The anorectum is a frequent source ofsignificant lower GI bleeding. It frequently manifests with small amounts of bright red blood noted on the toilet paper, coating the stool, or dripping into the toilet bowl. Many causes of anorectal bleeding, such as hemorrhoids and fissures, are recurrent. Constipation occasionally causes stercoral ulcers due to fecal impaction or the solitary rectal ulcer syndrome from mucosal trauma, rectal prolapse, or direct digital trauma to aid evacuation, which can lead to anorectal hemorrhage. In patients with portal hypertension, rectal varices can cause life threatening hemorrhage which often requires rectal packing or even emergent surgery to control. The finding of very prominent hemorrhoids should always prompt the question: "Does this patient have portal hypertension?" There is a separate chapter on hemorrhoids (see Chapter 92, "Hemorrhoids").
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Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.