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

Constipation, bloody stools?

Recently, I have been experiencing constipation when using the restroom, and my stool is brown.
After sitting for a while, there is a reddish discharge, but there is no blood when wiping.
I've also been under a lot of stress lately.
Should I undergo any specific tests? Thank you very much for your response.

Lydia, 10~19 year old female. Ask Date: 2017/08/05

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, a 15-year-old with constipation and suspected blood in the stool—stool tests can be performed to check for bleeding or the presence of food substances (such as red dragon fruit, hibiscus, cactus pigments, etc.).
Additionally, a rectal examination, including digital rectal examination and colonoscopy, may be necessary.
If there is significant black or red stool accompanied by symptoms such as palpitations, dizziness, or cold sweats, seek medical attention immediately! Wishing you safety and health! Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Gastroenterology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2017/08/05

More Info

Constipation and the presence of blood in stool can be concerning symptoms that warrant careful attention. It’s important to understand the potential causes and when to seek medical help.
Constipation is generally defined as having fewer than three bowel movements per week, and it can be accompanied by hard, dry stools that are difficult to pass. Stress, dietary habits, dehydration, and lack of physical activity are common contributors to constipation. In your case, you mentioned experiencing increased stress, which can certainly exacerbate gastrointestinal issues, including constipation.

The presence of brown stool is typically normal, as this is the color of digested food. However, the mention of red discharge can be alarming. If you notice red streaks or blood on the toilet paper or in the stool, it could indicate several conditions, ranging from minor to serious. The fact that you do not see blood when wiping but notice it in the stool could suggest that the blood is coming from the lower part of the gastrointestinal tract, such as the rectum or anus.

Common causes of blood in the stool include:
1. Hemorrhoids: Swollen veins in the lower rectum or anus that can bleed during bowel movements.

2. Anal fissures: Small tears in the lining of the anus, often caused by passing hard stools.

3. Diverticular disease: Pouches that can form in the colon wall and may bleed.

4. Gastrointestinal infections: Certain infections can lead to inflammation and bleeding.

5. Polyps or colorectal cancer: While less common, these can also present with blood in the stool, especially in older adults.

Given your symptoms of constipation and the presence of red discharge, it is advisable to seek medical attention. A healthcare provider may recommend several diagnostic tests, including:
- Physical examination: A thorough examination can help identify any visible issues such as hemorrhoids or fissures.

- Digital rectal exam: This can help assess for any abnormalities in the rectum.

- Stool tests: To check for the presence of blood or infections.

- Colonoscopy: If there is a concern for more serious conditions, a colonoscopy may be performed to visualize the colon and rectum directly.

In terms of management, addressing constipation is crucial. Here are some steps you can take:
1. Increase fiber intake: Aim for a diet rich in fruits, vegetables, whole grains, and legumes.

2. Stay hydrated: Drink plenty of water throughout the day to help soften stools.

3. Regular exercise: Physical activity can stimulate bowel movements.

4. Establish a routine: Try to set aside time each day for bowel movements, especially after meals.

If your symptoms persist or worsen, or if you experience additional symptoms such as severe abdominal pain, significant weight loss, or changes in bowel habits, it is essential to follow up with a healthcare provider promptly. They can provide a tailored approach to your situation and ensure that any serious conditions are ruled out.

In summary, while constipation and minor bleeding can sometimes be due to benign causes like hemorrhoids, it is important to consult a healthcare professional to rule out any serious underlying conditions. Early intervention can lead to better outcomes and peace of mind.

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