Blood in Stool: Causes and When to Seek Help - Gastroenterology and Hepatology

Rectal bleeding

I just had a bowel movement twice, and both times there was bleeding.
The first time, the stool was somewhat soft but had a normal shape and color.
There was no blood on the toilet paper, but it had a strange odor that wasn't typical of feces.
When I looked down, I noticed blood floating in the water, which was a dark red color.
Then I went again, and this time it was shorter and felt a bit harder, but the color was normal.
However, there was still a small amount of bright red blood floating in the water, while the rest of the water was normal.
Again, there was no blood on the toilet paper, and the odor was the same.
Both times, I didn't experience any pain in my rectum; it felt like a normal bowel movement, and I didn't feel particularly constipated (the second time was a bit less smooth).
I would like to ask the doctor if this could be a sign of cancer? I'm a bit worried...

Song, 10~19 year old female. Ask Date: 2019/02/19

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Based on the symptoms, the likelihood of hemorrhoidal bleeding is the highest.
It is recommended to seek medical attention from a colorectal surgeon.

Reply Date: 2019/02/19

More Info

When it comes to the presence of blood in stool, it can be a concerning symptom that warrants careful evaluation. Blood in the stool can arise from various causes, and understanding these causes is crucial in determining the appropriate next steps.
Firstly, the color and consistency of the blood can provide important clues. In your case, you mentioned seeing dark red blood floating in the water and fresh red blood alongside your stool. Dark red blood typically indicates that the source of bleeding is higher up in the gastrointestinal tract, such as the stomach or small intestine, while bright red blood usually suggests that the bleeding is occurring in the lower gastrointestinal tract, such as the rectum or colon.

Given that you experienced blood alongside your stool but did not notice any pain or discomfort, it is possible that the bleeding could be due to several benign conditions. Common causes of blood in the stool include hemorrhoids, anal fissures, diverticular disease, or even gastrointestinal infections. Hemorrhoids, for example, are swollen blood vessels in the rectal area that can bleed during bowel movements, especially if there is straining involved. Anal fissures, which are small tears in the lining of the anus, can also lead to bright red blood on the stool or toilet paper.

However, while these conditions are often not serious, it is essential to consider more serious causes as well. Conditions such as inflammatory bowel disease (IBD), colorectal polyps, or even colorectal cancer can also present with blood in the stool. The risk of colorectal cancer increases with age, and certain risk factors, such as a family history of colorectal cancer or personal history of polyps, can elevate this risk further.

In your case, since you are experiencing blood in your stool, it is advisable to seek medical attention promptly. A healthcare provider will likely perform a thorough evaluation, which may include a physical examination, a detailed medical history, and possibly diagnostic tests such as a colonoscopy. A colonoscopy is a procedure that allows the doctor to visualize the inside of the colon and rectum and can help identify any abnormalities, such as polyps or sources of bleeding.

It is understandable to feel anxious about the possibility of cancer, especially when experiencing concerning symptoms. However, it is important to remember that many causes of blood in the stool are treatable and not cancer-related. Early detection and intervention are key to managing any potential issues effectively.

In summary, while the presence of blood in your stool can be alarming, it is not necessarily indicative of cancer. It is essential to consult with a healthcare provider to determine the underlying cause of your symptoms. They will guide you through the necessary evaluations and help you understand the best course of action. Remember, timely medical attention can lead to better outcomes and peace of mind.

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