Dark Red Stools: Causes and When to Seek Help

Stool mixed with dark red substances?

Hello Doctor: I have had constipation since childhood.
Two months ago, I noticed deep red blood drops in my stool (which lasted for a week), and there was also blood when I wiped with toilet paper.
I have an external hemorrhoid and experienced a sharp pain in my anus during bowel movements, but I haven't had any bleeding since then.
Recently, I occasionally see something resembling dark red mixed in my stool, but I'm not sure if it's blood (it's not dripping on the surface; the stool is brown or light yellow but mixed with dark red).
I also don't feel any anal pain, and there is no blood when I wipe.
I often experience stomach pain, and sometimes I have lower abdominal pain along with constipation.
A doctor I saw in the past mentioned that I often have bloating, indigestion, and that constipation is causing my abdominal pain.
Is this a serious issue? Thank you for your response.

Linlin, 20~29 year old female. Ask Date: 2016/04/14

Dr. Ke Fangxu reply Surgery

Based on your description, it doesn't seem to be a serious issue.
The dark red substance in the stool is likely food residue, and even if there is slight bleeding, there is no need to worry excessively.
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 hemorrhoid suppositories at the pharmacy for use.
It is best not to take stool softeners indiscriminately; at this age, increasing dietary fiber and hydration should be sufficient.
However, if bleeding persists, it is advisable to consult a physician for evaluation.

Reply Date: 2016/04/14

More Info

When it comes to the presence of dark red stools or any unusual coloration in bowel movements, it is essential to understand the potential causes and when to seek medical attention. The symptoms you describe, including the presence of dark red material in your stool, a history of constipation, and abdominal pain, warrant careful consideration.

Firstly, the dark red coloration in your stool could be attributed to several factors. One of the most common causes is bleeding in the lower gastrointestinal tract, which can occur due to conditions such as hemorrhoids (external or internal), anal fissures, or diverticular disease. Given your history of external hemorrhoids and the experience of rectal pain during bowel movements, it is plausible that the dark red material you are observing could be related to hemorrhoidal bleeding. Hemorrhoids can cause bright red blood to appear on the toilet paper or in the stool, and in some cases, the blood may mix with the stool, leading to a darker appearance.

Another possibility is that the dark red material could be food remnants, particularly if you have consumed foods that can alter stool color, such as beets or certain berries. However, you mentioned that you have not eaten any red foods recently, which makes this less likely. Additionally, gastrointestinal bleeding from higher up in the digestive tract (such as the stomach or small intestine) typically results in black, tarry stools (melena) due to the digestion of blood, rather than dark red stools.

Your symptoms of abdominal pain and bloating, along with a history of constipation, suggest that there may be underlying gastrointestinal issues contributing to your discomfort. Conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even gastrointestinal infections could be factors to consider. The presence of abdominal pain, especially if it is persistent or worsening, should not be ignored.

Given that you have experienced rectal bleeding for a week and have ongoing gastrointestinal symptoms, it is crucial to seek medical attention. A healthcare provider may recommend several diagnostic tests, including a digital rectal examination, colonoscopy, or imaging studies, to evaluate the source of the bleeding and assess the overall health of your gastrointestinal tract. These tests can help rule out serious conditions such as colorectal cancer, especially if you are over the age of 50 or have a family history of gastrointestinal diseases.

In the meantime, managing your constipation is essential. Increasing dietary fiber intake, staying hydrated, and incorporating regular physical activity can help alleviate constipation and reduce the strain during bowel movements, which may help prevent further irritation of hemorrhoids. Over-the-counter stool softeners or laxatives may also be beneficial, but it is advisable to consult with a healthcare professional before starting any new medications.

In summary, while dark red stools can be caused by various factors, including hemorrhoids and dietary influences, your symptoms indicate that a thorough evaluation is necessary. Do not hesitate to reach out to a healthcare provider to discuss your symptoms and receive appropriate care. Early intervention can lead to better outcomes and peace of mind regarding your gastrointestinal health.

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