Blood in Stool: When to Seek Medical Advice

Regarding blood in stool wiping, please consult a doctor?

Hello Doctor, my bowel movements have been irregular; sometimes I experience constipation that leads to abdominal pain and have to go to the emergency room.
I have been having bowel movements every two to three days, but for the past month, I started taking digestive enzymes, and now I am having bowel movements about three times a day.
However, the amount is not substantial.
After this frequent bathroom use, I noticed a little blood on the toilet paper when wiping after a bowel movement.
The stool itself does not appear to have blood, but there is a slight pain around the anus that usually resolves after a few hours.
Last night, while urinating, I passed gas but did not have a bowel movement; however, the toilet was filled with blood and many small blood clots, turning the water red.
I also felt a slight pain around the anus.
Later, I used a pad before going to bed, and when I woke up in the morning, there was no blood on the pad.
I would like to ask the doctor what this situation might be.
Thank you.

Ms. Huang, 20~29 year old female. Ask Date: 2017/05/27

Dr. Ke Fangxu reply Surgery

This situation likely indicates a higher possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Warm sitz baths may help alleviate symptoms.
You can also purchase over-the-counter hemorrhoidal suppositories for use.
It is best to avoid taking so-called digestive enzymes available on the market, as they often contain laxative ingredients.
If bleeding persists, it is advisable to consult a physician for evaluation.

Reply Date: 2017/05/27

More Info

When it comes to blood in the stool, it is essential to understand that this symptom can indicate a range of medical conditions, some of which may require immediate attention. Given your description of irregular bowel movements, abdominal pain, and the presence of blood, it is crucial to seek medical advice promptly.

Possible Causes of Blood in Stool
1. Hemorrhoids: One of the most common causes of blood in the stool, especially if you are experiencing pain around the anus. Hemorrhoids are swollen veins in the lower rectum and anus that can cause bleeding during bowel movements.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to bleeding and pain during bowel movements.

3. Gastrointestinal Bleeding: Blood can originate from anywhere in the gastrointestinal tract, including the stomach, small intestine, or colon. Conditions such as diverticulosis, inflammatory bowel disease (IBD), or colorectal cancer can lead to significant bleeding.

4. Infections: Certain infections can cause inflammation and bleeding in the gastrointestinal tract. This includes bacterial infections, such as those caused by E. coli or Salmonella.

5. Polyps or Tumors: Benign or malignant growths in the colon can also cause bleeding. Regular screening, such as colonoscopy, is recommended for individuals over 45 or those with a family history of colorectal cancer.

When to Seek Medical Attention
You should seek medical advice if you experience any of the following:
- Persistent Blood: If blood continues to appear in your stool or on toilet paper, it is vital to consult a healthcare provider.

- Severe Pain: If you experience significant pain during bowel movements or in the abdominal area.

- Changes in Bowel Habits: If you notice a significant change in your bowel habits, such as increased frequency or consistency changes.

- Accompanying Symptoms: If you experience other symptoms such as fever, weight loss, or fatigue, these could indicate a more serious condition.

- Large Amounts of Blood: If you notice a large amount of blood in the toilet or if the blood is bright red, this may indicate a more severe issue.

Recommended Actions
1. Consult a Healthcare Provider: Given your symptoms, it is advisable to see a gastroenterologist or your primary care physician. They may recommend diagnostic tests such as a colonoscopy, blood tests, or imaging studies to determine the cause of the bleeding.

2. Keep a Symptom Diary: Document your bowel habits, any pain experienced, and the characteristics of the blood (color, amount, etc.). This information can be helpful for your healthcare provider.

3. Dietary Adjustments: While waiting for your appointment, consider increasing your fiber intake to help with bowel regularity. However, if you suspect that certain foods may be contributing to your symptoms, it may be wise to avoid them until you can discuss this with your doctor.

4. Avoid Straining: If you are experiencing constipation, try to avoid straining during bowel movements, as this can exacerbate conditions like hemorrhoids or fissures.

5. Stay Hydrated: Ensure you are drinking enough water, as hydration can help maintain regular bowel movements.

Conclusion
Blood in the stool is a symptom that should not be ignored. While it can be caused by relatively benign conditions like hemorrhoids or anal fissures, it can also indicate more serious gastrointestinal issues. Given your recent symptoms and changes in bowel habits, it is crucial to seek medical advice as soon as possible to determine the underlying cause and receive appropriate treatment.

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