Blood in Stool: Is It Hemorrhoids or Something Else?

Blood in the stool?

From April 25 to April 27, I had a bowel movement each day, and there was a slight amount of fresh blood when I wiped with toilet paper.
On April 28 at 1:40 PM, after finishing a bowel movement, I noticed a significant increase in the amount of blood (almost staining the entire piece of toilet paper).
Initially, I thought it was due to the stool being too hard, causing a rupture of the microvessels in the anal sphincter.
However, upon reflection, I did not experience any pain during these four days, and I had no other symptoms such as headaches, cough, nasal discharge, abdominal pain, or diarrhea.
My bowel movements were normal, being soft and of moderate consistency.
The only unusual symptom was the blood during wiping.
I would like to ask the doctor if this could be a symptom of hemorrhoids.
If a colonoscopy at a major hospital is recommended, I am open to it.
I would like to inquire if the doctor has encountered similar cases.
Thank you!

Wang Sanni, 20~29 year old female. Ask Date: 2016/04/28

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 hemorrhoid suppositories for use.
It is best not to take stool softeners indiscriminately; at this age, increasing dietary fiber and hydration should be sufficient.
If bleeding persists, it is advisable to consult a physician for evaluation.
Whether a colonoscopy is necessary can be discussed with the doctor.

Reply Date: 2016/04/28

More Info

When it comes to the presence of blood in the stool, it can be concerning and warrants careful evaluation. Based on your description, you have experienced bright red blood on toilet paper after bowel movements over several days, with an increase in the amount of blood noted. This situation raises several possibilities, with hemorrhoids being one of the most common causes, but it is essential to consider other potential conditions as well.

Hemorrhoids, which are swollen blood vessels in the rectal area, can cause bright red blood during bowel movements, especially if there is straining or if the stool is hard. The blood is typically seen on the toilet paper or in the toilet bowl, and it is usually painless, which aligns with your experience. However, the sudden increase in blood volume you mentioned could indicate a more significant issue, especially if it persists.

Other potential causes of rectal bleeding include anal fissures, diverticular disease, colorectal polyps, or even more serious conditions such as colorectal cancer. Anal fissures are small tears in the lining of the anus that can occur due to passing hard stools and can also cause bright red blood. Diverticulosis, which involves the formation of small pouches in the colon wall, can lead to diverticulitis and bleeding. Polyps are growths on the colon lining that can be benign or precancerous, and they may also cause bleeding.

Given that you have not experienced pain, changes in bowel habits, or other systemic symptoms (like fever or weight loss), the likelihood of a serious condition may be lower, but it is not impossible. The fact that you have had normal bowel movements and no accompanying symptoms is reassuring, but it does not eliminate the need for further investigation.

I strongly recommend that you consult with a healthcare provider, preferably a gastroenterologist, who can perform a thorough evaluation. A colonoscopy is often the gold standard for investigating the source of rectal bleeding, as it allows direct visualization of the colon and rectum. During this procedure, the doctor can identify any abnormalities, take biopsies if necessary, and provide treatment options.

In addition to a colonoscopy, your doctor may also consider other diagnostic tests, such as a complete blood count (CBC) to check for anemia, stool tests to rule out infections, or imaging studies if there are concerns about other gastrointestinal issues.

In summary, while hemorrhoids are a common cause of bright red blood in the stool, it is essential to rule out other potential causes, especially given the increase in blood volume you have observed. Seeking medical advice and undergoing appropriate testing will provide clarity and ensure that any necessary treatment can be initiated promptly. Remember, early detection and intervention are crucial for managing any gastrointestinal issues effectively.

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