Blood in Stool: When to Seek Medical Advice

Suspected blood in the stool?

Hello Doctor: I have recently started monitoring my bowel movements (for about two weeks).
I have been having regular bowel movements every evening after dinner.
The first few days seemed quite normal, but I suspect I might have hemorrhoids, as I occasionally notice a small amount of bright red blood when wiping, though not every time (the stool is odorless, yellow, and not particularly thin).
However, yesterday I noticed a slight yellow-red discoloration in the stool (only in the latter part).
I used to have an irregular diet, and I am quite concerned about whether there might be any issues.
Could you please advise what this might be? Is there a need for a colonoscopy? Thank you, Doctor.

Niming, 20~29 year old female. Ask Date: 2018/12/28

Dr. Ke Fangxu reply Surgery

At the age of 25, the likelihood of developing colorectal cancer is not zero, but generally speaking, it is very, very low.
Based on your description, it seems more like hemorrhoids.
I recommend starting with a light diet and maintaining a good lifestyle.
Spicy, irritating, and greasy foods should be avoided.
Increasing your intake of dietary fiber can also be beneficial.
If symptoms persist without improvement, you may want to consult a physician for medication or to undergo a colonoscopy.

Reply Date: 2018/12/28

More Info

When it comes to blood in stool, it can be a concerning symptom that warrants careful evaluation. Based on your description, it seems that you have been experiencing some bleeding, possibly related to hemorrhoids, which is not uncommon. However, the presence of blood in stool can indicate a variety of conditions, some of which may require medical attention.

Possible Causes of Blood in Stool
1. Hemorrhoids: As you mentioned, hemorrhoids can cause bright red blood on the toilet paper or in the stool. This is usually due to straining during bowel movements and is often associated with pain or discomfort.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can also lead to bright red blood and are typically accompanied by sharp pain during bowel movements.

3. Gastrointestinal Bleeding: Blood can also originate from higher up in the gastrointestinal tract. Conditions such as diverticulosis, inflammatory bowel disease (IBD), or even colorectal cancer can cause bleeding. The color of the blood can provide clues; for example, dark or tarry stools may indicate bleeding from the upper GI tract.

4. Dietary Factors: Sometimes, certain foods can cause changes in stool color. For example, beets can cause a reddish tint, while foods high in yellow dye can lead to yellowish stools.

When to Seek Medical Advice
Given your symptoms, here are some guidelines on when to seek medical advice:
- Persistent Symptoms: If the bleeding continues or worsens, it is important to consult a healthcare provider.

- Change in Stool Color: The appearance of yellow-red stools, especially if it is a new symptom, should be evaluated.

- Associated Symptoms: If you experience additional symptoms such as abdominal pain, changes in bowel habits, weight loss, or fatigue, you should seek medical attention promptly.

- Age and Risk Factors: If you are over 50 or have a family history of colorectal cancer or other gastrointestinal diseases, it is advisable to be more vigilant.

Diagnostic Procedures
A colonoscopy is a common procedure used to evaluate the colon and rectum for abnormalities. It allows doctors to visualize the lining of the intestines and can help identify the source of bleeding. Given your concerns about dietary habits and the recent changes in your stool, a colonoscopy may be warranted, especially if symptoms persist.

Conclusion
While hemorrhoids and anal fissures are common causes of blood in stool, it is essential to rule out more serious conditions. Monitoring your symptoms and seeking medical advice if they persist or worsen is crucial. A healthcare provider can offer a thorough evaluation and recommend appropriate diagnostic tests, such as a colonoscopy, to ensure your gastrointestinal health is properly assessed. Remember, early detection and intervention are key to managing any potential health issues effectively.

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