Blood in Stool: Causes and When to Seek Help - Gastroenterology and Hepatology

Blood in stool issue?

A little over a month ago, I was diagnosed with a gastric ulcer, which caused poor appetite and watery stools.
After starting medication for the ulcer, my appetite improved, and my stools became more formed.
However, on the day my stools were formed, I noticed a section of one stool had blood mixed in (the color was between bright red and dark red).
During my second bowel movement, the blood decreased, and there was mucus that matched the stool color, but it did not come into contact with blood.
When I consulted a doctor, they suggested it might be an internal hemorrhoid or due to mild gastroenteritis causing the blood in my stool, and advised me to monitor the situation.
After that, it seemed to fluctuate between having blood and not being sure if it was blood.
I then began experiencing constipation with harder stools, and blood reappeared.
Later, I was uncertain if it was food residue, dark mucus, or blood.
Subsequently, during an upper gastrointestinal examination, I noticed blood adhered to the surface of my stool (at this point, constipation was severe).
Constipation persisted, but the stools became somewhat softer, and I didn't have to strain for long to pass them, although they were still pellet-like.
Yesterday, I passed a particularly large stool that seemed to tear at the anus, resulting in a small amount of bright red blood.
Today, I also saw blood on the stool, though it was minimal and did not turn the water red or drip.
Currently, my stool color is dark brown, whereas it was previously golden yellow.
Should I undergo a colonoscopy, or could it be that internal hemorrhoids and anal fissures occurred at different times, leading to the blood in my stool? Should I continue to monitor this? I have increased my intake of fruits and vegetables, but I haven't been drinking enough water.

xuan, 10~19 year old female. Ask Date: 2017/06/02

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Miss.
Please seek medical attention and use a stool softener along with an anal ointment.
If you do not object, we can also perform a rectal examination.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2017/06/02

More Info

Understanding blood in stool can be concerning, and it's important to approach this issue with a clear understanding of potential causes and when to seek medical help. Blood in the stool can arise from various sources in the gastrointestinal tract, and the color and consistency of the blood can provide clues about its origin.

In your case, the presence of blood mixed with stool, especially if it appears bright red, may indicate bleeding from the lower gastrointestinal tract, such as the rectum or colon. This could be due to several reasons, including hemorrhoids, anal fissures, diverticular disease, or even more serious conditions like colorectal polyps or cancer. The fact that you have experienced changes in your bowel habits, such as constipation and the presence of hard stools, can contribute to anal fissures, which are tears in the lining of the anus that can cause bleeding, especially during bowel movements.

The intermittent nature of your symptoms, along with the changes in stool color and consistency, suggests that there may be multiple factors at play. The initial diagnosis of a gastric ulcer and subsequent treatment may have improved your appetite and stool consistency, but it’s crucial to monitor any new symptoms closely. The presence of mucus alongside blood can also indicate inflammation in the gastrointestinal tract, possibly due to conditions like irritable bowel syndrome (IBS) or infections.

Given your history of gastrointestinal issues and the recent changes in your bowel habits, it is advisable to consider further evaluation. A colonoscopy is a valuable diagnostic tool that allows for direct visualization of the colon and rectum, enabling the identification of any abnormalities such as polyps, inflammation, or lesions that may be causing the bleeding. While hemorrhoids and anal fissures are common and often benign causes of blood in the stool, it is essential to rule out more serious conditions, especially if the bleeding persists or is accompanied by other symptoms such as weight loss, severe abdominal pain, or changes in bowel habits.

In terms of dietary changes, increasing your intake of fruits, vegetables, and fiber can help alleviate constipation and promote regular bowel movements. However, it is equally important to ensure adequate hydration, as insufficient fluid intake can lead to harder stools and exacerbate constipation. Drinking plenty of water can help soften stools and reduce the risk of anal fissures.

In summary, while your symptoms may be related to benign conditions such as hemorrhoids or anal fissures, the presence of blood in the stool warrants careful monitoring and potentially further investigation. If the bleeding continues, worsens, or is accompanied by concerning symptoms, it is crucial to seek medical attention promptly. A healthcare provider can perform the necessary evaluations, including a colonoscopy, to determine the underlying cause and recommend appropriate treatment. Always prioritize your health and do not hesitate to reach out for professional guidance when needed.

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