Blood in Stool: Gastrointestinal Concerns and Solutions

Q: Blood in Stool: Gastrointestinal Concerns and Solutions

Hello： If you are very concerned, you can consult a gastroenterologist or a colorectal specialist. <br>Anal pain with slight bleeding is mostly caused by hemorrhoids or anal fissures. <br>Changhua Hospital cares about your health. <br>Dr. <br>Tsai An-shun.

Blood in the stool?

Hello Doctor: I have been experiencing diarrhea for almost two weeks, starting three weeks ago, with a couple of instances of constipation in between.
Most of my stools have been yellow and watery, accompanied by stomach discomfort, bloating, and nausea.
I have visited several clinics, and the doctors have diagnosed me with irritable bowel syndrome (IBS), but the medication has not improved my condition.
Last week, I went to Shin Kong Hospital to see a gastroenterologist, who diagnosed me with severe dyspepsia and IBS, prescribing a week’s worth of medication.
After finishing the medication, my bowel movements returned to normal, but I still experience bloating and a gurgling sensation in my stomach.
The doctor reviewed my past medical history and noted that due to work-related stress, I often find myself in a high-pressure environment and eat my meals quickly.
Last year, I underwent two gastroscopies (in June and November), which revealed small ulcers caused by gastroesophageal reflux disease (GERD) that were in the healing stage, as well as a small duodenal ulcer.
I have been consistently taking pantoprazole since then.
I am also concerned about potential colorectal issues, so I had fecal occult blood tests and blood tests done in November last year and January this year, both of which returned normal results, and there is no family history of colorectal cancer.
However, today, when I went to the bathroom, I felt a sudden urge to defecate, and after finishing, I noticed faint blood on the toilet paper when wiping (not a large amount of bright red blood, but a light trace).
I also felt some pain around my anus, which has made me worry about possible intestinal issues.
I have been taking the medication prescribed by the doctor at Shin Kong Hospital, and I wonder if the bleeding could be related to this medication or if there is an underlying gastrointestinal problem.
I have considered getting checked again, but the doctors believe my symptoms are consistent with IBS and that further tests are unnecessary, advising me to relax and follow the treatment.
However, seeing the blood on the toilet paper today has made me anxious again.
Could this be caused by hemorrhoids? (I have had them in the past but underwent surgery and had been fine for quite some time.)

Yan, 20~29 year old female. Ask Date: 2017/03/07

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: If you are very concerned, you can consult a gastroenterologist or a colorectal specialist.
Anal pain with slight bleeding is mostly caused by hemorrhoids or anal fissures.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2017/03/07

More Info

Understanding blood in stool can be a concerning issue, especially when accompanied by gastrointestinal symptoms such as diarrhea, bloating, and abdominal pain. Based on the information provided, it seems you have been experiencing a range of gastrointestinal symptoms for several weeks, including diarrhea, constipation, and now, the presence of blood on toilet paper after a bowel movement.
Firstly, it is important to recognize that the presence of blood in the stool or on toilet paper can arise from various causes, some of which may be benign while others could indicate a more serious condition. In your case, given your history of gastrointestinal issues, including irritable bowel syndrome (IBS) and previous ulcers, it is understandable that you are feeling anxious about the possibility of a more severe underlying condition.

The blood you observed on the toilet paper could potentially be attributed to several factors:
1. Hemorrhoids: Given your history of hemorrhoids, it is quite possible that the blood is a result of this condition. Hemorrhoids can become inflamed and bleed, especially during bowel movements, particularly if you are experiencing diarrhea or constipation, which can lead to straining.

2. Anal fissures: These are small tears in the lining of the anus that can occur due to passing hard stools or straining during bowel movements. They can cause sharp pain and bleeding, often seen as bright red blood on toilet paper.

3. Gastrointestinal inflammation: Conditions such as inflammatory bowel disease (IBD), including Crohn's disease or ulcerative colitis, can also present with blood in the stool. However, these conditions are usually accompanied by other symptoms such as severe abdominal pain, weight loss, and persistent diarrhea.

4. Diverticular disease: Diverticulosis can lead to diverticulitis, which may cause bleeding. This is more common in older adults but can occur in younger individuals as well.

5. Infection: Certain gastrointestinal infections can lead to bloody diarrhea, though this typically presents with more severe symptoms.

Given your recent medical history, including the diagnosis of severe dyspepsia and IBS, it is crucial to consider the impact of stress and dietary habits on your gastrointestinal health. Stress can exacerbate symptoms of IBS and may contribute to gastrointestinal discomfort and irregular bowel habits. Additionally, eating quickly and not allowing adequate time for digestion can lead to bloating and discomfort.

While the medication you are taking may help with your symptoms, it is essential to monitor your condition closely. If the blood persists or if you experience worsening symptoms such as increased pain, changes in bowel habits, or weight loss, it would be prudent to seek further evaluation. A gastroenterologist may recommend additional tests, such as a colonoscopy, to rule out any serious conditions, especially given your history of gastrointestinal issues.

In the meantime, consider the following strategies to help manage your symptoms:
- Dietary adjustments: Focus on a balanced diet rich in fiber to help regulate bowel movements. Avoiding trigger foods that may exacerbate your symptoms (such as spicy foods, caffeine, and alcohol) can also be beneficial.

- Stress management: Incorporate stress-reducing techniques such as mindfulness, yoga, or regular exercise to help alleviate symptoms related to IBS.

- Hydration: Ensure you are drinking plenty of fluids, especially if you are experiencing diarrhea, to prevent dehydration.

- Regular follow-ups: Keep in touch with your healthcare provider to monitor your symptoms and adjust your treatment plan as necessary.

In conclusion, while the presence of blood in your stool is understandably alarming, it is essential to approach the situation with a clear understanding of potential causes and to seek medical advice when necessary. Monitoring your symptoms and maintaining open communication with your healthcare provider will be key in managing your gastrointestinal health effectively.

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