Orange-Red Stools: Causes and Concerns for Young Adults

Small amounts of orange-red stool?

I am 23 years old and tend to be anxious.
I often experience heartburn and bloating, and I have a habit of having bowel movements every morning, which are often not smooth.
I need to go several times, and my stools tend to be hard.
I force myself to ensure I am completely clean before leaving the restroom.
Despite eating a lot of fruits and vegetables, there has been no improvement.
Two years ago, I underwent an endoscopy and was diagnosed with irritable bowel syndrome (IBS).
My stool tests have all been normal, and I had a colonoscopy last year which also confirmed IBS.
A few months ago, I started feeling a sharp pain and itching around the anus, which worsened the longer I sat.
I consulted a doctor who performed a digital examination and found an internal hemorrhoid.
They prescribed me suppositories and stool softeners, which provided relief for a few days, but the symptoms returned shortly after.
A few weeks later, due to very hard stools, I couldn't tolerate it anymore and took two laxatives.
I had multiple bowel movements; the first few were normal in color, but during the last one, I noticed a small amount of bright orange-red stool stuck on the toilet slope.
I was unsure if the blood was mixed in or separate, and I also saw some on the toilet paper, which made me very anxious.
I consulted a second doctor, explained my symptoms, and underwent another digital examination.
They found a small internal hemorrhoid, stating that the bleeding was due to friction causing a tear.
They recommended a colonoscopy, but I mentioned that last year's examination was normal, and they reassured me not to worry too much.
I felt somewhat relieved.
Since then, I have tried not to strain and reduced the frequency of my bowel movements.
I have increased my water and fruit and vegetable intake, and for a few days, my bowel movements were smooth and normal.
However, after a while, my stools became hard again and difficult to pass.
I took laxatives again, and during the last bowel movement, I noticed a small amount of orange-red stool.
I went to a third doctor for an examination.
They conducted a detailed consultation and a digital examination, finding three internal hemorrhoids.
The other two were not prominent, and they confirmed that the bleeding was due to hemorrhoids causing friction and tearing.
The doctor kindly performed rubber band ligation and mentioned that I would need three sessions.
They provided me with ointment and stool softeners.
After the second session, during a follow-up, the doctor said the hemorrhoids had fallen off.
For the past few weeks, my bowel movements have been smooth and the color normal, but recently, my stools have been either small pieces or one large, hard piece.
I am starting to feel anxious again, and today I noticed some orange-red stool on the toilet slope and toilet paper, but the color in the toilet seemed normal.
Is this bleeding from a hemorrhoid tear?

Yu, 20~29 year old female. Ask Date: 2017/05/30

Dr. Chen Jiaming reply Surgery

Online consultations should not result in any diagnosis without a physical examination and tests conducted by a physician.
Given that you have consulted multiple doctors and undergone numerous tests with consistent conclusions, what are your thoughts on this?

Reply Date: 2017/05/30

More Info

The presence of orange-red particles in your stool can be concerning, especially given your history of gastrointestinal issues and the recent diagnosis of hemorrhoids. It's important to understand the potential causes of these symptoms and when to seek further medical evaluation.

Firstly, the color of your stool can be influenced by various factors, including diet, medications, and underlying health conditions. Foods that are rich in pigments, such as carrots, beets, and certain fruits, can lead to changes in stool color. However, since you mentioned that you have not consumed such foods recently, it is less likely that diet is the sole cause of the orange-red coloration.

Given your history of irritable bowel syndrome (IBS) and the presence of hemorrhoids, it is plausible that the orange-red color you are observing could be related to minor bleeding from the hemorrhoids. Hemorrhoids can become irritated and bleed, especially if you are experiencing hard stools and straining during bowel movements. The blood from hemorrhoids is typically bright red, which could mix with your stool and give it an orange-red appearance, particularly if the bleeding is minor.

Your description of the stool being hard and requiring multiple attempts to pass could also contribute to the irritation of the hemorrhoids, leading to further bleeding. It’s crucial to manage your bowel habits to prevent straining, which can exacerbate hemorrhoid symptoms. Increasing your fiber intake through fruits, vegetables, and whole grains, along with adequate hydration, can help soften your stool and promote regular bowel movements.

You mentioned that you have undergone several medical evaluations, including colonoscopies, which have shown no significant abnormalities aside from the hemorrhoids. This is reassuring, as it suggests that more serious conditions, such as colorectal cancer, are unlikely, especially given your young age and the absence of alarming symptoms. However, the recurrence of hard stools and the presence of blood warrant ongoing attention.

If you continue to see orange-red particles in your stool or if the bleeding persists, it would be wise to follow up with your healthcare provider. They may recommend further evaluation, such as a repeat colonoscopy or other diagnostic tests, to rule out any other potential issues. Additionally, they can provide guidance on managing your hemorrhoids and improving your bowel habits.

In summary, while the orange-red color in your stool could be related to minor bleeding from hemorrhoids, it is essential to monitor your symptoms closely. Maintaining a high-fiber diet, staying hydrated, and avoiding straining during bowel movements are crucial steps in managing your condition. If symptoms persist or worsen, do not hesitate to seek medical advice for further evaluation and management.

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