Blood in Stool: Should You Worry About Colon Health?

Blood in the stool?

Hello, doctor.
About six months ago, I underwent a colonoscopy due to the discovery of blood in my stool.
The results were normal, although five small polyps were removed, which was considered a relatively high number.
The physician at that time mentioned that my bowel preparation was good, but not excellent, and recommended a follow-up examination in a year.
They also noted that I had mild hemorrhoids, but I did not experience any discomfort in the anal area, so I did not ask further questions.

Recently, I have noticed blood in my stool again, occurring approximately once every 3-4 weeks.
The frequency is low; sometimes there are tiny streaks of bright red blood mixed in with the stool, but there is no blood on the toilet paper.
Other times, there are small streaks of blood on the toilet paper, but none in the stool.
My daily routine is normal, I exercise regularly, eat fruits and vegetables, and drink 1500-2000 cc of water.
I have bowel movements 1-2 times a day, which are smooth and not constipated, mostly in the form of well-formed stools.
Occasionally, I experience diarrhea after indulging in greasy takeout or consuming too much milk.
I would like to ask if I need to undergo another colonoscopy.
Could this be due to internal hemorrhoids bleeding, even though I do not feel any discomfort in the anal area? I am quite confused and would appreciate your guidance.
Thank you!

k, 20~29 year old female. Ask Date: 2017/11/25

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Mr.
Internal hemorrhoids are vascular tissues located at the anal opening, which may occasionally bleed due to friction from prolonged sitting or constipation.
Generally, this condition is not serious.
However, since you have a history of polyps, it is important to follow the recommended schedule for monitoring to check if any new polyps have developed.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2017/11/25

More Info

When it comes to the presence of blood in your stool, it can understandably cause concern, especially given your previous history of polyps and mild hemorrhoids. Blood in the stool can arise from various sources, and understanding these can help alleviate some of your worries while guiding you on the next steps to take.

Firstly, it's important to note that the appearance of blood in the stool can be categorized based on its color and consistency. Bright red blood typically suggests that the source of bleeding is closer to the rectum or anus, such as hemorrhoids or anal fissures. In contrast, darker blood or tarry stools may indicate bleeding from higher up in the gastrointestinal tract, such as the stomach or small intestine.

Given your history of mild hemorrhoids, it is indeed possible that the blood you are observing could be related to this condition. Hemorrhoids can cause intermittent bleeding, especially during bowel movements, and may not always be accompanied by discomfort. The fact that you have not experienced any significant pain or discomfort in the anal area supports this possibility. However, the intermittent nature of your symptoms—occurring every few weeks—could also suggest other benign causes, such as minor tears or fissures, particularly if you occasionally consume oily or rich foods that may lead to softer stools.

Your previous colonoscopy, which revealed small polyps, is also a relevant factor. While the removal of polyps is a preventive measure against colorectal cancer, it is crucial to continue monitoring your bowel health. The recommendation for a follow-up colonoscopy in a year is standard practice, especially given your history. If you notice any changes in the frequency or nature of the bleeding, or if it becomes more pronounced, it would be prudent to consult your healthcare provider sooner.

In terms of your current lifestyle, it sounds like you are maintaining a healthy diet rich in fruits and vegetables, which is excellent for digestive health. Staying hydrated and having regular bowel movements are also beneficial. However, if you find that certain foods, like dairy or greasy meals, lead to gastrointestinal upset, it may be worth considering adjustments to your diet or consulting with a nutritionist.

Regarding your question about whether you should undergo another colonoscopy, it ultimately depends on the frequency and severity of the bleeding. If the blood in your stool persists or worsens, or if you start experiencing additional symptoms such as abdominal pain, changes in bowel habits, or weight loss, it would be advisable to seek further evaluation. A repeat colonoscopy may be warranted to rule out any new developments, especially since you have a history of polyps.

In summary, while the presence of blood in your stool can be alarming, it is essential to consider the context, including your medical history and lifestyle. Mild hemorrhoids could be a likely cause, but any persistent or concerning symptoms should prompt a discussion with your healthcare provider. Regular monitoring and open communication with your doctor will help ensure that any potential issues are addressed promptly.

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