Blood in Stool: Possible Causes and Concerns - Gastroenterology and Hepatology

Blood in the stool?

Hello Dr.
Chen, in recent months, my bowel movements have been somewhat irregular, often leaving me with a feeling of incomplete evacuation.
It feels like there is a portion that gets stuck at the anal opening, and I have to use my fingers to help.
Sometimes, my stools are hard, which causes anal fissures and bleeding.
The blood is bright red and sometimes it drips significantly into the toilet.
When I insert my finger into the anal canal, I can feel some broken skin.
In the past two days, my stools have been hard again, and I have started experiencing bloody stools.
When I touch my anus, I find it is covered in blood, and I can feel a small lump about 0.6 cm at the anal opening, but it does not hurt.
Whenever I exert pressure at the anus, it seems like the bleeding continues without stopping; even after wiping, there is still blood present.
Could this be a sign of hemorrhoids or rectal tumor-related bleeding? Which condition does my symptom resemble more closely? Thank you.
(I am overweight and do not exercise much, and due to my job, I sit all day.) In the past six months, I have had occasional bloody stools, which are superficial and do not mix with the stool.
Generally, I experience bright red blood when my stools are hard and dry.
After one episode of significant bleeding, the next day while sitting on the toilet, I exerted pressure but did not have a bowel movement.
However, when I wiped, there was bright red blood.
I am unsure if the blood's appearance is due to the cold, as the blood in the toilet resembled thin worm-like clots (I am uncertain if these clots were expelled or formed upon contact with the toilet water).
While sitting on the toilet, I occasionally feel small blood clots at the anal opening (I am unsure if they are clotted due to exposure to air).

Chen, 20~29 year old female. Ask Date: 2016/11/10

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Please go to the colorectal surgery department for further examination.

Reply Date: 2016/11/10

More Info

When it comes to understanding blood in stool, it is essential to consider various potential causes and concerns. Based on the symptoms you described, there are several possibilities that could explain your condition, including hemorrhoids and rectal tumors.

Hemorrhoids are swollen veins in the lower rectum and anus that can cause discomfort, itching, and bleeding. The blood you see is often bright red, indicating that it is coming from the lower gastrointestinal tract. Hemorrhoids can be caused by several factors, including straining during bowel movements, prolonged sitting, obesity, and a lack of physical activity, all of which seem to apply to your situation. The presence of small lumps or "masses" around the anus, which you mentioned, could also be indicative of external hemorrhoids or thrombosed hemorrhoids, which can be painful and may bleed.

On the other hand, rectal tumors, including benign polyps or malignant tumors, can also cause rectal bleeding. While the blood from tumors may sometimes be mixed with stool, it can also present as bright red blood on the surface, similar to hemorrhoidal bleeding. The fact that you have experienced significant blood loss and the presence of lumps could raise concerns about the possibility of a more serious condition.

Given your symptoms of hard stools, a feeling of incomplete evacuation, and the presence of blood, it is crucial to seek medical attention. A healthcare provider will likely perform a thorough examination, which may include a digital rectal exam, colonoscopy, or other imaging studies to determine the exact cause of your symptoms.
Additional Considerations:
1. Diet and Lifestyle: Your description of a sedentary lifestyle and infrequent exercise can contribute to constipation and straining during bowel movements, which exacerbates hemorrhoids. Increasing fiber intake through fruits, vegetables, and whole grains, along with adequate hydration, can help soften stools and reduce straining.

2. Potential Complications: If left untreated, conditions like hemorrhoids can lead to complications such as thrombosis or infection. Rectal tumors, if malignant, can lead to more severe health issues if not diagnosed and treated early.

3. Importance of Early Diagnosis: Early diagnosis is critical in managing any gastrointestinal condition. While hemorrhoids are common and often manageable, rectal bleeding should never be ignored, as it can be a sign of more serious conditions, including colorectal cancer.

4. Follow-Up: If you experience persistent symptoms, such as ongoing bleeding, changes in bowel habits, or any new symptoms like weight loss or abdominal pain, it is essential to follow up with your healthcare provider promptly.

In conclusion, while your symptoms may suggest hemorrhoids, the possibility of rectal tumors cannot be ruled out without further evaluation. It is vital to consult a healthcare professional for a proper diagnosis and treatment plan tailored to your specific situation. Taking proactive steps in managing your diet and lifestyle can also significantly improve your symptoms and overall health.

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