Blood in Stool and Frequent Diarrhea: When to Seek Colonoscopy

Blood in the stool and frequent diarrhea?

1.
Occasional bright red blood appears during bowel movements, and today I noticed that the blood seems to come out only after finishing the stool.
When I wipe with toilet paper, it is fresh blood, and there is a burning sensation in the anus.
2.
After eating certain foods, I immediately experience gastrointestinal discomfort and diarrhea, while others I am with are fine.
Sometimes, I also have a cyclical pattern of diarrhea, followed by a few days of constipation.
Should I undergo a colonoscopy?

Mr. Yang, 30~39 year old female. Ask Date: 2016/09/19

Dr. Ke Fangxu reply Surgery

This situation is likely a higher possibility of irritable bowel syndrome combined with 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 should also help alleviate symptoms.
You can purchase over-the-counter hemorrhoidal suppositories and use stool softeners, but it is best not to take them indiscriminately.
At this age, increasing the intake of dietary fiber and fluids should be sufficient.
If bleeding persists, it is advisable to consult a physician.
If there is still no improvement or if there are significant concerns, a colonoscopy can be arranged.

Reply Date: 2016/09/19

More Info

When it comes to the presence of blood in stool and frequent diarrhea, it is crucial to understand the underlying causes and when to seek further medical evaluation, such as a colonoscopy. Based on your description, there are several factors to consider.

Firstly, the occurrence of bright red blood in your stool, especially if it is noted at the end of a bowel movement and accompanied by a burning sensation around the anus, raises the possibility of several conditions. The most common causes of bright red blood in the stool include hemorrhoids, anal fissures, and diverticular disease. Hemorrhoids are swollen veins in the rectal area that can bleed during bowel movements, particularly if there is straining or constipation involved. Anal fissures, which are small tears in the lining of the anus, can also cause sharp pain and bleeding during or after bowel movements.
Given that you have experienced both diarrhea and constipation, it is possible that the straining associated with constipation could lead to hemorrhoids or fissures, which would explain the bleeding. However, if the bleeding persists or is accompanied by other concerning symptoms such as significant abdominal pain, weight loss, or changes in bowel habits, further investigation is warranted.

The fact that you experience gastrointestinal discomfort and diarrhea after eating certain foods, while others do not, suggests a potential food intolerance or sensitivity. This could lead to a condition known as irritable bowel syndrome (IBS), which is characterized by alternating episodes of diarrhea and constipation, along with abdominal discomfort. IBS is often triggered by specific foods, stress, or hormonal changes.

In terms of diagnostic testing, a colonoscopy is a valuable tool for evaluating the lower gastrointestinal tract. It allows for direct visualization of the colon and rectum, and any abnormalities such as polyps, inflammation, or tumors can be biopsied for further analysis. Given your symptoms of blood in the stool and the history of gastrointestinal issues, it would be prudent to discuss the possibility of a colonoscopy with your healthcare provider.
While it may seem daunting, a colonoscopy is generally a safe procedure and can provide peace of mind by ruling out serious conditions such as colorectal cancer, especially if you are over the age of 45 or have risk factors for colorectal disease. Additionally, if there is a family history of colorectal cancer or polyps, this further emphasizes the need for screening.

In conclusion, based on your symptoms of blood in the stool, abdominal discomfort, and the pattern of diarrhea and constipation, it is advisable to consult with a gastroenterologist. They can assess your symptoms in detail, consider your medical history, and determine whether a colonoscopy or other diagnostic tests are necessary. Early intervention is key in managing gastrointestinal issues effectively, and addressing these symptoms promptly can lead to better outcomes and improved quality of life.

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