Blood in Stool: When to Seek Medical Attention

Rectal bleeding

Yesterday, I had blood in my stool for the first time.
The initial stool was somewhat hard and did not have blood, but later I had two pieces of stool, each with a small strip of red blood on the surface, and one large hard stool with more blood on the surface.
I noticed slight blood when wiping after the first and second bowel movements.
Today, I had several bowel movements; the first one was very thick, followed by several yellow soft stools, which appeared to have no blood on the surface, and there was no blood when wiping.
However, there was red liquid sediment in the water around the stool.
I had a colonoscopy over three years ago that showed no abnormalities.
Should I have another colonoscopy, or is it sufficient to consult a physician for a digital rectal exam? Thank you.

Liú, 30~39 year old female. Ask Date: 2018/01/16

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 you can purchase hemorrhoid suppositories at the pharmacy.
It is best not to take laxatives indiscriminately.
Although the risk of developing colorectal cancer at the age of 37 is not zero, it is generally considered relatively low.
Based on your description, it seems more like hemorrhoids.
It is advisable to maintain a light diet and a good lifestyle routine, avoiding spicy, irritating, and greasy foods.
If bleeding persists, it is best to consult a physician for evaluation, and a colonoscopy may be arranged if necessary.

Reply Date: 2018/01/16

More Info

When it comes to noticing blood in your stool, it is essential to take this symptom seriously and seek medical attention promptly. Blood in the stool can be indicative of various underlying conditions, some of which may require immediate intervention.
In your case, the presence of bright red blood on the surface of your stool, especially if it is accompanied by hard stools, could suggest a few possibilities. The most common cause of bright red blood in the stool is hemorrhoids, which are swollen blood vessels in the rectal area that can bleed during bowel movements, particularly if the stool is hard and difficult to pass. Another possibility is anal fissures, which are small tears in the lining of the anus that can occur due to straining during bowel movements.

However, while hemorrhoids and fissures are common and often benign causes of rectal bleeding, it is crucial to rule out more serious conditions. These can include diverticular disease, inflammatory bowel disease (IBD) such as Crohn's disease or ulcerative colitis, and even colorectal cancer, especially if you have a family history of gastrointestinal diseases or if you are over the age of 50.

Given that you had a colonoscopy three years ago with no abnormalities found, it may seem less likely that you have a serious condition, but it is still important to consider that new symptoms can arise. The fact that you have experienced blood in your stool again warrants further evaluation.
Here are some steps you should consider taking:
1. Consult a Healthcare Provider: It is advisable to contact your healthcare provider as soon as possible. They may recommend a physical examination, which could include a digital rectal exam to assess for any abnormalities in the rectal area.

2. Consider a Follow-Up Colonoscopy: Depending on your age, medical history, and the characteristics of the blood in your stool, your doctor may recommend a follow-up colonoscopy. This is particularly important if the bleeding persists, if you experience changes in your bowel habits, or if you have any other concerning symptoms such as weight loss, abdominal pain, or changes in appetite.

3. Monitor Symptoms: Keep track of your bowel movements, noting any changes in color, consistency, or frequency, as well as any associated symptoms like pain, discomfort, or changes in appetite. This information can be valuable for your healthcare provider.

4. Dietary Considerations: Ensure you are consuming a diet high in fiber to help prevent constipation and hard stools, which can exacerbate issues like hemorrhoids and fissures. Staying hydrated is also crucial.

5. Avoid Self-Diagnosis: While it may be tempting to search for answers online, it is essential to avoid self-diagnosing. Many gastrointestinal conditions can present similarly, and only a healthcare professional can provide an accurate diagnosis and appropriate treatment.

In summary, while the presence of blood in your stool can often be attributed to benign causes like hemorrhoids or fissures, it is essential to seek medical attention to rule out more serious conditions. Early intervention can lead to better outcomes, so do not hesitate to reach out to your healthcare provider for guidance.

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