Blood in Stool: Causes and Solutions for Digestive Health

Bowel issues

Hello Doctor, since last week, I have noticed blood on the toilet paper after having a bowel movement.
Yesterday, there was even a small amount of blood in the toilet, and I mistakenly thought my menstrual period had started.
I have had bowel movements for two consecutive days (yesterday and today), and again, there was blood when I wiped, along with a bit of mucus.
However, the shape of my stool has been normal, and I do not experience pain in the anus after bowel movements.
The first two times, I felt the stool was a bit rough, and I suspect it might be a fissure.
Today, it seems that the injury has not healed and has reopened (last night, I asked a family member to apply some medication).
My family suggests that it might be due to my recent low fluid intake and insufficient fiber.
What could be the issue? Thank you.

Li En, 20~29 year old female. Ask Date: 2017/08/24

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, if you experience pain in the anus during bowel movements, it may be due to anal fissures.
You can take stool softeners and apply topical medications.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2017/08/24

More Info

When you notice blood in your stool or on toilet paper after wiping, it can understandably cause concern. The presence of blood can be attributed to several potential causes, and understanding these can help you address the issue effectively. Based on your description, it seems you might be experiencing a common condition related to bowel movements, but it’s essential to consider various factors.

Possible Causes of Blood in Stool
1. Hemorrhoids: This is one of the most common causes of blood in the stool, especially if the blood is bright red and appears on the toilet paper or in the toilet bowl. Hemorrhoids are swollen veins in the lower rectum or anus that can bleed during bowel movements, particularly if you are straining or if your stool is hard.

2. Anal Fissures: Given your mention of having rough stools, it’s possible that you may have developed anal fissures. These are small tears in the lining of the anus that can occur when passing hard or large stools, leading to bleeding and pain during bowel movements.

3. Diverticular Disease: This condition involves the formation of small pouches in the colon wall, which can become inflamed or infected, leading to bleeding. However, this is less common in younger individuals.

4. Inflammatory Bowel Disease (IBD): Conditions such as Crohn's disease or ulcerative colitis can cause inflammation in the digestive tract, leading to symptoms like blood in the stool, diarrhea, and abdominal pain.

5. Polyps or Colorectal Cancer: While less likely, especially if you are younger and otherwise healthy, polyps can bleed and may be a sign of colorectal cancer. Regular screenings are recommended based on age and risk factors.

Recommendations for Management
1. Increase Fiber and Hydration: Since your family suggested that you may not be drinking enough water and not getting enough fiber, it’s crucial to address these dietary factors. Increasing your fiber intake through fruits, vegetables, whole grains, and legumes can help soften your stool and make it easier to pass, reducing the risk of fissures and hemorrhoids. Additionally, drinking plenty of water can help maintain hydration and support healthy bowel movements.

2. Avoid Straining: When you feel the urge to go, try not to delay your bowel movements, as this can lead to harder stools. If you find yourself straining, consider using a stool softener or a fiber supplement after consulting with a healthcare provider.

3. Topical Treatments: If you suspect hemorrhoids or fissures, topical treatments such as hydrocortisone creams or over-the-counter ointments can help reduce inflammation and promote healing. However, it’s essential to follow the instructions and consult a healthcare professional if symptoms persist.

4. Monitor Symptoms: Keep track of your symptoms, including the frequency and amount of blood, any associated pain, changes in bowel habits, or the presence of mucus. This information will be helpful for your healthcare provider.

5. Consult a Healthcare Provider: Given that you have experienced this issue for a couple of days, it would be wise to consult a healthcare provider for a thorough evaluation. They may recommend a physical examination, and possibly a colonoscopy or other diagnostic tests, to rule out any serious conditions.

Conclusion
While the presence of blood in your stool can be alarming, many cases are due to benign conditions such as hemorrhoids or anal fissures, especially if there is no pain associated with bowel movements. However, it’s crucial to take this symptom seriously and seek medical advice to ensure proper diagnosis and treatment. By addressing dietary habits and consulting with a healthcare professional, you can work towards improving your digestive health and alleviating your symptoms.

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