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

Blood in the stool?

Hello doctor, this morning after using the restroom, I noticed some red substances mixed in my stool, but there was no pain when wiping, and I didn't see any blood on the toilet paper.
Later in the evening, after another bowel movement, I only felt some gas, but when I wiped, I found a small amount of stool with some bright red streaks of blood.
My bowel habits remain the same as before, typically two to three times a day, usually after waking up or after meals.
The only change was that two days ago, I had diarrhea after eating something questionable.
Additionally, I had an upper endoscopy and colonoscopy done in late March 2018, which were normal except for gastroesophageal reflux.
What could the situation described above indicate? Thank you.

Lin Xiansheng, 30~39 year old female. Ask Date: 2019/03/21

Dr. Chen Qifeng reply Gastroenterology and Hepatology

It is recommended to seek medical attention from a colorectal surgeon.

Reply Date: 2019/03/21

More Info

When it comes to the presence of blood in stool, it can be concerning and warrants careful evaluation. Based on your description, it seems that you have noticed red streaks in your stool, which can be indicative of several potential causes. Here’s a breakdown of what might be happening and when you should seek medical attention.

Possible Causes of Blood in Stool
1. Hemorrhoids: One of the most common causes of bright red blood in the stool is hemorrhoids. These are swollen veins in the lower rectum or anus that can bleed during bowel movements, especially if you have been straining or if your stool is hard.

2. Anal Fissures: Similar to hemorrhoids, anal fissures are small tears in the lining of the anus that can occur due to passing hard stools. They can cause pain and bleeding during bowel movements.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can lead to diverticulitis if these pouches become inflamed or infected. This condition can also cause bleeding.

4. Polyps or Colorectal Cancer: While less common, polyps (growths on the lining of the colon) or colorectal cancer can cause bleeding. The blood may appear darker or mixed with stool rather than bright red.

5. Gastrointestinal Infections: Infections from bacteria, viruses, or parasites can lead to inflammation of the intestines, which may result in blood in the stool, often accompanied by diarrhea.

6. Food-Related Issues: As you mentioned having eaten something potentially unclean, foodborne illnesses can cause gastrointestinal symptoms, including bleeding.

When to Seek Medical Help
Given that you have experienced blood in your stool, it is advisable to consult a healthcare professional, especially if:
- The bleeding persists or worsens.

- You experience additional symptoms such as abdominal pain, fever, or changes in bowel habits.

- You notice significant changes in the color or consistency of your stool.

- You have a history of gastrointestinal issues or family history of colorectal cancer.

Diagnostic Steps
If you decide to seek medical attention, your doctor may recommend several diagnostic tests, including:
- Physical Examination: A thorough examination to check for external signs of hemorrhoids or fissures.

- Colonoscopy: Since you had a colonoscopy last year with normal results, your doctor may consider repeating this test if symptoms persist or worsen.

- Stool Tests: To check for infections or blood.

- Imaging Studies: Such as a CT scan if there is suspicion of diverticulitis or other internal issues.

Conclusion
While the presence of blood in stool can be alarming, many causes are benign and treatable. However, it is essential to take this symptom seriously and consult with a healthcare provider to rule out any serious conditions. Given your previous gastrointestinal health and the recent changes, a professional evaluation is the best course of action to ensure your health and peace of mind.

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