Blood in Stool: Is It Hemorrhoids or Something More Serious?

Large amounts of bright red blood in the stool?

Hello, doctor.
Recently, I have been experiencing blood in the toilet during bowel movements (about every two days), and my stools also have blood in them.
This has been happening almost every time for nearly a month.
When I wipe with toilet paper, there is mostly bright red blood.
After using the restroom, I do have hemorrhoids, but they are not very painful.
I have both internal and external hemorrhoids, but the frequent bleeding has made me quite concerned.
I read in medical reports that having a significant amount of bright red blood in the stool could also indicate colorectal cancer.
I would like to ask if these symptoms might not be due to hemorrhoids but rather something like cancer.
Thank you, doctor!

E, 20~29 year old female. Ask Date: 2016/04/21

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 25 is not zero, it is generally very low.
If symptoms persist without improvement, you may consult a physician for medication.
If there is still no improvement or if you are very concerned, a colonoscopy can be arranged.

Reply Date: 2016/04/21

More Info

When it comes to the presence of blood in stool, it can indeed be concerning, and your symptoms warrant careful evaluation. The bright red blood you are experiencing, especially if it is consistently present in your stool and on toilet paper, can be indicative of several conditions, ranging from benign to serious.
The most common cause of bright red blood in the stool is hemorrhoids, particularly if you have a history of internal and external hemorrhoids. Hemorrhoids can cause bleeding during bowel movements, especially if there is straining involved. However, the persistence and frequency of your symptoms over the past month suggest that further investigation is necessary to rule out other potential causes.

Other conditions that can lead to rectal bleeding include anal fissures, diverticular disease, inflammatory bowel disease (IBD) such as Crohn's disease or ulcerative colitis, and colorectal polyps. More seriously, conditions such as colorectal cancer can also present with blood in the stool. While hemorrhoids are a common cause, the presence of blood should not be dismissed, especially given the duration and frequency of your symptoms.

It is important to note that while hemorrhoids are often associated with pain and discomfort, they do not always cause significant pain, especially if they are not thrombosed (clotted). The fact that you have hemorrhoids does not exclude the possibility of other conditions, including more serious ones.

Given your situation, I strongly recommend that you seek medical attention as soon as possible. A healthcare provider, preferably a gastroenterologist or a colorectal specialist, can perform a thorough evaluation. This may include a physical examination, a digital rectal exam, and potentially a colonoscopy, which is a procedure that allows the doctor to view the inside of your colon and rectum. A colonoscopy is particularly important because it can help identify any abnormalities such as polyps, tumors, or signs of inflammatory bowel disease.

In addition to a colonoscopy, your doctor may also recommend blood tests to check for anemia, which can occur if there is significant blood loss. They may also inquire about other symptoms you might be experiencing, such as changes in bowel habits, weight loss, abdominal pain, or changes in appetite, which can provide further clues to your condition.

In summary, while hemorrhoids are a common cause of bright red blood in the stool, the persistence of your symptoms over the past month necessitates further investigation to rule out more serious conditions, including colorectal cancer. Please prioritize scheduling an appointment with a healthcare provider to discuss your symptoms and undergo the necessary evaluations. Early detection and intervention are crucial for the best possible outcomes in any gastrointestinal condition.

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