Blood in Stool: Is It Hemorrhoids or Colon Cancer?

Rectal bleeding

Hello, doctor.
Today at noon, I felt very uncomfortable in my stomach because I ate too much.
I went to the bathroom and spent a long time there, eventually experiencing diarrhea.
After that, I felt a bit better and took a nap.
Around 3 PM, I felt uncomfortable again and went to the bathroom, but this time I couldn't have a bowel movement; I only passed gas.
When I wiped, I noticed a pool of bright red blood on the toilet paper, but there was no pain.
Although I didn't have a significant bowel movement, I kept passing gas from 3 PM until dinner time.
I want to know if this is hemorrhoids or colon cancer, and whether I need to get a colonoscopy.
(Additionally, I've been staying up late recently; for instance, I only slept 2 to 3 hours today.
I wonder if this is related.)
Supplement 1: I had surgery on my small intestine when I was younger, so I've often experienced diarrhea and digestive issues throughout my life.
I read online that one of the symptoms of colon cancer can also be diarrhea.

Supplement 2: A few months ago, I had pain from my wisdom teeth and was prescribed antibiotics at the hospital.
The side effects mentioned diarrhea, which was different from my usual diarrhea and was dark brown in color.
At that time, I also had some anal fissures, which healed but then reopened due to the diarrhea, causing pain and some blood when wiping.
I read online that recurrent anal fissures can lead to hemorrhoids, so could this be a contributing factor?
Supplement 3: This is the third time I've noticed blood in my stool.
The first time was around April or May when I noticed dark brown blood in the toilet.
At that time, I was also experiencing wisdom tooth pain and was taking anti-inflammatory painkillers and antibiotics, so I didn't think much of it, and the next day it returned to normal.
On the 21st of last month, I noticed blood in my stool for the second time, but this time it wasn't visible in the toilet; I only saw some dark brown blood when wiping, and it also returned to normal the next day.
This time is the third occurrence, but the blood is bright red.

Niming, 30~39 year old female. Ask Date: 2018/07/27

Dr. Ke Fangxu reply Surgery

At the age of 37, the likelihood of developing colorectal cancer is not zero, but generally, it is relatively low.
Based on your description, it seems more like bleeding from hemorrhoids rather than from an anal fissure.
However, a doctor's examination is necessary to confirm the diagnosis.
It is advisable to maintain a light diet and good lifestyle habits, avoiding spicy, irritating, and greasy foods.
Increasing dietary fiber intake can also be beneficial.
If symptoms persist without improvement, you may consult a physician for medication or to undergo a colonoscopy.

Reply Date: 2018/07/27

More Info

When it comes to the presence of blood in stool, it can be a concerning symptom that warrants careful evaluation. Your situation raises several important points regarding potential causes, including hemorrhoids and colon cancer, as well as the influence of dietary habits and previous medical history.

Firstly, the fact that you have observed fresh red blood on the toilet paper after bowel movements suggests that the bleeding is likely originating from the lower gastrointestinal tract, which includes the rectum and anus. This is often associated with conditions such as hemorrhoids or anal fissures, especially if you have a history of constipation or straining during bowel movements. Hemorrhoids are swollen veins in the rectum or anus that can bleed, particularly during bowel movements. Anal fissures, which are small tears in the lining of the anus, can also cause pain and bleeding, especially if you have experienced hard stools or straining.

Your mention of having had surgery on your small intestine and experiencing chronic diarrhea and digestive issues adds another layer of complexity. Surgical history can sometimes lead to changes in bowel habits and may predispose individuals to conditions like irritable bowel syndrome (IBS), which can cause alternating patterns of diarrhea and constipation. Additionally, the use of antibiotics, as you noted, can disrupt the normal gut flora and lead to gastrointestinal symptoms, including diarrhea.

Regarding your concern about colon cancer, it is important to note that while blood in the stool can be a symptom of colon cancer, it is not the only indicator. Colon cancer symptoms can include changes in bowel habits, unexplained weight loss, abdominal discomfort, and fatigue. However, the presence of bright red blood is more commonly associated with lower gastrointestinal issues rather than cancer, especially in younger individuals. Given your age and the intermittent nature of your symptoms, the likelihood of colon cancer is lower, but it cannot be completely ruled out, especially considering your family history.

In your case, since this is the third instance of blood in your stool, it would be prudent to seek medical evaluation. A healthcare provider may recommend a digital rectal exam and possibly a colonoscopy to visualize the colon and rectum directly. A colonoscopy is particularly important if there are any concerning features, such as a change in bowel habits, persistent bleeding, or if you have a family history of colorectal cancer.
Additionally, lifestyle factors such as sleep deprivation can impact gastrointestinal health. Chronic lack of sleep can lead to increased stress and may exacerbate digestive issues. It’s essential to maintain a balanced diet rich in fiber, stay hydrated, and manage stress levels to promote healthy bowel function.

In summary, while your symptoms may suggest hemorrhoids or anal fissures, the presence of blood in the stool warrants further investigation to rule out more serious conditions. It is advisable to consult with a gastroenterologist who can provide a thorough assessment and recommend appropriate diagnostic tests. Early detection and intervention are key to managing any potential gastrointestinal issues effectively.

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