Is hot sauce the source of my anal aggravation?

Dear Bendin’-n Burnin’, 

It seems like you’ve got a real bum conundrum here—it’s hard to reckon with the fact that something you love so much could be the cause of your pain. While spicy food could be to blame for your symptoms, there are other possible reasons you might have a bloody bum. In any case, blood can be alarming, and it might put your mind at ease to speak with a health care provider to get a proper diagnosis. Eating spicy food on its own cannot cause your stomach or any other organ in your digestive tract to bleed. That said, a compound in spicy foods (called capsaicin) can lead to diarrhea which may cause you to have blood in your stool. 

When you have diarrhea, the force with which stool exits the body and vigorous wiping afterward can lead to tears in the anal lining. In turn, these tears, or anal fissures, may result in blood on toilet paper or in your stool. If this resonates with your experience, it might be helpful to adjust your diet. If you’re unsure whether spicy food is the culprit in this bloody scene, it’s worth exploring other possibilities. 

You mention that you’re seeing blood on the toilet paper after you wipe. Usually, the type of blood that shows up on toilet paper is bright red, which can be a sign of active bleeding in the lower digestive system, including the lower colon, rectum, and anus. The most common cause of bleeding in the lower digestive tract is the presence of hemorrhoids in the anus or rectum. Hemorrhoids are swollen and inflamed veins in the anal area that can be torn or ruptured. They’re caused by increased pressure on the veins of the lower digestive tract. This pressure is often a result of heavy lifting, diarrhea, and extra straining due to constipation. Additionally, if you do indeed have hemorrhoids, your daily caffeine consumption could exacerbate your symptoms. 

Hemorrhoids aside, there are other reasons why you could be experiencing rectal bleeding and painful bowel movements. Other potential causes for rectal bleeding include: 

• Anal abscesses caused when the glands 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 

To get to the root of this issue, it may be helpful to start inspecting your stool after a bathroom session. Is the blood bright red or is it darker? Darker blood typically indicates older bleeding higher up in the digestive tract, like in the stomach, upper colon, or small intestine. Is it just your toilet paper that’s bloody or are your stools themself bloody? If you notice red stools, did you recently eat beets, tomatoes, red peppers, or anything made with red food dye? These foods could be the reason stool looks red, not blood. 

All that said, there could be various reasons you might have a burning and bleeding bum. In which case, it may be helpful to speak with a health care professional to help determine the cause of your bottom woes and assist you in setting up a treatment plan, if necessary. It’s especially recommended to speak with a health care professional if you’re experiencing other signs and symptoms like lightheadedness and persisting heavy or frequent bleeding. 

Hoping you find some relief!