Blood in Stool: Causes and When to Seek Help

Blood in the stool?

Hello Doctor, recently I have been experiencing alternating episodes of soft stools and normal stools (with soft stools occurring more frequently).
Additionally, my bowel movements are about once a day, and I do not experience constipation.
Previously, I occasionally had abdominal pain, and after consulting a doctor, I was informed that my gastrointestinal motility is too fast.
Since it has only been two weeks, the doctor initially diagnosed it as gastroenteritis rather than irritable bowel syndrome.
After taking medication, the abdominal pain has improved, but I still frequently experience bowel sounds after eating, and I continue to have soft stools.
The color is normal and there is no blood, and the size is also normal.
However, recently I have noticed some blood streaks in my stools (which are soft).
The appearance does not show any blood color.
I have previously experienced bleeding due to hard stools, and occasionally I feel a burning sensation in my anus during bowel movements.
There is no family history of colorectal cancer.
Doctor, what could be the possible cause of this? Should I undergo a colonoscopy?

Xiao Ye, 20~29 year old female. Ask Date: 2016/05/24

Dr. Ke Fangxu reply Surgery

Although the probability of developing colorectal cancer at the age of 23 is not zero, it is generally very low.
Based on your description, it seems more likely to be irritable bowel syndrome combined with hemorrhoidal bleeding.
It is recommended to start with a light diet and maintain a good lifestyle.
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: 2016/05/24

More Info

Blood in stool can be a concerning symptom, and understanding its potential causes is crucial for determining the appropriate course of action. In your case, the presence of blood in your stool, even if it appears as streaks in soft stools, warrants careful consideration. Here’s a breakdown of possible causes and when you should seek further medical evaluation.

Possible Causes of Blood in Stool
1. Hemorrhoids: One of the most common causes of blood in the stool is hemorrhoids, which are swollen veins in the rectum or anus. They can cause bright red blood on the toilet paper or in the stool, especially after straining during bowel movements.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to bleeding and a burning sensation during bowel movements.

3. Gastrointestinal Infections: Infections can cause inflammation in the intestines, leading to symptoms like diarrhea, abdominal pain, and sometimes blood in the stool. This could be consistent with your recent diagnosis of gastroenteritis.

4. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause inflammation in the gastrointestinal tract, leading to symptoms such as diarrhea, abdominal pain, and blood in the stool.

5. Diverticular Disease: Diverticulosis and diverticulitis can also lead to bleeding in the digestive tract. Diverticulitis occurs when diverticula (small pouches) become inflamed or infected.

6. Polyps or Colorectal Cancer: Although less common, polyps in the colon can bleed, and in some cases, they can be precursors to colorectal cancer. Given your family history is clear, this is less likely but still a consideration, especially if symptoms persist.

When to Seek Help
Given your symptoms, particularly the presence of blood in your stool, it is advisable to consult a healthcare professional for further evaluation. Here are some specific indicators that warrant immediate medical attention:
- Persistent Blood: If the blood in your stool continues or worsens, it is essential to seek medical advice.

- Change in Bowel Habits: Any significant changes in your bowel habits, such as increased frequency of diarrhea or constipation, should be discussed with a doctor.

- Severe Abdominal Pain: If you experience severe or worsening abdominal pain, this could indicate a more serious condition.

- Signs of Anemia: Symptoms such as fatigue, weakness, or dizziness could suggest that you are losing blood and may need further evaluation.

Diagnostic Tests
A colonoscopy is a common procedure used to examine the interior of the colon and rectum. It can help identify the source of bleeding, whether it be hemorrhoids, polyps, or signs of IBD or cancer. Given your symptoms and the presence of blood, discussing the possibility of a colonoscopy with your doctor is a prudent step.

Conclusion
In summary, while there are several benign causes for blood in the stool, it is essential to take this symptom seriously. Given your recent gastrointestinal issues and the presence of blood, I recommend scheduling an appointment with your healthcare provider to discuss your symptoms in detail. They may suggest further testing, such as a colonoscopy, to rule out any serious conditions and to provide you with peace of mind. Early intervention is key in managing gastrointestinal health, so don’t hesitate to seek help.

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