Hot sauce: Appetizing, but anally aggravating?

Originally Published: July 14, 2006 - Last Updated / Reviewed On: January 24, 2013
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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 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 its own. In some cases, they can lead to inflammation in people who have very sensitive stomachs, such as those with Irritable Bowel Syndrome (IBS). However, because you have a history of frequently enjoying spicy foods before the bleeding started, this is probably not the case. Is it possible that the blood is actually in your stools? If this is the case, you may want to consider seeing a medical provider sooner rather than later.

Ulcers, which are caused commonly by the bacterium Helicobacter pylori or non-steroidal anti-inflammatory drugs such as ibuprofen or aspirin, can wear away at the walls of the stomach and duodenum (small intestine) and cause bleeding.

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 and/or on toilet paper. They are 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.

Alternatively, an anal fissure, or a cut on the lining of the anus, may be responsible for the bleeding. In the worst-case scenarios, bleeding from the digestive system can signify various forms of cancer, cirrhosis, Crohn's Disease, or polyps, especially if it is accompanied by pain.

Because there are so many different things that can cause the bleeding, it is probably a good idea to visit a health care provider. If you're a student at Columbia, you can make an appointment with Columbia Health (Morningside campus) by calling 212-854-2284 or logging on to Open Communicator. If you are on the Medical Center campus, contact the Student Health Service at 212-305-3400 for an appointment.

May your bum stop its burnin'!

Alice