Blood in Stool: Is It Hemorrhoids or Colon Cancer? - Surgery

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Rectal bleeding


I have been experiencing constipation frequently, and sometimes there is blood in my stool, although it doesn't happen every time.
This occurs approximately every 2-3 weeks.
The bleeding situation involves the toilet water being bright red, and when I wipe, there is fresh blood on the toilet paper.
Occasionally, there are even clots resembling blood on the paper.
Could this be hemorrhoids or colon cancer? The shape of my stool varies; sometimes it is small and pellet-like, and other times it is thicker.
I have not noticed any long, thin shapes.
The amount of stool varies as well, sometimes being a lot and other times very little.
Thank you.

Niming, 20~29 year old female. Ask Date: 2016/06/09

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.
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: 2016/06/09

More Info


When it comes to the presence of blood in stool, it is essential to approach the situation with caution and a clear understanding of the potential causes. Based on your description, you are experiencing intermittent blood in your stool, which can be alarming and understandably concerning, especially considering your family history of colon cancer. However, it is crucial to differentiate between the possible causes of rectal bleeding, which can range from benign conditions like hemorrhoids to more serious issues such as colorectal cancer.

Firstly, the characteristics of the blood you are observing are significant. Fresh red blood, particularly if it is seen in the toilet water or on toilet paper, often suggests that the source of the bleeding is lower in the gastrointestinal tract, such as the rectum or anus. This is commonly associated with conditions like hemorrhoids, anal fissures, or other benign rectal issues. Hemorrhoids, in particular, are swollen veins in the rectal area that can bleed during bowel movements, especially if you are experiencing constipation or straining. The fact that you mention the blood appears intermittently and is sometimes accompanied by blood clots could further indicate hemorrhoids or an anal fissure, especially if the blood is bright red.

On the other hand, while colorectal cancer can also present with blood in the stool, it typically comes with other symptoms, such as changes in bowel habits, unexplained weight loss, abdominal pain, or changes in the consistency of the stool (e.g., narrow stools). The absence of these additional symptoms, along with your description of the blood being bright red and the stool varying in size and shape, may suggest that your situation is less likely to be cancer-related. However, it is important to note that colorectal cancer can present in various ways, and not all patients will exhibit the classic symptoms.

Given your history of constipation and the variability in your stool consistency, it is advisable to focus on dietary changes and hydration to help alleviate constipation. Increasing your intake of fiber-rich foods, such as fruits, vegetables, and whole grains, can help improve bowel regularity. Additionally, staying well-hydrated is crucial for maintaining healthy bowel movements. If you are experiencing hard, pellet-like stools, this can lead to straining and increase the likelihood of hemorrhoids or fissures.

Despite the likelihood of benign causes, your family history of colon cancer does place you at a higher risk, and it is essential to take any rectal bleeding seriously. I recommend that you schedule an appointment with a healthcare provider, preferably a gastroenterologist, for a thorough evaluation. They may suggest a digital rectal exam and possibly a colonoscopy to rule out any serious conditions, including colorectal cancer. A colonoscopy is a valuable diagnostic tool that allows for direct visualization of the colon and rectum, and it can also facilitate the removal of any polyps that may be present.

In summary, while your symptoms may suggest hemorrhoids or other benign conditions, it is crucial to consult with a healthcare professional for a definitive diagnosis and appropriate management. Early detection and intervention are key in addressing any potential issues, especially given your family history. Taking proactive steps now can help ensure your health and peace of mind moving forward.

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