Blood in Stool: Constipation and Dietary Impact

Blood on the stool can occur due to straining during bowel movements?

Hello doctor, I usually eat very few fruits and vegetables, and I don't drink water often.
I've always had issues with constipation, and my stools are pellet-like.
As a working professional, I often feel the urge to have a bowel movement right after breakfast, but it's inconvenient to do so outside, so I hold it in until around 5 or 6 PM.
By that time, my stools become very hard, and there is sometimes blood mixed in.
My lower abdomen feels bloated (it only feels bloated when I hold in my bowel movement all day).
Typically, my stools are very hard and have a white mucus coating, and after I finish, I pass very foul-smelling gas.
Thank you for your help, doctor.

HUA, 20~29 year old female. Ask Date: 2017/05/26

Dr. Chen Jiaming reply Surgery

You are actually quite aware of where the problem lies.
The urge to defecate indicates that stool may have already reached the lower colon or rectum.
If it stays there for too long, it will continue to absorb water, becoming drier and harder to pass.
It is more comfortable and pleasant to go to the bathroom when you feel the urge (of course, you may have concerns about being in public, but this is a matter of mental adjustment; the time spent will not be much longer than that for urination, unless your job requires you to limit your water intake and avoid using the restroom, which is not beneficial for your health).
However, you can try to change your bowel habits.
Consider taking advantage of your body's tendency to feel the urge after breakfast.
Upon waking up, before washing up, drink a large glass of warm water (400-500 cc) or a lukewarm beverage on an empty stomach (it should not be too hot to drink all at once).
This will signal your gastrointestinal tract to wake up early.
Afterward, you can wash up and see if you can generate the urge to defecate before heading out, allowing for a quick bathroom visit at home.
If your morning schedule is already tight, try adjusting your routine by going to bed an hour earlier and waking up half an hour earlier.
Additionally, increasing your daily water intake (by about 1000 milliliters) and moderately increasing your fruit and vegetable consumption can also improve your bowel movements.
I hope this helps!

Reply Date: 2017/05/26

More Info

It sounds like you are experiencing a combination of constipation and rectal bleeding, which can be concerning. Let's break down your symptoms and discuss the potential causes and implications.

Firstly, your description of having hard, pellet-like stools is indicative of constipation. This condition often arises from a diet low in fiber, which is common when there is insufficient intake of fruits and vegetables. Fiber is crucial for maintaining regular bowel movements as it adds bulk to the stool and helps it pass more easily through the intestines. Additionally, inadequate hydration can exacerbate constipation, as water is essential for softening the stool.

The presence of blood in your stool, especially when accompanied by hard stools, may suggest a few possibilities. One common cause of rectal bleeding in the context of constipation is anal fissures. These are small tears in the lining of the anus that can occur when passing hard stools, leading to pain and bleeding. Another possibility is hemorrhoids, which are swollen veins in the rectal area that can bleed, particularly during bowel movements. The white mucus you mentioned could be a sign of irritation or inflammation in the intestines, which can occur with chronic constipation.

The fact that you are experiencing abdominal bloating and discomfort, particularly after holding in your bowel movements throughout the day, is also significant. Holding in bowel movements can lead to increased pressure in the intestines, which may contribute to discomfort and exacerbate constipation.

Given your symptoms, it is essential to address both your dietary habits and your bowel health. Here are some recommendations:
1. Increase Fiber Intake: Aim to include more fruits, vegetables, whole grains, and legumes in your diet. Foods high in fiber can help soften your stool and promote regular bowel movements. Gradually increase your fiber intake to avoid gas and bloating.

2. Stay Hydrated: Drink plenty of water throughout the day. Adequate hydration is crucial for preventing constipation and ensuring that fiber can do its job effectively.

3. Establish a Routine: Try to set aside time each day for a bowel movement, ideally after meals when your digestive system is most active. This can help train your body to have regular bowel movements.

4. Consider Over-the-Counter Remedies: If dietary changes are not sufficient, you might consider using over-the-counter laxatives or stool softeners, but these should be used sparingly and not as a long-term solution without consulting a healthcare provider.

5. Consult a Healthcare Professional: Given the presence of blood in your stool and the discomfort you are experiencing, it is advisable to consult a healthcare professional for a thorough evaluation. They may recommend tests to rule out any underlying conditions, such as inflammatory bowel disease or other gastrointestinal issues.

In summary, your symptoms suggest a combination of constipation and potential anal or rectal issues, likely exacerbated by dietary habits. Addressing your diet and hydration, along with seeking medical advice, will be crucial in managing your symptoms and preventing further complications. Remember, it is always better to err on the side of caution when it comes to health concerns, especially when there is blood involved.

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