Blood in Stool: Is It Constipation or Hemorrhoids? - Surgery

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Blood in stool and constipation?


Hello doctor, I would like to ask about some abdominal discomfort I've been experiencing for the past week, along with a feeling of needing to have a bowel movement, but I haven't been able to pass stool.
Is this constipation? I've also noticed bleeding during bowel movements; on March 13, the blood was bright red, and today there was blood along with a small clot.
Could this be due to constipation and possibly indicate an internal hemorrhoid issue? If I need to go to the hospital for an examination, which department should I see?

Yujie, 10~19 year old female. Ask Date: 2016/04/16

Dr. Xu Kaixi reply Surgery


Rectal bleeding is an abnormal symptom that can range from common hemorrhoids to other serious gastrointestinal diseases.
Based on your description, in addition to the bleeding with blood clots, abdominal pain, and changes in bowel habits, it is advisable to visit a hospital's gastroenterology or surgical outpatient department for further examination and treatment.

Reply Date: 2016/04/16

More Info


When it comes to understanding blood in stool, it’s essential to differentiate between various potential causes, including constipation and hemorrhoids. Based on your description, it sounds like you are experiencing symptoms that could be related to both conditions.

First, let’s address the issue of constipation. Constipation is characterized by infrequent bowel movements or difficulty passing stool, which can lead to straining during defecation. This straining can cause small tears in the anal lining, known as anal fissures, or exacerbate existing hemorrhoids, leading to bleeding. The presence of fresh red blood in your stool, especially if it appears after straining, often indicates that the bleeding is coming from the lower gastrointestinal tract, which includes the rectum and anus.

In your case, the fresh red blood and the small blood clot you mentioned could indeed be associated with hemorrhoids, particularly if you have been experiencing discomfort and a feeling of fullness in your abdomen. Hemorrhoids are swollen veins in the rectal area that can become inflamed and bleed, especially during bowel movements. They can be internal (inside the rectum) or external (around the anus), and symptoms may include pain, itching, and visible blood on the toilet paper or in the stool.

However, it’s important to note that while hemorrhoids are a common cause of rectal bleeding, they are not the only possibility. Other conditions, such as anal fissures, diverticular disease, or even more serious issues like colorectal polyps or cancer, can also lead to similar symptoms. Given your symptoms of abdominal discomfort and the presence of blood, it is advisable to seek medical attention.

If you decide to visit a healthcare provider, you should consider seeing a gastroenterologist or a colorectal surgeon. These specialists are trained to diagnose and treat conditions related to the gastrointestinal tract, including issues like constipation, hemorrhoids, and other potential causes of rectal bleeding. During your visit, the doctor may perform a physical examination, including a digital rectal exam, and may recommend further diagnostic tests such as a colonoscopy if necessary.

In the meantime, managing your constipation is crucial. Increasing your dietary fiber intake through fruits, vegetables, and whole grains can help soften your stool and promote regular bowel movements. Staying hydrated by drinking plenty of water is also essential. Over-the-counter stool softeners or laxatives may provide relief, but it’s best to consult with a healthcare provider before starting any medication.

In summary, while your symptoms may suggest hemorrhoids or constipation, it is essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment. Early intervention can prevent complications and improve your overall health.

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