Blood in Stool: Causes and When to Seek Help

Blood streaks or clots in the stool?

Hello, doctor.
I discovered blood in my stool the day before yesterday.
Last year, I had a few instances where I noticed blood or blood-tinged fluid on toilet paper after wiping, but sometimes it coincided with my menstrual period or was after eating some red fruits and vegetables, so I didn't pay much attention to it.
I am a student who often eats out, and my lifestyle is irregular; however, my bowel movements are usually regular, and I have never experienced constipation.
In the past few months, I have occasionally felt abdominal pain right after eating, and sometimes I have 2 to 3 bowel movements a day, where I can see food fibers in my stool.
I thought it was due to eating too quickly or possibly unclean food.
Sometimes after a bowel movement, I feel like there is still more to pass, so I continue to sit, and a little bit more stool comes out.
Over the past year, my stool has often been thinner than before, and occasionally after wiping, I notice mucus on the toilet paper, which I am quite sure is coming out with the stool.
The stool color is normal, but the shape is often small and somewhat soft.
Recently, my stomach makes loud gurgling noises after eating, and people often joke that I didn't eat enough.
The day before yesterday, my bowel movement was smooth and without discomfort, but when I wiped, I noticed a faint red blood stain on the toilet paper along with the stool.
After wiping a couple of times, it was gone.
The stool was a normal color and felt somewhat soft, and the toilet water had no color, but there seemed to be slight reddish-brown streaks on the toilet bowl slope.
About one to two hours later, I felt the urge to go again.
The second bowel movement was also quick and smooth, without pain, but I noticed a red lump at the end of the stool.
When I picked it up with chopsticks, it was about the size of a coin and resembled a jelly-like blood clot.
When I broke it apart, the texture was thick and seemed to contain a bit of clear mucus, not entirely blood.
The next day's stool was very normal, with a normal color and well-formed.
However, today during my bowel movement, I again noticed blood mixed with the stool, and there were a few tiny blood streaks that were hard to see with the naked eye.
My weight has remained stable, with no loss.
Last year, my grandmother had a benign colon polyp removed, and my family thinks that at my young age, it might be internal hemorrhoids, but I don't feel any discomfort, and the amount of blood is very small.
There was another instance with a blood clot-like substance.
I would like to consult with you, doctor.
Thank you!

Nìmíng, 20~29 year old female. Ask Date: 2018/01/14

Dr. Ke Fangxu reply Surgery

This situation likely indicates a higher possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Increasing dietary fiber intake can also be beneficial.
Warm sitz baths may help alleviate symptoms, and over-the-counter hemorrhoid suppositories can be used.
It is best not to take stool softeners indiscriminately.
If bleeding persists, it is advisable to consult a physician for evaluation.
If necessary, a colonoscopy can also be arranged.

Reply Date: 2018/01/14

More Info

When it comes to the presence of blood in stool, it is essential to understand the potential causes and when to seek medical attention. Blood in the stool can be alarming, and while it can sometimes be benign, it can also indicate more serious conditions that require prompt evaluation.

Possible Causes of Blood in Stool
1. Hemorrhoids: One of the most common causes of blood in the stool, especially in young adults, is hemorrhoids. These are swollen blood vessels in the rectal area that can bleed during bowel movements, often resulting in bright red blood on toilet paper or in the toilet bowl.

2. Anal Fissures: Small tears in the lining of the anus can occur due to passing hard stools or straining during bowel movements. This can lead to bright red blood and discomfort.

3. Diverticular Disease: Diverticulosis, which involves small pouches forming in the colon wall, can lead to diverticulitis, where these pouches become inflamed or infected, potentially causing bleeding.

4. Polyps or Colorectal Cancer: Although less common in younger individuals, polyps (growths on the colon lining) can bleed. Some polyps can be precursors to colorectal cancer, making it important to monitor any changes in bowel habits or stool appearance.

5. Gastrointestinal Infections: Certain infections can cause inflammation and bleeding in the gastrointestinal tract, leading to blood in the stool.

6. Inflammatory Bowel Disease (IBD): Conditions such as Crohn's disease or ulcerative colitis can cause significant inflammation and bleeding in the digestive tract.

When to Seek Medical Help
Given your symptoms, it is crucial to consult a healthcare provider, especially since you have noticed blood in your stool multiple times, along with changes in bowel habits. Here are some specific indicators that warrant immediate medical attention:
- Persistent Blood: If you continue to see blood in your stool over several days, it is essential to seek evaluation.

- Change in Bowel Habits: Any significant changes in your bowel habits, such as increased frequency or consistency changes, should be discussed with a doctor.

- Associated Symptoms: If you experience additional symptoms such as abdominal pain, weight loss, fever, or changes in appetite, these could indicate a more serious condition.

- Family History: Given your family history of colon polyps, it is prudent to be proactive about your gastrointestinal health.

Recommended Steps
1. Consult a Gastroenterologist: A specialist can perform a thorough evaluation, which may include a physical examination, blood tests, and possibly imaging studies or a colonoscopy to visualize the colon and rectum directly.

2. Diet and Lifestyle: As a student with irregular eating habits, consider adopting a balanced diet rich in fiber, which can help regulate bowel movements and potentially reduce the risk of hemorrhoids and constipation.

3. Hydration: Ensure you are drinking enough fluids, as dehydration can lead to harder stools and increased straining during bowel movements.

4. Monitor Symptoms: Keep a detailed record of your symptoms, including the frequency and appearance of blood, any associated pain, and dietary habits. This information will be valuable for your healthcare provider.

In summary, while some causes of blood in the stool can be benign, it is essential to take this symptom seriously, especially given your history and the frequency of occurrence. Seeking medical advice is the best course of action to ensure your health and peace of mind.

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