Blood in Stool: Causes and When to Seek Help

Blood streaks in stool?

Last week, I experienced fresh blood in my stool, which had never happened before, so I went to the emergency room to see a doctor.
The X-ray and blood tests were normal, and I also had a stool examination (the doctor performed a digital rectal exam).
The report seemed to indicate a 3+, but the doctor mentioned that the color appeared dark red, so he recommended an upper endoscopy.
After consulting with a gastroenterologist before the endoscopy, it was determined that it was unnecessary, and I was referred to a colorectal specialist.
The colorectal doctor found a small internal hemorrhoid.
I initially asked if I should have a colonoscopy, but I felt a bit scared, so the doctor suggested starting with medication.
After taking the medication, there was some improvement, but two days later, I had blood in my stool again.
I thought I would observe it for a while.
After another two days (I always check my stool after using the bathroom), I noticed some streaks of blood in the stool (not much, and there was no active bleeding).
Could this be related to the internal hemorrhoid, or could it possibly indicate other symptoms? Note: I remember experiencing anal itching and gastrointestinal discomfort before the blood in the stool, but the gastrointestinal symptoms disappeared after having a bowel movement.

Huang Xiaoxin, 20~29 year old female. Ask Date: 2019/06/21

Dr. Ke Fangxu reply Surgery

This situation is likely indicative of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Increasing dietary fiber intake can also be beneficial.
Warm sitz baths may help alleviate symptoms, and over-the-counter hemorrhoid suppositories can be used.
It is best to avoid taking stool softeners indiscriminately.
If bleeding persists, it is advisable to consult a physician for evaluation, and a colonoscopy may be arranged if necessary.

Reply Date: 2019/06/21

More Info

Experiencing blood in your stool can be alarming, and it's understandable to seek clarity on the potential causes and when to seek further medical help. Blood in the stool can arise from various sources, and understanding these can help you navigate your symptoms and treatment options.

Common Causes of Blood in Stool
1. Hemorrhoids: These are swollen veins in the lower rectum or anus that can cause bright red blood during bowel movements. Given your mention of having an internal hemorrhoid, this could be a likely cause of the blood you observed.

2. Anal Fissures: Small tears in the lining of the anus can also lead to bleeding, often accompanied by pain during bowel movements.

3. Diverticular Disease: Diverticulosis, which involves small pouches forming in the colon wall, can lead to diverticulitis, causing bleeding.

4. Gastrointestinal Conditions: Conditions such as inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, can cause blood in the stool.

5. Polyps or Colorectal Cancer: While less common, polyps can bleed, and colorectal cancer is a serious condition that can present with blood in the stool.

6. Infections: Certain infections can cause gastrointestinal bleeding, leading to blood in the stool.

When to Seek Help
You should seek immediate medical attention if you experience any of the following:
- Large Amounts of Blood: If you notice a significant amount of blood, especially if it is bright red or dark and tarry.

- Accompanying Symptoms: If you experience severe abdominal pain, dizziness, fainting, or any signs of shock (such as rapid heartbeat or confusion).

- Persistent Symptoms: If blood in your stool continues or worsens despite treatment.

Diagnostic Procedures
In your case, the recommendation for a colonoscopy may be warranted, especially if symptoms persist or worsen. A colonoscopy allows for a direct view of the colon and rectum, enabling the physician to identify any abnormalities such as polyps, tumors, or sources of bleeding. While it can be intimidating, it is a crucial tool for diagnosing potential serious conditions.

Management and Treatment
Since you have already consulted with a gastroenterologist and received treatment for your internal hemorrhoid, it is essential to follow up on your symptoms. If the bleeding continues or if you develop new symptoms, further evaluation may be necessary.
- Dietary Changes: Increasing fiber intake can help manage hemorrhoids and prevent constipation, which can exacerbate symptoms.

- Medications: Over-the-counter treatments for hemorrhoids may provide relief, but if symptoms persist, prescription medications or procedures may be needed.

Conclusion
While internal hemorrhoids are a common cause of blood in the stool, it is crucial to remain vigilant about your symptoms. If you notice any changes or if the bleeding recurs, do not hesitate to seek further medical evaluation. Early detection and treatment of any underlying conditions can significantly improve outcomes. Always communicate openly with your healthcare provider about your concerns and symptoms to ensure you receive the appropriate care.

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