Blood in Stool: Causes and When to Seek Help

Blood in stool issue?

Hello, doctor.
My bowel habits are usually normal, and I do not experience constipation.
About two weeks ago, I had diarrhea due to a cold, and after taking anti-diarrheal medication, I returned to normal.
However, in the following days, my stools became somewhat hard, and sometimes there is a little blood when I wipe.
Yesterday, during a bowel movement (without abdominal pain), I noticed red blood on the surface of the stool (only part of it; the toilet was not stained red, but there was some blood when wiping).
The same thing happened today.
Could you please advise what might be the issue? Thank you.

Ms. Chen, 20~29 year old female. Ask Date: 2016/03/25

Dr. Ke Fangxu reply Surgery

Based on your description, it seems to be an anal fissure.
The typical symptoms include pain during bowel movements accompanied by slight bleeding.
The causes of anal fissures are often due to hard stools, but diarrhea, frequent bowel movements, or prolonged straining can also lead to fissures.
It is recommended to improve bowel habits and to take warm sitz baths to alleviate symptoms.
Topical ointments and suppositories can also be used for treatment.
If symptoms persist for more than a week without improvement, it is advisable to consult a physician for further evaluation.

Reply Date: 2016/03/25

More Info

Understanding blood in stool can be concerning, and it is essential to approach this issue with a clear understanding of potential causes and when to seek medical help. Blood in the stool can arise from various sources within the gastrointestinal tract, and its appearance can vary significantly depending on the underlying cause.

In your case, you mentioned that you experienced diarrhea due to a cold, followed by some hard stools and the presence of blood when wiping. The fact that you observed red blood on the surface of your stool and some blood when wiping could indicate a few possibilities:
1. Hemorrhoids: One of the most common causes of bright red blood in the stool is hemorrhoids. These are swollen blood vessels in the rectal area that can bleed, especially during bowel movements, particularly if the stool is hard or if there has been straining.

2. Anal Fissures: Another common cause of bright red blood is an anal fissure, which is a small tear in the lining of the anus. This can occur due to passing hard stools and can cause pain and bleeding during bowel movements.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can also lead to bleeding. This bleeding may be more significant and can occur without pain.

4. Gastrointestinal Infections: Since you had diarrhea, it is also possible that an infection could have caused inflammation in the gastrointestinal tract, leading to bleeding.

5. Polyps or Colorectal Cancer: While less common, the presence of polyps or colorectal cancer can also lead to blood in the stool. These conditions are more likely if there are other symptoms present, such as changes in bowel habits, weight loss, or abdominal pain.

Given your symptoms, it is crucial to monitor the situation closely. If the bleeding persists, increases in volume, or is accompanied by other symptoms such as abdominal pain, changes in bowel habits, or weight loss, it is essential to seek medical attention promptly. A healthcare provider may recommend a physical examination, possibly including a digital rectal exam, and may suggest further diagnostic tests such as a colonoscopy to evaluate the source of the bleeding.

In summary, while the presence of blood in the stool can often be attributed to benign causes such as hemorrhoids or anal fissures, it is essential to remain vigilant. If you notice any concerning changes or if the bleeding continues, do not hesitate to consult a healthcare professional for a thorough evaluation and appropriate management. Early intervention can help address any underlying issues effectively and prevent potential complications.

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