Blood in Stool: When to Seek Surgical Advice

There is a small amount of blood in the stool?

In the evening, I had a bowel movement after holding it for about ten minutes.
The stool was formed, and since I usually have a lot, the amount this time was comparable to my usual.
It wasn't hard; in fact, I would describe it as soft, with a relatively thick diameter (which is typical for me).
I usually check my stool before flushing, and this time I noticed some slight traces of blood at the end of the stool.
The amount was small, and the color of the blood appeared to be dark red (fresh), visible under a flashlight, not black.
There didn't seem to be any mucus; the situation was similar to blood stains appearing on the last part of the stool, which was somewhat soft and had a clay-like consistency, but 95-98% of the stool was formed.
It felt like the blood traces were not attached to the stool.
The overall color of the stool was golden brown, and there were "no" blood traces on the toilet paper.
The stool on the paper appeared to be a very light orange-brown, possibly due to eating pumpkin.
I've been passing gas more frequently these past few days, and it has been quite foul.
There is no abdominal pain, no significant weight loss, and no urgency.
A few days ago, I occasionally experienced sharp pain around the anus, but it wasn't frequent, lasting about a second each time.
Since I am studying abroad, I may be under increased stress lately.
I would like to ask a doctor how I should handle this situation.
Thank you very much!

Xiao Le, 30~39 year old female. Ask Date: 2018/02/26

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 to avoid taking stool softeners indiscriminately.
If bleeding persists, it is advisable to consult a physician.
If necessary, a colonoscopy can be arranged.

Reply Date: 2018/02/26

More Info

When it comes to the presence of blood in the stool, it is essential to approach the situation with caution and awareness of potential underlying issues. Based on your description, it seems that you have noticed some minor blood streaks on the last part of your stool, which is soft and not particularly hard. The blood appears to be a deep red color, and you have not observed any blood on the toilet paper after wiping. Additionally, you mentioned experiencing occasional sharp pains around the anal area, but there are no significant changes in your weight or bowel habits.

Here are some key points to consider regarding your situation:
1. Possible Causes: Blood in the stool can arise from various sources, including hemorrhoids, anal fissures, diverticular disease, or more serious conditions such as gastrointestinal bleeding from polyps or tumors. Given that you have experienced occasional sharp pains in the anal area, it is possible that you may have a hemorrhoid or an anal fissure, which can cause minor bleeding, especially after a bowel movement.

2. Characteristics of the Blood: The fact that the blood is bright red and appears only on the stool's surface suggests that it is likely coming from the lower gastrointestinal tract, such as the rectum or anus. Darker blood or black stools typically indicate bleeding from higher up in the gastrointestinal tract, which is more concerning.

3. When to Seek Medical Advice: While minor bleeding may not always indicate a serious problem, it is crucial to monitor the situation closely. You should seek medical advice if:
- The bleeding persists or worsens.

- You experience significant pain, discomfort, or changes in bowel habits.

- You notice any other concerning symptoms, such as weight loss, fatigue, or changes in appetite.

- You have a family history of gastrointestinal diseases.

4. Stress and Lifestyle Factors: You mentioned that you are currently under stress due to studying abroad. Stress can exacerbate gastrointestinal issues and may contribute to symptoms like increased gas and changes in bowel habits. It is essential to manage stress through relaxation techniques, regular exercise, and a balanced diet.

5. Next Steps: Given your current symptoms, it would be prudent to consult a healthcare professional for a thorough evaluation. They may recommend a physical examination, possibly including a rectal exam, and may suggest further diagnostic tests such as a colonoscopy if necessary. This will help rule out any serious conditions and provide peace of mind.

6. Self-Care Measures: In the meantime, consider adopting some self-care measures:
- Increase your fiber intake to promote regular bowel movements and prevent straining.

- Stay hydrated to help soften your stool.

- Avoid heavy lifting or straining during bowel movements.

- If you suspect hemorrhoids, over-the-counter treatments may provide relief.

In conclusion, while the presence of blood in your stool can be alarming, it is essential to assess the situation carefully. Monitoring your symptoms and seeking medical advice when necessary will help ensure that any potential issues are addressed promptly. Remember, your health is paramount, and it is always better to err on the side of caution when it comes to unusual symptoms.

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