Blood in Stool: When to Seek Medical Attention

Rectal bleeding

About a month ago, after having a bowel movement, I noticed some blood on the toilet paper.
A few days later, I went to the hospital to consult a doctor, who suggested it might be hemorrhoids since there was no examination indicating an anal fissure.
After returning home, I did not experience any more bleeding.
However, today when I went to the bathroom for a bowel movement, I noticed blood on the toilet paper again.
In the past few days, I have frequently felt the urge to have a bowel movement, but sometimes only a small amount of stool comes out, and at times it is watery.
There was also an instance where I suddenly experienced severe abdominal pain, and after having a bowel movement, my stomach still felt strange.
About 20 minutes later, the pain returned, and I went to the bathroom again, where the stool was watery.
Should I go to the hospital for an examination? Thank you.

Da Mi, 10~19 year old female. Ask Date: 2016/07/22

Dr. Ke Fangxu reply Surgery

Based on your description, it seems to be an anal fissure.
The typical symptoms include pain during bowel movements accompanied by slight bleeding.
If there is concurrent bleeding from hemorrhoids, the amount of blood may be greater.
The primary cause of anal fissures is usually hard stools; however, diarrhea, frequent bowel movements, or prolonged straining can also lead to fissures.
It is recommended to improve bowel habits and to take warm sitz baths to alleviate symptoms.
If lactose intolerance is present, it is advisable to temporarily avoid dairy products.
Topical ointments and suppositories can also be used for treatment.
If symptoms persist for more than a week without improvement, it is important to consult a physician to identify the underlying issue.

Reply Date: 2016/07/22

More Info

When it comes to blood in the stool, it is essential to take this symptom seriously, as it can indicate a variety of underlying health issues, some of which may require immediate medical attention. Based on your description, it seems that you have experienced blood on the toilet paper after bowel movements, which initially was attributed to hemorrhoids by your doctor. However, the recurrence of blood and the associated symptoms of abdominal pain and changes in bowel habits warrant further investigation.

Understanding the Symptoms
1. Blood in Stool: The presence of blood can be due to several reasons, including hemorrhoids, anal fissures, diverticular disease, inflammatory bowel disease (IBD), or even colorectal cancer. Hemorrhoids and anal fissures are common causes, especially if the blood is bright red and appears on the toilet paper or in the toilet bowl. However, the recurrence of blood and the presence of other gastrointestinal symptoms, such as abdominal pain and changes in stool consistency, suggest that a more thorough evaluation is necessary.

2. Abdominal Pain: Sudden and severe abdominal pain can indicate various conditions, including gastrointestinal infections, bowel obstruction, or inflammatory conditions. If the pain is persistent or severe, it is crucial to seek medical attention.

3. Changes in Bowel Habits: Experiencing watery stools or changes in bowel frequency can be indicative of gastrointestinal issues, such as infections, food intolerances, or inflammatory bowel diseases like Crohn's disease or ulcerative colitis.

When to Seek Medical Attention
Given your symptoms, it is advisable to seek medical attention promptly if you experience any of the following:
- Persistent Blood in Stool: If you notice blood in your stool again, especially if it persists or increases in quantity, you should consult a healthcare provider.

- Severe Abdominal Pain: If the abdominal pain is severe, persistent, or accompanied by other symptoms such as fever, vomiting, or inability to pass gas or stool, you should seek immediate medical care.

- Changes in Bowel Movements: If you experience significant changes in your bowel habits, such as diarrhea that lasts more than a couple of days, or if you notice any signs of dehydration (such as excessive thirst, dry mouth, or decreased urination), you should see a doctor.

- Weight Loss or Fatigue: Unexplained weight loss or fatigue accompanying these symptoms should also prompt a visit to a healthcare provider.

What to Expect During a Medical Evaluation
When you visit a healthcare provider, they may perform several assessments, including:
- Physical Examination: A thorough examination, including a digital rectal exam, may be performed to check for hemorrhoids or other abnormalities.

- Laboratory Tests: Blood tests may be ordered to check for anemia or signs of infection.

- Imaging Studies: Depending on your symptoms, imaging studies such as an abdominal ultrasound, CT scan, or colonoscopy may be recommended to visualize the gastrointestinal tract and identify any underlying issues.

Conclusion
In summary, while hemorrhoids can cause blood in the stool, the recurrence of this symptom, along with abdominal pain and changes in bowel habits, suggests that further evaluation is necessary. It is always better to err on the side of caution when it comes to gastrointestinal symptoms. Seeking medical attention will help ensure that any potential issues are identified and treated promptly, allowing for better management of your health. Please do not hesitate to reach out to a healthcare provider for a thorough evaluation.

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