Blood in Stool: Causes and Concerns for Patients

Rectal bleeding

Hello Doctor: I have been experiencing significant rectal bleeding for about ten years, but recently, whether I have hard or soft stools, I notice blood every time I go to the bathroom.
The bleeding sometimes appears as a layer of bright red or dark red blood coating the surface of the stool, or there may be blood on the outer part of the stool.
At times, there are drops of blood; other times, the toilet bowl is stained red.
The amount of blood varies, sometimes more, sometimes less, and there is always blood when I wipe.
After a bowel movement, I feel like I haven't completely emptied my bowels, but I can't pass any more stool.
Could this possibly be colon cancer? Thank you for your response, Doctor.

Miss Huang, 20~29 year old female. Ask Date: 2019/06/23

Dr. Ke Fangxu reply Surgery

At the age of 26, the likelihood of developing colorectal cancer is not zero, but generally speaking, it is very, very low.
Based on your description, it seems more like hemorrhoidal bleeding.
It is advisable 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 want to consult a physician for medication or consider undergoing a colonoscopy.

Reply Date: 2019/06/23

More Info

When it comes to blood in the stool, it is essential to understand the potential causes and the necessary steps to take for proper diagnosis and treatment. The symptoms you describe—such as bright red or dark red blood on the stool, dripping blood, and the feeling of incomplete evacuation—are concerning and warrant immediate 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 there is straining involved.

2. Anal Fissures: Small tears in the lining of the anus can also cause bleeding. This is often accompanied by pain during bowel movements.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon, can lead to diverticulitis, where these pouches become inflamed or infected, resulting in bleeding.

4. Polyps: Colorectal polyps are growths on the lining of the colon or rectum. While many are benign, some can develop into cancer over time.

5. Colorectal Cancer: Given your concern about the possibility of colon cancer, it is important to note that blood in the stool can indeed be a symptom of colorectal cancer, especially if accompanied by changes in bowel habits, unexplained weight loss, or abdominal pain.

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

7. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause significant inflammation and bleeding in the intestines.

Next Steps
Given the duration and severity of your symptoms, it is crucial to seek medical evaluation as soon as possible. Here are some recommended steps:
1. Consult a Gastroenterologist: A specialist in digestive disorders can perform a thorough evaluation. This may include a physical examination, a review of your medical history, and specific tests.

2. Diagnostic Tests: You may need a colonoscopy, which allows the doctor to view the inside of your colon and rectum directly. This procedure can help identify the source of bleeding, whether it be hemorrhoids, polyps, or other conditions.

3. Imaging Studies: In some cases, imaging studies such as a CT scan may be necessary to evaluate the gastrointestinal tract further.

4. Laboratory Tests: Blood tests can help assess your overall health, including checking for anemia, which can result from chronic blood loss.

Importance of Early Detection
Early detection of any potential issues, especially concerning colorectal cancer, significantly improves treatment outcomes. If cancer is diagnosed, treatment options may include surgery, chemotherapy, or radiation therapy, depending on the stage and location of the cancer.

Conclusion
While there are several potential causes for blood in the stool, some of which are benign, it is essential not to dismiss these symptoms. The presence of blood, especially if it has been ongoing for ten years and has recently worsened, should prompt immediate medical evaluation. Do not hesitate to reach out to a healthcare professional to discuss your symptoms and undergo the necessary diagnostic procedures. Early intervention can make a significant difference in your health outcomes.

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