Blood in Stool Without Discomfort: Possible Causes

Rectal bleeding without any discomfort?

Hello Doctor: Today I experienced blood in my stool.
The blood is a slight dark red color, and the stool itself is a normal yellow-brown, elongated shape (not hard or dry); the bowel movement was smooth and without discomfort (even after finishing), and there was no blood when wiping, nor any foul odor.
However, I only noticed the blood after the bowel movement, so I'm not sure if it was expelled with the stool or if it simply mixed in (but the blood does not appear to be just on the surface of the stool).
It resembles the situation some women experience during their menstrual period, but based on my cycle, it cannot be menstruation, and there was no blood on my underwear.
What conditions could this indicate? Is it possible that it could be cancer, or could it be hemorrhoids or polyps? Recently, I had a week of reversed day-night cycles, but I have adjusted back for several days now; could this be related? (I do not have anemia or fever, my weight has not decreased, there has been no recent diarrhea, and my bowel habits have not changed; I have regular bowel movements every 1 to 2 days.) Thank you.

R, 10~19 year old female. Ask Date: 2017/05/27

Dr. Ke Fangxu reply Surgery

This situation is likely indicative 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 the toilet.
Warm sitz baths may help alleviate symptoms, and you can also purchase over-the-counter hemorrhoid suppositories.
It is best not to take stool softeners indiscriminately.
If bleeding persists, it is advisable to consult a physician.
Although the likelihood of developing colorectal cancer at the age of 18 is not zero, it is generally very low.
Based on your description, it seems more like hemorrhoids.
It is suggested to maintain a light diet and a healthy lifestyle, avoiding spicy, irritating, and greasy foods.
If symptoms continue without improvement, you may want to ask a physician for medication or to undergo a colonoscopy.

Reply Date: 2017/05/27

More Info

When it comes to the presence of blood in stool, it can understandably cause concern, especially regarding the potential for serious conditions such as cancer. However, based on the details you've provided, there are several possible explanations for your symptoms that are worth considering.

First and foremost, the fact that you describe the blood as a "slight dark red" and that your stool is normal in color and consistency suggests that the bleeding may not be originating from the upper gastrointestinal tract, where blood typically appears bright red due to being fresh. Instead, dark red blood can indicate a source closer to the rectum or lower colon, which could be associated with conditions such as hemorrhoids, anal fissures, or polyps.

1. Hemorrhoids: These are swollen veins in the lower rectum or anus that can cause bleeding, especially during bowel movements. If the blood is bright red and appears on the toilet paper or in the toilet bowl, hemorrhoids are a common cause. They can be painless, which aligns with your experience of having no discomfort during or after bowel movements.

2. Anal Fissures: These are small tears in the lining of the anus that can occur due to passing hard stools. They can cause bleeding and pain during bowel movements, but in some cases, the pain may not be severe enough to be noticeable.

3. Polyps: These are growths on the lining of the colon or rectum that can bleed. While most polyps are benign, some can develop into cancer over time. Regular screening is important, especially if you have a family history of colorectal cancer.

4. Diverticular Disease: Diverticula are small pouches that can form in the walls of the colon. If these become inflamed or infected, they can cause bleeding.

5. Gastrointestinal Conditions: Conditions such as inflammatory bowel disease (IBD), including Crohn's disease or ulcerative colitis, can also lead to blood in the stool, although these are often accompanied by other symptoms like abdominal pain or diarrhea.

Regarding your concerns about cancer, while it is always prudent to consider this possibility, the absence of other alarming symptoms such as weight loss, changes in bowel habits, fever, or anemia makes it less likely. However, any instance of blood in the stool warrants further investigation, particularly if it persists or is accompanied by other symptoms.

As for your recent change in sleep patterns, while it is unlikely to be a direct cause of blood in the stool, stress and irregular sleep can affect overall gastrointestinal health. Stress can exacerbate conditions like irritable bowel syndrome (IBS), which may lead to changes in bowel habits or discomfort.

In conclusion, while there are several benign explanations for the presence of blood in your stool, it is essential to consult a healthcare professional for a thorough evaluation. They may recommend a physical examination, possibly including a rectal exam, and further diagnostic tests such as a colonoscopy to determine the exact cause of the bleeding. Early detection and treatment are crucial, especially for conditions that could potentially lead to more serious health issues.

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