Blood in Stool: Causes, Risks, and When to Seek Help

Blood in the stool?

I usually sit for long periods, have constipation, exercise very little, and often eat fried foods.
In the past few months, I've noticed light red blood on the toilet paper when wiping after a bowel movement, although there is no obvious blood in the toilet.
After wiping a second time, there is no blood.
There have been two instances where I saw blood in the toilet about the size of a 50 NT dollar coin.
Sometimes, when my stool is soft, there is also blood.
Could you please tell me what this situation might be? Is it possible that this is colon cancer? How much blood in the stool necessitates a medical examination? Should I undergo a colonoscopy?

Jin, 20~29 year old female. Ask Date: 2016/03/20

Dr. Ke Fangxu reply Surgery

This situation likely indicates a higher possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Warm sitz baths may also help alleviate symptoms.
You can purchase over-the-counter hemorrhoidal suppositories for use.
It is best not to take stool softeners indiscriminately; at this age, increasing dietary fiber and hydration should be sufficient.
Although the risk of developing colorectal cancer at the age of 26 is not zero, it is generally very low.
It is advisable to maintain a light diet and a healthy lifestyle.
If symptoms persist without improvement, you may consult a physician for medication.
If there is still no improvement or if you are very concerned, you can arrange for a colonoscopy.

Reply Date: 2016/03/20

More Info

Blood in stool can be a concerning symptom, and understanding its potential causes, risks, and when to seek medical help is crucial. Given your description of experiencing bright red blood on toilet paper and occasionally in the toilet bowl, it is important to consider several factors.

Possible Causes of Blood in Stool
1. Hemorrhoids: One of the most common causes of bright red blood in stool is hemorrhoids, which are swollen veins in the lower rectum or anus. They can cause bleeding during bowel movements, especially if you are experiencing constipation and straining.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain and bleeding during bowel movements.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can lead to diverticulitis, where these pouches become inflamed or infected, potentially causing bleeding.

4. Polyps or Colorectal Cancer: While less common, polyps (growths on the colon lining) can bleed, and some may develop into cancer. Colorectal cancer can present with blood in the stool, changes in bowel habits, or unexplained weight loss.

5. Gastrointestinal Infections: Certain infections can cause inflammation and bleeding in the gastrointestinal tract, leading to blood in the stool.

Risks and When to Seek Help
The presence of blood in stool should always be taken seriously, especially if it is persistent or accompanied by other symptoms such as:
- Significant abdominal pain
- Changes in bowel habits (diarrhea or constipation)
- Unexplained weight loss
- Fatigue or weakness
- Changes in the color or consistency of your stool
If you notice blood in your stool, it is advisable to seek medical attention promptly. A healthcare provider may recommend a physical examination and possibly a colonoscopy to investigate the source of the bleeding.

The Role of Colonoscopy
A colonoscopy is a procedure that allows a doctor to examine the inner lining of your colon and rectum using a flexible tube with a camera. It is often recommended if there are concerning symptoms, such as:
- Blood in the stool
- A family history of colorectal cancer
- Age over 50 (or younger if there are risk factors)
- Changes in bowel habits

Conclusion
Given your symptoms, including the presence of blood on toilet paper and in the toilet bowl, it is essential to consult a healthcare professional. They can provide a thorough evaluation and determine whether a colonoscopy or other diagnostic tests are necessary. Early detection and treatment are key to addressing any potential issues, especially concerning conditions like colorectal cancer.
In the meantime, consider making lifestyle changes such as increasing your fiber intake, staying hydrated, and engaging in regular physical activity to help alleviate constipation and reduce the risk of hemorrhoids and anal fissures. However, these measures should not replace professional medical advice, especially in the presence of concerning symptoms.

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