Dear Alice,

I enjoy my spicy foods. In fact, the spicier, the better. If I break a sweat when I'm eating, I've made a successful meal. I'm extremely active, physically, and I rarely get sick. I don't use tobacco, but I drink coffee daily. I average about two bowel movements a day, and I've found within the last week or so, blood on my toilet paper when I wipe my arse. Can the blood be caused by my spicy foods? I had my wife check out the area in question, and she says that it doesn't look like my rectum was bleeding (but it sure felt like it for about two minutes). I just wanted to know if the spicy foods can actually cause bleeding around there, and if so, does this mean that the bleeding could be caused in other places within my digestive system?

Bendin'-n Burnin'

Dear Bendin'-n-Burnin',

Sorry to hear that your rectum is wrecking your life right now! The good news is that there may not be any reason to cool off on the spicy foods just yet. Although eating spicy foods can irritate your stomach and aggravate other digestive problems, they cannot cause your stomach or any other organ in your digestive tract to bleed on their own. In some cases, they can lead to inflammation in people who have very sensitive stomachs, including those with irritable bowel syndrome (IBS). However, because you have a history of frequently enjoying spicy fare before the bleeding started, this may not be the case. So, what could be the cause? Read on to find out more.

The most common cause of bleeding in the lower digestive tract (which consists of the large intestine and rectum) is the presence of hemorrhoids in the anus or rectum. Hemorrhoids are swollen and inflamed veins in that area that can be torn or ruptured, leading to the appearance of bright red blood in the toilet or on toilet paper. They’re caused by increased pressure on the veins of the lower digestive tract, and common sources of the pressure include (but are not limited to) heavy lifting, diarrhea, and extra straining due to constipation.

Besides hemorrhoids, other potential causes for rectal bleeding include:

  • Anal fissures, which is a tear in the skin of the anus
  • Anal abscesses caused when the glands just inside the anus become blocked
  • Diverticulitis, which is a bulging pouch that forms on the wall of the intestine
  • Inflammatory bowel diseases (IBD), including ulcerative colitis or Crohn's disease
  • Chronic constipation
  • Hard stool
  • Ulcers
  • Colon polyps, which are small mounds of cells that form on the lining of the colon (while most are harmless, some can develop into colon cancer)

Adapted from the Cleveland Clinic and Mayo Clinic.

Bendin'-n-Burnin', another possibility is that the blood is actually in your stools. If this is the case, it could be a sign of something more serious going on. Therefore, you may want to consider seeing a medical provider sooner rather than later to get to the cause of your bum conundrum.

So, what can be done about rectal bleeding? Well, it largely depends on the root cause. If the bleeding lasts for more than a day, or is heavy and includes pain or cramping, it’s recommended that you visit a health care provider. They may perform a visual exam and an internal exam. If the provider is concerned about internal ulcers or polyps, they might also recommend performing a colonoscopy. In any case, getting it checked out can help determine the cause of your bottom woes and assist you in setting up a possible treatment plan.

May your bum stop its burnin'!

Alice!

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