Hidden Blood in Stool: Concerns About Hemorrhoids and Colon Cancer

Hello, I would like to inquire about blood in the stool?

Hello Doctor, I have some concerns I would like to ask about.
Is it possible for blood in the stool to be present without any visible blood on the surface? Since I had bleeding from hemorrhoids before, I have been paying more attention to my stool.
Sometimes I even separate it to check.
This morning, I noticed that the stool appeared normal on the outside, but when I looked closer, there were orange-red spots on the food fibers.
I'm not sure if it's blood; at first glance, it looked red, but later it seemed like it might not be.
I have not experienced any other symptoms related to colorectal cancer.
I had a digital rectal exam in June and October of last year, and it was noted that I have hemorrhoids.
Could you please clarify if blood from colorectal cancer is typically persistent? Thank you.

Jack, 20~29 year old female. Ask Date: 2016/09/05

Dr. Ke Fangxu reply Surgery

Indeed, blood in the stool may be difficult to detect due to its small quantity or because it is mixed with the feces.
Therefore, if there are concerns, it is generally recommended to undergo an immunochemical fecal occult blood test.
If the result is positive, a colonoscopy may be considered.
Blood in the stool associated with colorectal cancer can be persistent or intermittent; however, relying solely on the pattern of bleeding to determine whether it is colorectal cancer is completely unreliable.

Reply Date: 2016/09/05

More Info

When it comes to the presence of blood in stool, it can understandably raise concerns about serious conditions such as hemorrhoids or colon cancer. Your question about whether blood can be hidden within the stool without any visible signs on the surface is quite relevant. Indeed, it is possible for blood to be present in the stool without being visibly apparent. This can occur in cases of gastrointestinal bleeding where the blood is mixed with the stool, making it difficult to detect without specific tests, such as a fecal occult blood test.

In your case, you mentioned observing orange-red spots on the stool, which raises the question of whether this could be blood. The color and appearance of stool can vary significantly based on diet, hydration, and other factors. For instance, certain foods, particularly those high in beta-carotene (like carrots) or those that are artificially colored, can impart an orange hue to the stool. Additionally, if you have been consuming foods rich in fiber, such as fruits and vegetables, this could also contribute to the appearance of your stool.

Regarding your concerns about hemorrhoids, it is important to note that hemorrhoids can cause bleeding, which may appear as bright red blood on toilet paper or in the toilet bowl. However, if the blood is mixed with the stool, it may indicate a different issue, such as a more significant gastrointestinal problem. Hemorrhoids typically cause bright red blood due to their location in the lower rectum, while bleeding from higher in the gastrointestinal tract can lead to darker blood or even black, tarry stools.

As for colon cancer, the symptoms can vary widely among individuals. While some may experience persistent blood in their stool, others may not notice any blood at all, especially in the early stages. Colon cancer can also present with changes in bowel habits, unexplained weight loss, abdominal pain, or changes in the consistency of the stool. However, it is crucial to understand that the presence of blood in the stool does not automatically indicate cancer, as there are numerous benign conditions that can cause similar symptoms.

You mentioned that you have had digital rectal exams in the past, which indicated the presence of hemorrhoids. This is a good step in monitoring your condition. However, if you continue to notice changes in your stool, such as the appearance of blood or unusual colors, it would be prudent to consult with a gastroenterologist. They may recommend further diagnostic tests, such as a colonoscopy, to rule out any serious conditions, including polyps or malignancies.

In summary, while it is possible for blood to be hidden in the stool, the appearance of your stool can also be influenced by various dietary factors. Given your history of hemorrhoids and your current observations, it is advisable to maintain regular check-ups with your healthcare provider. If you notice persistent changes or have any new symptoms, do not hesitate to seek medical advice. Early detection and intervention are key in managing any gastrointestinal issues effectively.

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