Diarrhea with Blood: Causes and When to Seek Help

Diarrhea with blood in the stool?

Hello, Doctor: I have hemorrhoids and usually have a bowel movement every two days.
Recently, I have been experiencing severe constipation.
The day before yesterday, after having a bowel movement, there was no visible blood in the stool, and no blood upon wiping, and the shape was normal, but I felt that my bowel was not completely empty.
This morning, I had a soft stool (no blood), and tonight I experienced diarrhea, which was characterized by a lot of gas.
After the diarrhea, I noticed bright red blood upon wiping, and there was also fresh blood in the toilet (splashing).
I have no abdominal discomfort, just a strong urge to have a bowel movement.
The last time I had diarrhea was 17 days ago, and it was the same situation, with a lot of blood in the toilet.
Upon observing the diarrhea this time, I noticed a lot of mucus in the stool, and there was a very small amount of bright red blood mixed in, so I cannot confirm whether it was from contamination or if there was blood in the gastrointestinal tract.
Doctor, could diarrhea cause bleeding from hemorrhoids? Should I monitor my condition and seek medical attention only if there is no improvement? Thank you for your response!

Niming, 30~39 year old female. Ask Date: 2018/01/17

Dr. Ke Fangxu reply Surgery

This situation is likely due to diarrhea, which increases the possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid diarrhea 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 hemorrhoidal suppositories can be used as well.
If bleeding persists, it is advisable to consult a physician.
If necessary, a colonoscopy can be arranged.

Reply Date: 2018/01/17

More Info

Diarrhea with blood can be concerning, and it's important to understand the potential causes and when to seek medical help. In your case, you have a history of hemorrhoids and have recently experienced significant constipation followed by diarrhea with blood. Here’s a breakdown of the situation:
1. Causes of Blood in Stool: Blood in the stool can arise from various sources within the gastrointestinal tract. Common causes include hemorrhoids, anal fissures, diverticulosis, inflammatory bowel disease (IBD) such as Crohn's disease or ulcerative colitis, infections, and even colorectal cancer. Given your history of hemorrhoids, it is possible that the blood you observed could be due to hemorrhoidal bleeding, especially if you have been straining during bowel movements.

2. Hemorrhoids and Diarrhea: Hemorrhoids can indeed bleed, particularly after episodes of constipation or diarrhea. The straining associated with constipation can exacerbate hemorrhoids, leading to bleeding. Additionally, diarrhea can irritate the anal area, potentially causing existing hemorrhoids to bleed. The presence of mucus in your stool, along with the blood, could indicate irritation or inflammation in the intestines.

3. When to Seek Help: While minor bleeding from hemorrhoids may not be a cause for alarm, the presence of fresh blood in your stool, especially if it is recurrent, warrants medical evaluation. You should seek medical attention if:
- The bleeding persists or worsens.

- You experience significant abdominal pain or cramping.

- You notice changes in your bowel habits, such as increased frequency or consistency changes.

- You experience symptoms like fever, weight loss, or fatigue, which could indicate a more serious underlying condition.

4. Self-Monitoring: If the bleeding is minimal and you have no other concerning symptoms, you might consider monitoring your condition for a short period. However, given the recurrence of blood in your stool and your history of hemorrhoids, it would be prudent to consult a healthcare professional sooner rather than later. They may recommend a physical examination, possibly including a rectal exam, and may suggest further investigations like a colonoscopy to rule out other causes.

5. Potential Tests and Treatments: A healthcare provider may perform tests to determine the source of the bleeding. This could include blood tests, stool tests, or imaging studies. If hemorrhoids are confirmed as the source, treatments may range from dietary changes and topical treatments to more invasive procedures if necessary.

In summary, while hemorrhoids can cause bleeding, the presence of blood in your stool, especially with a change in bowel habits, should not be ignored. It is advisable to consult a healthcare provider for a thorough evaluation to rule out any serious conditions and to receive appropriate treatment. Your health is paramount, and addressing these symptoms early can lead to better outcomes.

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