Blood in Stool: When to Seek Medical Attention

Bowel issues?

Hello Doctor: I usually have regular meals and work schedules, and I tend to eat out only on weekends.
I don't consume a lot of vegetables, but I do eat a significant amount of fruit.
I do not smoke, drink alcohol, or chew betel nut.
I drink water frequently during work hours, and I generally have daily bowel movements that are smooth (mostly soft stools).
Occasionally, I might have a day or two without a bowel movement, or I might have more than two bowel movements in a day.
About 5-6 years ago, I experienced hemorrhoids, but after using a suppository from the pharmacy, my condition improved, and I haven't had hemorrhoids since.

However, in the past year, I suddenly noticed blood (bright red) in my stool.
The blood seems to be on the surface of the stool rather than dark, tarry blood.
Initially, the frequency of blood was low, and after wiping with toilet paper 1-2 times, there was no more blood.
But in the past few months, I have had blood in almost every bowel movement, and I can feel drops of blood in the toilet when straining, turning the water bright red.
Again, after wiping, there is no blood, but my underwear has been stained with blood.
Last month, I noticed a blood clot resembling a small sac (about 1 cm by 0.5 cm) on the toilet paper after wiping, which did not break or ooze blood when squeezed.
The blood is still on the surface of the stool and not dark.
In the past 2-3 weeks, the blood in my stool has disappeared, and my bowel movements have been normal.
However, I have experienced two instances where I had a strong urge to defecate in the morning, but after going to the bathroom, I only passed a small amount before the urge subsided.
After leaving the bathroom for a while, the urge returned, and I rushed back, but again, I only passed a little.
This happened about 2-3 times before the urge finally stopped, with intervals of about half an hour between urges.
I looked up some signs of colorectal cancer online, and aside from the blood in my stool (which is bright red), I don't seem to have any other symptoms.
I initially thought it was nothing serious, but due to the recent frequent urges, I wanted to consult a doctor.
Should I seek further evaluation at a major hospital? If so, which department should I visit? Thank you for your attention and guidance.

Mr. Chen, 40~49 year old female. Ask Date: 2016/11/24

Dr. Yu Mingchang reply Surgery

Hello; please take a moment to check the colorectal department regarding colonoscopy examinations.
The Ministry of Health and Welfare Changhua Hospital cares about you.

Reply Date: 2016/11/24

More Info

When it comes to the presence of blood in stool, it is essential to understand the potential causes and when to seek medical attention. In your case, the fact that you have experienced bright red blood on the stool and toilet paper, along with a history of hemorrhoids, suggests that the bleeding may be related to hemorrhoids or anal fissures. However, given the persistence and changes in your symptoms, it is crucial to approach this situation with caution.

Understanding Blood in Stool
1. Types of Blood: Blood in the stool can appear in different forms. Bright red blood typically indicates that the bleeding is occurring in the lower gastrointestinal tract, such as the rectum or anus. Dark, tarry stools (melena) usually indicate bleeding from higher up in the gastrointestinal tract, such as the stomach or small intestine.

2. Common Causes: The most common causes of bright red blood in the stool include:
- Hemorrhoids: Swollen veins in the lower rectum or anus that can bleed during bowel movements.

- Anal Fissures: Small tears in the lining of the anus, often caused by passing hard stools.

- Diverticular Disease: Small pouches that can form in the colon wall and may bleed.

- Colorectal Polyps or Cancer: Abnormal growths in the colon that can bleed.

3. Symptoms to Monitor: While you mentioned that the blood has decreased recently, it is essential to monitor for other symptoms, such as:
- Changes in bowel habits (diarrhea or constipation).

- Abdominal pain or cramping.

- Unexplained weight loss.

- Changes in appetite.

- Fatigue or weakness.

When to Seek Medical Attention
You should seek medical attention if:
- The bleeding persists or worsens.

- You experience significant abdominal pain.

- You notice changes in your bowel habits that are concerning.

- You experience symptoms of anemia, such as fatigue, weakness, or dizziness.

- You have a family history of colorectal cancer or other gastrointestinal diseases.

Recommended Actions
Given your symptoms and history, it would be prudent to consult a healthcare professional. You should consider seeing a gastroenterologist, a specialist in digestive system disorders. They can perform a thorough evaluation, which may include:
- A physical examination.

- A digital rectal exam to check for hemorrhoids or fissures.

- A colonoscopy to visualize the colon and rectum, which can help identify any polyps, tumors, or other abnormalities.

Conclusion
While your symptoms may be related to hemorrhoids or another benign condition, the presence of blood in the stool should never be taken lightly, especially with a change in your bowel habits. It is always better to err on the side of caution and seek medical advice. Early detection and treatment can significantly improve outcomes, especially if there are underlying conditions that need to be addressed. Please make an appointment with a gastroenterologist to discuss your symptoms and receive appropriate care.

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