Bowel Issues: Blood, Discomfort, and Concerns About Cancer

Bowel issues

Hello doctor, in recent years, my stools have been quite large.
I previously had an issue where there was blood in the toilet after bowel movements, and it felt like hemorrhoids were being pushed out, but they would gradually retract afterward.
Over the past two years, after increasing my water intake and consumption of fruits and vegetables, my bowel movements have been occurring daily or every two days, and I have almost no instances of blood in the toilet.
Occasionally, when my stools are harder, there may be a very small amount of blood when wiping, and I also experience some itching.
The usual color of my stools is light brown, but if I eat vegetables like sweet potato leaves a few days prior, the color changes to dark green.
When wiping, I can see some fibers on the toilet paper.
After a bowel movement, I also notice a white discharge about the size of a fifty-cent coin that comes out after the stool, sometimes present and sometimes not, but it is mostly there, especially when the stool is harder and larger.
I am very concerned that this recurring white discharge after bowel movements might indicate colon cancer.

Ms. Chen, 20~29 year old female. Ask Date: 2019/03/24

Dr. Ke Fangxu reply Surgery

At the age of 22, the likelihood of developing colorectal cancer is not zero, but generally speaking, it is extremely low.
Based on your description, it seems more likely that you are experiencing increased mucus secretion from the rectum, which is often related to prolonged bowel movements.
It is recommended to maintain a light diet and a good lifestyle routine.
Spicy, irritating, and greasy foods should be avoided, and increasing your intake of dietary fiber may also be beneficial.
If symptoms persist without improvement, you should consult a physician for medication or consider undergoing a colonoscopy.

Reply Date: 2019/03/24

More Info

When it comes to bowel issues, particularly the presence of blood in stool, it is understandable to have concerns about serious conditions such as colorectal cancer, especially given your family history. However, based on the symptoms you described, it is more likely that your issues are related to less severe conditions, such as hemorrhoids or anal fissures, rather than cancer.

Firstly, the presence of bright red blood on toilet paper or in the toilet bowl typically indicates bleeding from the lower gastrointestinal tract, which includes the rectum and anus. Common causes of this type of bleeding include hemorrhoids, which are swollen veins in the rectal area that can bleed during bowel movements, especially if the stool is hard or if there is straining involved. Anal fissures, which are small tears in the lining of the anus, can also cause pain and bleeding during bowel movements. Given that you mentioned experiencing blood only occasionally and in small amounts, this aligns more with hemorrhoids or fissures rather than a more serious condition.

Your description of having a hard stool and the sensation of discomfort or itching may further support the likelihood of hemorrhoids. Increasing your water intake and dietary fiber can help soften your stool and reduce the strain during bowel movements, which may alleviate your symptoms. It’s also important to avoid prolonged sitting on the toilet and to not rush the process of bowel movements.

Regarding the white discharge you mentioned, this could be mucus, which is not uncommon and can be produced by the intestines. Mucus can be present in stool for various reasons, including irritation or inflammation of the intestines, but it is not a definitive indicator of cancer. If the mucus is accompanied by other concerning symptoms, such as significant changes in bowel habits, persistent abdominal pain, or weight loss, it would be prudent to consult a healthcare professional for further evaluation.

While your family history of colorectal cancer does increase your risk, it is important to note that colorectal cancer is relatively rare in younger individuals, particularly those under 50. The American Cancer Society recommends that average-risk individuals begin screening for colorectal cancer at age 45. However, if you have a family history of colorectal cancer, especially in first-degree relatives, it may be advisable to discuss earlier screening options with your healthcare provider.

In summary, while it is natural to be concerned about serious conditions like cancer, your symptoms are more suggestive of benign conditions such as hemorrhoids or anal fissures. Maintaining a healthy diet rich in fiber, staying hydrated, and monitoring your symptoms are essential steps. If your symptoms persist or worsen, or if you have any new concerning symptoms, it is crucial to seek medical advice. A healthcare professional can provide a thorough evaluation and may recommend tests such as a colonoscopy if deemed necessary. Remember, early detection and intervention are key to managing any health concerns effectively.

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