Blood in Stool: When to Seek Medical Attention

Blood on toilet paper after wiping can indicate several potential issues, such as hemorrhoids, anal fissures, or other gastrointestinal conditions

Hello doctor, I have recently noticed blood streaks in my stool, and there is also bright red blood when I wipe.
The last two bowel movements did not have blood streaks, but there is still bright red blood when I wipe (the amount of blood is gradually decreasing).
What do these symptoms indicate? Do I need to see a doctor? How should I treat this? Thank you.

Zhong, 20~29 year old female. Ask Date: 2016/04/27

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 fluid intake should be sufficient.
If bleeding persists, it is advisable to consult a physician for evaluation.

Reply Date: 2016/04/27

More Info

When you notice blood in your stool or on toilet paper, it can understandably cause concern. The presence of bright red blood typically indicates that the bleeding is occurring in the lower gastrointestinal tract, which includes the rectum and anus. This can be due to several conditions, some of which are benign, while others may require medical attention.

Common causes of bright red blood in the stool include:
1. Hemorrhoids: Swollen blood vessels in the rectum or anus that can bleed during bowel movements. This is one of the most common causes of bright red blood and is often accompanied by itching or discomfort.

2. Anal fissures: Small tears in the lining of the anus, often caused by passing hard stools. These can also lead to bright red blood and are usually painful.

3. Diverticular disease: This includes diverticulosis and diverticulitis, where small pouches form in the colon wall and can become inflamed or infected, leading to bleeding.

4. Colorectal polyps or cancer: Polyps are growths on the lining of the colon or rectum that can bleed. While most polyps are benign, some can develop into cancer over time. Colorectal cancer can also cause bleeding.

5. Gastrointestinal infections: Certain infections can cause inflammation and bleeding in the gastrointestinal tract.

Given your symptoms of having blood on the toilet paper and the gradual decrease in the amount of blood, it is important to consider a few factors:
- Duration and Frequency: If the bleeding persists or worsens, or if you experience other symptoms such as abdominal pain, changes in bowel habits, or weight loss, you should seek medical attention.

- Associated Symptoms: If you have any additional symptoms like fever, severe pain, or changes in your stool consistency (like diarrhea or constipation), these could indicate a more serious condition.

- Medical History: If you have a history of gastrointestinal issues, hemorrhoids, or other related conditions, this context can help your healthcare provider make a more informed assessment.

In general, it is advisable to consult a healthcare professional when you notice blood in your stool, especially if it is a new symptom. A doctor may perform a physical examination, ask about your medical history, and possibly recommend further tests such as a colonoscopy or imaging studies to determine the cause of the bleeding.

Treatment will depend on the underlying cause of the bleeding. For instance, hemorrhoids may be treated with topical medications, lifestyle changes, or procedures to remove them. Anal fissures may require dietary changes to soften stools and promote healing. If polyps or cancer are found, further treatment such as removal or surgery may be necessary.

In conclusion, while some causes of blood in the stool are benign, it is crucial to take this symptom seriously and seek medical advice to rule out any serious conditions. Early diagnosis and treatment can significantly improve outcomes and alleviate any potential complications.

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