Rectal Bleeding

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Rectal bleeding refers to bleeding from the rectum, colon, or anus. It usually shows up as bright red blood in the stool, in the toilet, or on the toilet paper (1). Some women might experience postpartum rectal bleeding, along with pain and discomfort, after a cesarean section or vaginal delivery.

This MomJunction post tells you the reasons behind postpartum blood in the stool, the relief measures you can take, and ways to prevent it.

Causes Of Postpartum Rectal Bleeding

The possible causes of rectal bleeding after delivery include.

  • Hemorrhoids (swollen veins in the rectum and anus): Hemorrhoids are common during pregnancy, especially in the third trimester and first few weeks after delivery. These swollen veins rupture and bleed as you strain while passing hard stool as a result of postpartum constipation (2) or when you wipe the anal area using a tissue.
  • Anal fissures: Hard stools could also cause cracks in the skin around the anus, known as anal fissures. These could be painful and cause bleeding (3).

How To Deal With Postpartum Rectal Bleeding?

Here are some of the ways to manage hemorrhoids and anal fissures and soothe postpartum rectal bleeding (2) (4).

  1. Try a warm water bath. You may use a sitz bath, which is a small water tub that fits over the toilet seat. Sitting in the sitz bath for about 10 to 15 minutes after each bowel movement or for two to three times a day could soothe irritation. Add Epsom salt to water to help reduce swelling and pain.

You can also soak yourself in a bathtub. Relax the anal muscles while soaking in the bathtub. It helps maximize the blood flow and speed up healing. It can also lower the pain associated with bowel movements.

  1. Apply ice compress (wrap some ice in a clean cloth) on the hemorrhoids and leave it for about ten minutes. This helps reduce swelling and discomfort. Alternate between hot and cold treatments — begin with ice compress and follow it up with a warm sitz bath.
  1. Clean the anal region using a soft and unscented tissue. You may also use medicated wipes or moist the tissue with witch hazel to speed up the healing process.
  1. Practice kegel exercises as they could help improve blood circulation in the rectal tissue region and the perineum. They also help tone the vaginal and pelvic-floor muscles (5).
  1. Sit on a soft cushion or a pillow to get relief from the rectal pressure. Sitting on a recliner or a rocking chair is likely to be more comfortable than sitting on a straight-backed chair.
  1. Limit activities that induce rectal pressure. Hemorrhoids generally occur due to the pressure exerted on the rectal area. The risk factors are likely to be obesity, lifting of heavy items, constipation, straining to have a stool, or sitting on the toilet seat for a prolonged period.
  1. Do not control the urge to pass stool as it could aggravate the pain and discomfort caused by hemorrhoids and make the stools dry.
  1. Limit the time spent in the toilet as sitting for a long time puts pressure on the rectal veins, which could increase bleeding.
  1. Use over-the-counter hemorrhoid creams, suppositories, ointments, or sprays after consulting a doctor. They could relieve itching and discomfort in the rectal region.
  1. Address constipation by including high-fiber foods in your diet and drinking enough water. These could ease constipation and reduce the discomfort caused by hemorrhoids and rectal bleeding.

If these home treatment measures do not provide you relief from postpartum rectal bleeding, your doctor might prescribe medicines such as stool softeners, opioids, and pain relievers.

When To See A Doctor?

Seek the help of your healthcare provider if you experience the following symptoms:

  • Significant rectal bleeding that is continuous or heavy
  • Abnormal growths in the anal region
  • Fresh blood in your stools
  • Change in the stool color
  • Pain while passing stool or urinating
  • Lack of control over stool passage
  • Dizziness or shortness of breath

Your doctor may schedule lab tests or imaging tests to determine the cause of blood in the stools.

How To Prevent Postpartum Rectal Bleeding?

Take measures to prevent constipation,  which could decrease the possibility of postpartum hemorrhoids and anal fissures, the main causes of postpartum rectal bleeding (6). The following measures could help you prevent postpartum rectal bleeding.

  • Drink enough water and other healthy liquids
  • Eat dietary fiber diet that includes whole-grain bread, beans, cereals, fresh fruits, and vegetables in your everyday diet.
  • Listen to your body and attend the nature call when you feel the urge.
  • Maintain a healthy body weight.
  • Take a probiotic supplement or a fiber supplement after checking with your doctor.
  • Do regular exercises, such as walking and swimming, and practice yoga.

Is It Normal To Bleed When You Poop After Having A Baby?

Finding drops or streaks of blood in your postpartum poop, toilet bowl, or tissue during the first few days after childbirth is common. You may also notice it in your panty after you visit the washroom.

Rectal bleeding after pregnancy is usually not a serious problem since the factors causing it (hemorrhoids or anal fissures) resolve on their own. In some cases, when they do not resolve, your healthcare provider might determine the severity of the condition by checking your signs and symptoms. In severe cases, you may be recommended a minor surgery.

References:

1. Rectal bleeding; U.S. Department of Health and Human Services National Institutes of Health (2018)
2. Common Conditions; University of Rochester Medical Center
3. Understanding Minor Rectal Bleeding; American Society for Gastrointestinal Endoscopy
4. What to Know After Having Your Baby; UNM Hospitals
5. Vagina changes after childbirth – Sexual health; NHS
6. Hemorrhoids And Anal Fissures; University Health Services, Tang Center