What medication should I take for rectal bleeding during a bowel movement, which resembles urinary incontinence (loss of bladder control) from the anus?

From the Guidelines

If you're experiencing rectal bleeding that resembles urination from your rectum, you should not self-medicate but seek immediate medical attention. This symptom could indicate several serious conditions including hemorrhoids, anal fissures, inflammatory bowel disease, diverticulosis, or even colorectal cancer. While over-the-counter medications like hydrocortisone creams might temporarily relieve discomfort from minor hemorrhoids, they won't address potentially serious underlying causes. The volume of bleeding you describe suggests a condition requiring professional evaluation. A healthcare provider will need to perform an examination to determine the exact cause and appropriate treatment. In the meantime, avoid straining during bowel movements, stay hydrated, and consider a fiber supplement to soften stool. Blood in stool, especially in significant amounts, affects your circulatory system and could lead to anemia or other complications if left untreated. This symptom requires proper diagnosis before any medication regimen can be recommended.

According to the most recent guidelines, such as those from the World Journal of Emergency Surgery 1, the management of bleeding anorectal varices involves the use of non-selective beta-adrenergic blockers for prevention and prophylaxis, vasoactive drugs like terlipressin or octreotide to reduce splanchnic blood flow and portal pressure, and a short course of prophylactic antibiotics. However, these recommendations are based on very low-quality evidence and should be considered in the context of individual patient needs and under the guidance of a healthcare provider.

In terms of specific medications, the use of vasoactive drugs such as terlipressin or octreotide is suggested for reducing splanchnic blood flow and portal pressure in patients with bleeding anorectal varices 1. Additionally, a short course of prophylactic antibiotic is recommended to reduce the risk of spontaneous bacterial peritonitis and improve survival in patients with cirrhosis and gastrointestinal bleeding, including rectal bleeding 1.

It's crucial to note that the management of rectal bleeding should prioritize the identification and treatment of the underlying cause, rather than just the symptoms. Therefore, seeking immediate medical attention is paramount to ensure proper diagnosis and treatment, and to prevent potential complications.

From the FDA Drug Label

Warnings ... Stop use and ask a doctor if you have rectal bleeding The FDA drug label does not answer the question.

From the Research

Causes of Rectal Bleeding

• Rectal bleeding can be caused by various factors, including anal fissures, hemorrhoidal disease, proctitis, and rectal cancer 2
• The causes of rectal bleeding can range from benign to life-threatening 3

Diagnostic Evaluation

• Diagnostic evaluation for rectal bleeding is complex and may deviate from available guidelines 4
• Risk factors for colorectal cancer should be documented in patients' charts, but this is often not done, with documentation rates ranging from 9% to 66% 4
• A colonoscopy is often recommended for patients with rectal bleeding, with 89% of patients needing one according to clinical guidelines 4

Treatment Options

• Treatment options for rectal bleeding depend on the underlying cause and may include conservative, topical, interventional, and surgical treatments 2
• Decision-making for treatment should be based on laboratory results, imaging studies, and risk scoring calculations 3

Importance of Medical Attention

• Rectal bleeding can be a sign of a serious underlying condition, such as colorectal cancer, and should be evaluated by a medical professional 4
• Patients with rectal bleeding should seek medical attention to determine the cause and receive appropriate treatment 3, 2