Blood in Stool: Causes and Concerns for Your Health

Rectal bleeding

Hello, doctor.
About a year ago, I noticed blood in my stool.
Initially, the stool was coffee-colored and banana-shaped, but after 5-10 minutes, blood would seep out from underneath the stool, settling at the bottom of the toilet without mixing with the water.
This doesn't seem like hemorrhoid symptoms, as the initial stool was normal, and the blood felt like it was oozing out.
This situation occurs about 1-2 times a month and is not continuous.
I would appreciate your insight, as my grandfather passed away from colon cancer, which makes me a bit concerned about the possibility of cancer.

Niming, 10~19 year old female. Ask Date: 2017/10/19

Dr. Chen Jiaming reply Surgery

Your description is indeed quite unusual.
I recommend that the next time you experience this condition, you schedule a simple fecal occult blood test with a gastroenterologist or a colorectal surgeon.
Your age is not typically associated with a high incidence of colorectal cancer, and your symptoms do not seem to align with it.

Reply Date: 2017/10/19

More Info

Understanding blood in stool can be a concerning issue, especially given your family history of colorectal cancer. It's important to approach this symptom with caution and seek medical advice. Blood in the stool can arise from various causes, some benign and others more serious.
From your description, it appears that you experience blood in your stool intermittently, with the blood settling at the bottom of the toilet bowl and not mixing with the water. This could suggest that the blood is coming from a source in the lower gastrointestinal tract, such as the rectum or anus, rather than from higher up in the digestive system, where it might mix with the stool and change color (like in the case of upper GI bleeding, which often results in black, tarry stools).

Here are some potential causes of blood in the stool:
1. Hemorrhoids: While you mentioned that this doesn't seem like a hemorrhoid issue, it's still worth noting that hemorrhoids can cause bright red blood, especially during bowel movements. They are swollen veins in the lower rectum or anus.

2. Anal fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to bright red blood on the stool or toilet paper.

3. Diverticular disease: Diverticula are small pouches that can form in the walls of the colon. If they become inflamed or infected (diverticulitis), they can cause bleeding.

4. Polyps: These are growths on the lining of the colon or rectum. Some polyps can bleed, and while many are benign, certain types can develop into cancer over time.

5. Colorectal cancer: Given your family history, this is a valid concern. Blood in the stool can be a symptom of colorectal cancer, especially if accompanied by changes in bowel habits, unexplained weight loss, or abdominal pain.

6. Gastrointestinal infections: Certain infections can cause inflammation and bleeding in the intestines.

7. Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can lead to blood in the stool due to inflammation of the intestinal lining.

Given your symptoms and family history, it is crucial to consult a healthcare provider for a thorough evaluation. They may recommend a colonoscopy, which is a procedure that allows doctors to view the inside of the colon and rectum, and can help identify the source of bleeding. Other diagnostic tests, such as stool tests or imaging studies, may also be necessary.

In the meantime, keep track of your symptoms. Note the frequency of the blood in your stool, any accompanying symptoms (like pain, changes in bowel habits, or weight loss), and any dietary changes. This information can be very helpful for your healthcare provider.

It’s understandable to feel anxious about the possibility of serious conditions like cancer, especially with a family history. However, many causes of blood in the stool are treatable and not life-threatening. Early detection and intervention are key, so don’t hesitate to seek medical advice. Your health is paramount, and addressing these symptoms promptly can lead to better outcomes.

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