Blood in Stool: When to Seek Medical Attention

Rectal bleeding

Hello, after using the toilet today, I noticed that the water in the bowl was red.
When I wiped my anus with tissue, there was also bright red blood.
However, there was no pain during or after the bowel movement, and the process was smooth, just like usual.
I don't have daily bowel movements and occasionally experience constipation.
What could be the possible causes of this? Should I see a doctor immediately, or should I monitor the situation to see if the bleeding occurs again?

Lin, 20~29 year old female. Ask Date: 2019/12/27

Dr. Ke Fangxu reply Surgery

This situation likely indicates a higher possibility 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.
If necessary, a colonoscopy can also be arranged.

Reply Date: 2019/12/27

More Info

Seeing blood in your stool can understandably be alarming, and it's important to approach this situation with caution. The presence of bright red blood in the toilet bowl or on toilet paper can indicate several potential issues, some of which may require 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 or constipation involved.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can cause sharp pain and bleeding during or after 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, potentially causing bleeding.

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

5. Polyps or Colorectal Cancer: While less common, polyps (growths on the colon lining) or colorectal cancer can also cause bleeding. This is particularly a concern if you have risk factors such as a family history of colorectal cancer or if you are over the age of 50.

When to Seek Medical Attention
Given your description of the situation—bright red blood without pain during bowel movements—it is advisable to monitor your symptoms closely. However, you should seek medical attention if:
- The bleeding persists or worsens.

- You experience any abdominal pain, cramping, or discomfort.

- You notice changes in your bowel habits, such as diarrhea or constipation that lasts more than a few days.

- You experience other symptoms such as dizziness, weakness, or fainting, which could indicate significant blood loss.

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

Self-Monitoring and Next Steps
If the bleeding is a one-time occurrence and you do not have any accompanying symptoms, you may choose to observe for a few days. Keep track of any further episodes of bleeding, changes in your bowel habits, or any new symptoms that arise. If you notice any concerning changes, do not hesitate to contact your healthcare provider.

Conclusion
While bright red blood in the stool can often be attributed to benign causes like hemorrhoids or anal fissures, it is essential to remain vigilant. If you have any doubts or if the situation changes, consulting with a healthcare professional is the best course of action. They may recommend further evaluation, such as a physical examination or possibly a colonoscopy, to determine the underlying cause of the bleeding. Remember, it’s always better to err on the side of caution when it comes to your health.

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