Blood in Stool: Causes and When to Seek Help - Surgery

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Rectal bleeding


Hello Dr.
Ke: One time, after a hurried lunch, I felt unwell when I got home in the evening.
I had a slight fever and chills, felt fatigued all over, and experienced nausea.
The next morning, I had diarrhea with blood in my stool.
I had another bowel movement after lunch, but the amount of blood was reduced.
However, my appetite did not worsen, and I did not have any abdominal pain.
After that, my bowel movements returned to normal, and there was no more blood.
Could this be related to the high pressure and emotional fluctuations associated with my work? Thank you for your response.

Ayou, 40~49 year old female. Ask Date: 2016/04/14

Dr. Ke Fangxu reply Surgery


If the bleeding is occasional, it can be monitored, as it may be caused by gastroenteritis leading to diarrhea and hemorrhoidal bleeding.
If there is no further bleeding, it is not a concern.
However, if symptoms recur, further examination is necessary.
Irritable bowel syndrome can cause abnormal intestinal motility due to emotional fluctuations.
If the diarrhea frequently correlates with work-related stress, the likelihood of this condition being the cause is higher.

Reply Date: 2016/04/14

More Info


Understanding blood in stool can be concerning, and it’s important to recognize the potential causes and when to seek medical help. Blood in the stool can arise from various sources within the gastrointestinal tract, and the nature of the blood (whether it is bright red or dark) can provide clues about its origin.

In your case, the symptoms you described—fever, chills, fatigue, nausea, and diarrhea with blood—could indicate a gastrointestinal infection or inflammation. Common causes of blood in the stool include:
1. Infections: Bacterial infections (such as those caused by E. coli, Salmonella, or Shigella) can lead to bloody diarrhea. These infections often result from consuming contaminated food or water. Given that you experienced these symptoms after a meal, it’s possible that you contracted a foodborne illness.

2. Inflammatory Bowel Disease (IBD): Conditions like Crohn’s disease or ulcerative colitis can cause inflammation in the intestines, leading to symptoms such as abdominal pain, diarrhea (which may be bloody), and systemic symptoms like fever and fatigue.

3. Diverticular Disease: Diverticulitis, which occurs when diverticula (small pouches in the colon) become inflamed or infected, can also cause bleeding.

4. Hemorrhoids or Anal Fissures: While these are less likely to cause systemic symptoms like fever, they can lead to bright red blood in the stool, especially if there is straining during bowel movements.

5. Polyps or Colorectal Cancer: Although less common, especially in younger individuals, polyps or malignancies can cause bleeding and should be ruled out, particularly if symptoms persist.

Given your symptoms, it is crucial to monitor your condition closely. If you experience any of the following, you should seek medical attention promptly:
- Persistent or worsening abdominal pain
- Continued or increased blood in the stool
- Severe dehydration (e.g., dizziness, dry mouth, decreased urination)
- High fever that does not respond to over-the-counter medications
- Symptoms that do not improve or worsen over a few days
Regarding your question about the relationship between high stress and gastrointestinal symptoms, stress can indeed exacerbate gastrointestinal issues. Stress can lead to changes in gut motility and increase the likelihood of conditions like irritable bowel syndrome (IBS), which may manifest as diarrhea or other bowel irregularities. However, while stress can influence gastrointestinal health, the presence of blood in the stool should always be evaluated by a healthcare professional to rule out more serious conditions.

In conclusion, while your symptoms may resolve on their own, it is essential to remain vigilant. If you notice any alarming signs or if your symptoms persist, do not hesitate to consult a healthcare provider for a thorough evaluation and appropriate management. Early intervention can be crucial in addressing any underlying issues effectively.

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