Occasional Blood in Stool: Causes and Concerns

Q: Occasional Blood in Stool: Causes and Concerns

Hello： The majority of the condition mentioned is caused by hemorrhoids. <br>For safety reasons, it is recommended to visit a hospital's colorectal surgery department for further examination to confirm the cause. <br>Thank you for your message!

Sometimes there is blood when wiping after a bowel movement?

I have been experiencing blood in my stool occasionally when I wipe after a bowel movement.
The blood appears to be bright red and usually resolves within 2 to 3 days, but then it recurs after some time.
This has been happening for over a month now.
The first time I noticed blood was on November 26 of last year, when I saw the toilet water turn red, although the stool itself was normal in shape.
There was bright red blood on the toilet paper after wiping.
The next day, there was less blood in the toilet water, and the stool remained shaped (with some blood seeping from the bottom).
After about three days, the situation gradually improved, and there was no blood.
About a month later, around December 26, I noticed blood again after wiping.
This lasted for 2 to 3 days before returning to normal.
Then, after another week or two, I found blood again (mostly visible on the toilet paper, sometimes with blood or a yellowish-orange liquid seeping from the bottom of the stool).
This has been ongoing for nearly two months now.
Recently, I noticed blood again during bowel movements (which has since improved).
On January 10, I had two bowel movements; the first consisted of three pieces that were dark brown with yellowish discharge, one of which floated.
The second was more like shaped stool, and there was a little blood on the toilet paper after both movements.
On January 13, the stool was shaped but appeared dry and cracked on the surface, with fresh blood seeping from the bottom of the toilet.
There was blood on the toilet paper as well.
The next day, January 14, the stool remained shaped, and the blood appeared to be less.
There were some clots on the surface of the stool, but I wasn't sure if they were remnants.
There was also a bit of blood seeping from the bottom (when I first looked in the toilet right after the bowel movement, there was no blood, but after standing up, I noticed some seeping out).
On January 15 and 16, my bowel movements appeared normal again with no blood.
I had an acute appendicitis surgery in April last year, and the doctor mentioned that the ruptured appendix might have caused some mucous to adhere to the intestines, advising me to eat smaller, more digestible meals.
In June, I had developed 2 to 3 external hemorrhoids, which improved with medication and are now gone.
My weight has remained stable over the past two months, my appetite is about the same, and I have been having bowel movements almost every day.
When I first noticed blood in my stool, I consulted a doctor who looked at a photo and said it was likely hemorrhoids.
Occasionally, I experience slight pain, irritation, and moisture (sweat) around the anal area.

Mr. Zhou, 20~29 year old female. Ask Date: 2019/01/16

Dr. Xie Rongyuan reply Internal Medicine

Hello: The majority of the condition mentioned is caused by hemorrhoids.
For safety reasons, it is recommended to visit a hospital's colorectal surgery department for further examination to confirm the cause.
Thank you for your message!

Reply Date: 2019/01/16

More Info

When it comes to the occasional presence of blood in stool, it's important to understand that this symptom can arise from various causes, some of which may be benign while others could indicate more serious health issues. Based on your description, it seems that you have experienced intermittent episodes of bright red blood on toilet paper and occasionally in the toilet bowl after bowel movements, with periods of improvement lasting a few days to weeks.
The most common causes of bright red blood in the stool include:
1. Hemorrhoids (Piles): Given your previous history of external hemorrhoids, this is a likely cause. Hemorrhoids can bleed, especially during bowel movements, and the blood is usually bright red due to its proximity to the anal opening. Straining during bowel movements or passing hard stools can exacerbate this condition.

2. Anal Fissures: These are small tears in the lining of the anus that can occur due to passing hard stools. They often cause sharp pain during and after bowel movements, along with bright red blood.

3. Diverticular Disease: Diverticula are small pouches that can form in the walls of the colon. If these become inflamed or infected, they can bleed, leading to blood in the stool.

4. Colorectal Polyps or Cancer: Although less common, especially in younger individuals, polyps or colorectal cancer can cause bleeding. The blood may be bright red or darker, depending on the location of the bleeding within the gastrointestinal tract.

5. Gastrointestinal Infections: Certain infections can cause inflammation and bleeding in the intestines, leading to blood in the stool.

6. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can lead to bleeding due to inflammation of the intestinal lining.

Given your history of acute appendicitis and the surgical intervention you underwent, it's also worth noting that any surgical history can sometimes lead to changes in bowel habits or complications, although this is less likely to be the direct cause of your current symptoms.

Recommendations:
1. Consult a Gastroenterologist: Since this has been a recurring issue for over two months, it is crucial to consult a gastroenterologist for a thorough evaluation. They may recommend a colonoscopy to visualize the colon and rectum, which can help identify any underlying issues such as polyps, fissures, or signs of IBD.

2. Dietary Adjustments: Ensure you are consuming a high-fiber diet to help soften stools and reduce straining during bowel movements. Staying hydrated is also essential.

3. Avoid Straining: If you experience constipation, consider using stool softeners or mild laxatives as recommended by your healthcare provider.

4. Monitor Symptoms: Keep track of any additional symptoms such as changes in bowel habits, abdominal pain, weight loss, or changes in appetite, and report these to your doctor.

5. Follow-Up on Hemorrhoids: If hemorrhoids are confirmed as the cause, treatments may include topical medications, dietary changes, or in some cases, procedures to remove them.

In summary, while hemorrhoids and anal fissures are common causes of bright red blood in the stool, it is essential to rule out other potential causes through proper medical evaluation. Early diagnosis and treatment can help manage symptoms effectively and prevent complications.

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