Blood in Stool: Should You Worry About Colon Cancer?

Blood on toilet paper after wiping can indicate several conditions, such as hemorrhoids, anal fissures, or gastrointestinal issues. It is important to consult a healthcare professional

Hello Doctor, I have been troubled by some issues recently.
Three years ago, I experienced persistent diarrhea occasionally accompanied by dark red streaks of blood, which led me to undergo numerous tests, including a colonoscopy and endoscopy.
The results showed that my stomach was normal, but I had colon polyps and some external and internal hemorrhoids.
The polyps were removed and tested as benign.
At that time, the doctor diagnosed me with irritable bowel syndrome and prescribed me a chronic medication, and I have been fine for the past few years.
However, I still find it difficult to clean myself thoroughly after a bowel movement and often need to wipe multiple times to feel clean.
Additionally, I have been experiencing severe anal itching.
Recently, I have started having episodes of diarrhea (sometimes accompanied by abdominal pain) and constipation.
I have been taking fenugreek and antidepressants.
This has been going on for about three months, and I have noticed slight dark red streaks (clots) of blood when wiping, along with mucus—sometimes the mucus has blood, and sometimes it does not.
Occasionally, my stool also has a small amount of dark red blood.
Doctor, could this be a sign of colon cancer? Do I need to undergo another colonoscopy? Thank you for your response.

Mr. R, 20~29 year old female. Ask Date: 2019/04/24

Dr. Ke Fangxu reply Surgery

At the age of 28, the likelihood of developing colorectal cancer is not zero, but generally speaking, it is very low.
Based on your description, it seems more like irritable bowel syndrome combined with hemorrhoidal bleeding.
It is recommended to start with a light diet and maintain a good lifestyle.
Spicy, irritating, and greasy foods should be avoided, and increasing dietary fiber intake can also be beneficial.
If symptoms persist without improvement, you may consult a physician for medication or to undergo a colonoscopy.

Reply Date: 2019/04/24

More Info

When it comes to the presence of blood in stool, it can understandably cause significant concern, especially given your family history and previous medical issues. Based on the information you've provided, it seems that you have a history of gastrointestinal issues, including irritable bowel syndrome (IBS) and previous polyps that were benign. While these conditions can lead to symptoms such as changes in bowel habits and the presence of blood, it is essential to approach the situation with a comprehensive understanding of potential causes.

The presence of blood in the stool can arise from various sources within the gastrointestinal tract. In your case, the dark red blood and the accompanying mucus could indicate several possibilities, including hemorrhoids, anal fissures, or even inflammation related to IBS. Hemorrhoids, for instance, are swollen blood vessels in the rectum or anus that can bleed, especially during bowel movements. Given your history of anal itching and the need for repeated wiping, hemorrhoids could be a likely culprit.

However, the fact that you have experienced a change in bowel habits, including diarrhea and constipation, along with the presence of blood, warrants further investigation. While your previous colonoscopy showed benign polyps, it is important to note that new symptoms can arise, and the risk of colorectal cancer, although generally low in younger individuals, is not zero, especially with a family history of cancer.
The presence of mucus in your stool, particularly when accompanied by blood, can also indicate inflammation in the intestines, which could be related to conditions like ulcerative colitis or Crohn's disease. These conditions can cause symptoms similar to what you are experiencing, including abdominal pain, changes in bowel habits, and the presence of blood or mucus.

Given your symptoms and history, it would be prudent to consult with a gastroenterologist. They may recommend a repeat colonoscopy, especially since you have new symptoms that have persisted for three months. A colonoscopy can provide a direct view of the colon and rectum, allowing for the identification of any abnormalities, including new polyps, inflammation, or other potential issues.

In the meantime, it is essential to monitor your symptoms closely. Keep track of any changes in your bowel habits, the color and consistency of your stool, and any associated symptoms like abdominal pain or changes in appetite. This information will be valuable for your healthcare provider in determining the next steps.

Additionally, consider discussing your current medications, including any antidepressants or supplements, with your doctor. Some medications can affect bowel habits and may contribute to gastrointestinal symptoms.

In summary, while your symptoms may not immediately indicate colon cancer, they do warrant further evaluation to rule out any serious conditions. A proactive approach, including a consultation with a gastroenterologist and possibly a repeat colonoscopy, will help ensure that any underlying issues are addressed promptly. Remember, early detection and intervention are key in managing gastrointestinal health effectively.

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