Blood in Stool: When to Seek Medical Attention

Blood in the stool?

Hello, doctor.
This year, I have experienced blood in my stool twice, with an interval of over a month between the two occurrences.
The most recent incident was in early March.
Both times, I had abdominal pain and diarrhea, and when I wiped with toilet paper, there was fresh blood.
However, I did not visually see any blood in the stool itself, and there was no pain in the anal area.
I often have soft stools but rarely experience constipation, and sometimes I have bowel movements two to three times a day, with the first one being larger in volume.
I have read articles from doctors that say if there is no "persistent" bleeding, it is not a concern.
I would like to know what is meant by "persistent"—does it refer to continuous days of bleeding, or does my situation, with intervals of over a month, also count as "persistent"? If I experience this again after a few days, what should I do?

Hong Zheng, 20~29 year old female. Ask Date: 2017/03/16

Dr. Ke Fangxu reply Surgery

At this age, bleeding is often due to hemorrhoidal bleeding.
Instead of getting entangled in ongoing issues, it is better to improve lifestyle habits and bowel habits.
As long as the bleeding is not severe enough to cause anemia, there is no need for excessive worry.

Reply Date: 2017/03/16

More Info

When it comes to the presence of blood in stool, it is essential to understand the potential implications and when to seek medical attention. The fact that you have experienced blood in your stool on two separate occasions, with a gap of over a month between incidents, raises some important considerations.

Firstly, the presence of blood in the stool can be indicative of various conditions, ranging from benign to serious. Common causes include hemorrhoids, anal fissures, diverticular disease, and gastrointestinal bleeding from conditions such as ulcers or polyps. In some cases, blood may not be visible in the stool itself but can be detected through tests, which is why it is crucial to monitor your symptoms closely.

The term "persistent" in a medical context typically refers to symptoms that occur repeatedly over a short period. For instance, if you were to experience blood in your stool on consecutive days or multiple times within a week, that would be considered persistent. In your case, since the occurrences are spaced out by more than a month, it may not fit the strict definition of persistence. However, it is still significant enough to warrant attention, especially given that you have experienced abdominal pain and diarrhea alongside the blood.

If you experience blood in your stool again, even if it is after a gap, it is advisable to consult a healthcare professional. They may recommend further evaluation, which could include a physical examination, blood tests, or imaging studies such as a colonoscopy. A colonoscopy is particularly useful for visualizing the interior of the colon and can help identify any abnormalities such as polyps or lesions that may need to be addressed.

In addition to the frequency and timing of the blood in your stool, other symptoms should also be taken into account. If you experience any of the following, it is crucial to seek medical attention promptly:
1. Increased Frequency of Blood: If the blood becomes more frequent or is accompanied by a change in bowel habits.

2. Change in Stool Color: Dark, tarry stools or bright red blood can indicate different sources of bleeding.

3. Abdominal Pain: Severe or worsening abdominal pain should not be ignored.

4. Weight Loss: Unexplained weight loss can be a sign of a more serious underlying condition.

5. Fatigue or Weakness: These symptoms may indicate anemia due to blood loss.

In summary, while your current situation may not fit the definition of persistent symptoms, the recurrence of blood in your stool, even after a gap, is a valid reason to seek medical advice. It is always better to err on the side of caution when it comes to gastrointestinal symptoms, especially those involving blood. A healthcare professional can provide a thorough evaluation and determine if any further action is necessary to ensure your health and well-being.

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