Blood in Stool: When to See a Doctor and What Tests to Expect - Internal Medicine

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Rectal bleeding


If you often notice blood at the bottom of the toilet after having a bowel movement, with no blood elsewhere, and the blood appears to be mixed with stool but is not very noticeable, and the blood is not bright red while the stool is brown, which type of specialist should you see and what kind of tests should be done? Thank you for your assistance!

ryook, 20~29 year old female. Ask Date: 2017/09/11

Dr. Xiao Yongxun reply Internal Medicine


Dear Mr.
Ryook:
1.
Generally speaking, if the blood in the stool appears bright red, it may indicate lower gastrointestinal bleeding; if the color is dark black and shiny like tar, it should be considered as upper gastrointestinal bleeding.

2.
Stool that is brown in color can be normal, but it may also indicate minor bleeding; if necessary, a fecal occult blood test (either biochemical or immunological) should be conducted.

3.
If you are considering visiting a general hospital, you can go directly to the colorectal surgery department or the hepatobiliary and gastroenterology department.
As for what examinations to undergo, it is advisable to discuss this with your attending physician.

Reply Date: 2017/09/11

More Info


Seeing blood in your stool can be concerning, and it’s important to understand what it might indicate and when to seek medical attention. Blood in the stool can arise from various sources within the gastrointestinal tract, and the color and consistency of the blood can provide clues about its origin.


When to See a Doctor
You should definitely see a doctor if you notice blood in your stool, especially if it is persistent or accompanied by other symptoms such as:
- Abdominal pain or cramping
- Changes in bowel habits (such as diarrhea or constipation)
- Unexplained weight loss
- Fatigue or weakness
- Dizziness or fainting
Given your description of the blood being present at the bottom of the toilet bowl and mixed with your stool, it’s crucial to have this evaluated. The fact that the blood is not bright red could suggest that it is coming from higher up in the gastrointestinal tract, such as the colon or even the stomach, rather than from hemorrhoids or anal fissures, which typically produce bright red blood.


Which Specialist to See
For blood in the stool, you would typically start by seeing a gastroenterologist, a doctor who specializes in the digestive system. They will be able to evaluate your symptoms and determine the necessary tests.


Tests You Might Expect
1. Physical Examination: The doctor will likely start with a thorough physical examination, including a rectal exam, to check for any obvious sources of bleeding.

2. Blood Tests: A complete blood count (CBC) may be ordered to check for anemia, which can occur if there has been significant blood loss.

3. Stool Tests: The doctor may request a stool sample to check for the presence of blood (occult blood test) or to test for infections.

4. Colonoscopy: This is a common procedure where a flexible tube with a camera is inserted into the rectum to visualize the colon. It allows the doctor to look for polyps, tumors, or other abnormalities that could be causing the bleeding.

5. Upper Endoscopy: If the doctor suspects that the bleeding might be coming from the upper gastrointestinal tract (esophagus, stomach, or duodenum), they may recommend an upper endoscopy.

6. Imaging Studies: In some cases, imaging studies such as a CT scan may be necessary to get a better look at the structures in your abdomen.


Conclusion
In summary, seeing blood in your stool is a symptom that should not be ignored. It is essential to consult a gastroenterologist who can guide you through the necessary evaluations and tests. Early diagnosis and treatment are crucial, as they can help identify serious conditions such as colorectal cancer, inflammatory bowel disease, or gastrointestinal bleeding from other sources.
Make sure to document any additional symptoms you may have and share them with your doctor, as this information can be vital for diagnosis. Remember, while it can be alarming to see blood in your stool, many causes are treatable, and timely medical intervention can lead to better outcomes.

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