Bowel Health: When to Worry About Blood and Discomfort

Not clean enough?

Recently, after wiping myself following a bowel movement, I noticed a small amount of blood on the toilet paper.
It was minimal, just a little that could easily be overlooked if not closely examined.
I remember that the day before, I hadn't had a bowel movement, and I had previously experienced hard stools that left some blood on the paper.
However, this time, the blood appeared somewhat jelly-like, but it was just a little, which felt different from before.
When I visited my family doctor for a cold, I mentioned this, and the doctor advised me to monitor the situation, suggesting it might be due to food irritation and not to worry too much.
After a few days of observation, I didn't see any blood, which relieved my concerns.
In comparison to before, my stool volume has decreased, and the consistency and timing have become irregular.
Previously, my stools were always complete and formed, and I would typically have a bowel movement a few hours after breakfast, which was quite regular.
Now, I'm not sure if it's due to the hot weather, eating less, or a decrease in vegetables, but my dietary habits have changed, leading to irregular bowel movements.
Usually, my stools are soft, although sometimes they are complete; there have been instances where they start hard and then become soft and mushy, and I'm unsure if this is normal.
Occasionally, I experience bloating and abdominal pain, but these symptoms tend to resolve after a bowel movement or passing gas.
Sometimes, my stools have mucus, especially when I can't pass them or when they are too hard.

I also experience occasional sharp pain and itching around the anus, but this sensation disappears quickly.
Lately, I've felt like my bowel movements are incomplete, with a sensation of residual stool.
When I try to empty my bowels completely, I often can't, and it feels like I'm just passing gas, leading to a feeling of blockage.
I also feel like I can't clean myself properly, which causes me to wipe harder, resulting in a feeling of swelling and pain around the anus.
If I feel like I haven't fully emptied my bowels today, usually that sensation is gone by the next morning, until my next bowel movement or sometimes after passing gas.
In June of this year, I underwent a health check, and the fecal occult blood test was normal.
I tend to feel anxious about medical examinations, especially those I haven't undergone before, and I worry about follow-up appointments (I have a history of follicular thyroid carcinoma that requires regular monitoring).
This anxiety sometimes leads to abdominal pain and diarrhea, and my doctor often tells me that I'm too tense.
I was particularly worried before and after the occult blood test, and I recall that my bowel movement issues began around the time of the examination, making the presence of blood feel more pronounced.
Ultimately, I'm unsure if I genuinely have a problem or if I'm just overly sensitive and anxious.
Overall, I don't have abdominal pain, and although I'm eating less, my appetite is fine, and my weight hasn't decreased.
Since my next follow-up appointment is still some time away, I'm uncertain if I should seek another doctor for further evaluation regarding the issues mentioned above.

YUN, 20~29 year old female. Ask Date: 2017/08/15

Dr. Ke Fangxu reply Surgery

At the age of 26, the likelihood of developing colorectal cancer is not zero, but generally speaking, it is very, very low.
Based on your description, it seems more like irritable bowel syndrome (IBS).
It is recommended to follow a light diet and maintain a good lifestyle.
Spicy, irritating, and greasy foods should be avoided.
If symptoms persist without improvement, you may consult a physician for medication or consider undergoing a colonoscopy.

Reply Date: 2017/08/15

More Info

When it comes to bowel health, noticing blood in your stool can understandably cause a great deal of anxiety. It's important to remember that while blood in the stool can be a sign of a serious condition, it can also result from less severe issues, such as hemorrhoids or anal fissures, especially if the amount is small and there are no accompanying severe symptoms.
In your case, you mentioned that the blood was minimal and that you had experienced some changes in your bowel habits, including softer stools and occasional discomfort. These symptoms can often be linked to dietary changes, stress, or even minor gastrointestinal disturbances. The fact that you had a normal fecal occult blood test in June is reassuring, as it suggests that there were no significant issues at that time.

However, the psychological aspect of health anxiety can exacerbate your symptoms. It's common for individuals to become hyper-aware of bodily sensations, especially after experiencing a health scare. This heightened awareness can lead to a cycle of worry and physical symptoms, such as abdominal pain or changes in bowel habits. Stress can significantly impact gut health, leading to conditions like irritable bowel syndrome (IBS), which can cause symptoms such as bloating, gas, and changes in stool consistency.

Here are some suggestions to help you manage your concerns and maintain bowel health:
1. Dietary Adjustments: Ensure you are consuming a balanced diet rich in fiber, which can help regulate bowel movements and prevent constipation. Incorporate fruits, vegetables, whole grains, and adequate hydration into your meals. If you notice that certain foods seem to trigger discomfort, consider keeping a food diary to identify potential culprits.

2. Stress Management: Since you mentioned that stress exacerbates your symptoms, it may be beneficial to explore stress-reduction techniques. Practices such as mindfulness, yoga, or meditation can help calm your mind and reduce anxiety. Regular physical activity, which you are already engaging in, is also a great way to alleviate stress.

3. Regular Check-ups: Continue to follow up with your healthcare provider. If your symptoms persist or worsen, or if you notice any new symptoms (such as significant weight loss, persistent abdominal pain, or changes in appetite), it’s important to seek further evaluation. You might consider discussing your health anxiety with your doctor, as they can provide support and possibly refer you to a mental health professional if needed.

4. Monitor Symptoms: Keep track of your bowel habits, including frequency, consistency, and any associated symptoms. This information can be helpful for your healthcare provider in assessing your condition.

5. Avoid Self-Diagnosis: While it’s natural to search for answers online, self-diagnosing can lead to increased anxiety. Instead, focus on discussing your concerns with a medical professional who can provide accurate information and guidance.

6. Communication with Your Doctor: When you do visit your doctor, be open about your concerns regarding your bowel health and any anxiety you are experiencing. This can help them understand your situation better and provide tailored advice.

In conclusion, while it’s essential to be vigilant about changes in your bowel health, it’s equally important to manage anxiety and stress that may accompany these changes. By adopting a proactive approach to both your physical and mental health, you can work towards achieving a better balance and peace of mind. If you continue to feel uncertain or anxious about your health, don’t hesitate to seek further medical advice.

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