Blood in Stool: Is It Hemorrhoids or Colon Cancer?

Rectal bleeding

This Wednesday, I experienced diarrhea and noticed a stool that had a jelly-like blood resembling strawberry jam.
There was a bit of blood on the toilet paper, and I felt a burning sensation after bowel movements.
On Thursday, my stool was soft, and I did not notice any blood or discomfort.
On Friday, I had another episode of diarrhea and again saw a jelly-like blood, but this time there was no blood on the toilet paper, and I still felt a burning sensation.
Five months ago, I had a fecal occult blood test, which was negative.
Could this phenomenon be caused by hemorrhoids, or is it a sign of colorectal cancer? I had bleeding during my student years, and it was said to be internal hemorrhoids.

Lin Xiansheng, 30~39 year old female. Ask Date: 2020/05/08

Dr. Ke Fangxu reply Surgery

This situation is likely indicative of 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 not to take stool softeners indiscriminately.
If bleeding persists, it is advisable to consult a physician.
If necessary, a colonoscopy can also be arranged.

Reply Date: 2020/05/08

More Info

When it comes to the presence of blood in stool, it can be a concerning symptom that warrants careful evaluation. Based on your description, it appears that you are experiencing intermittent episodes of blood mixed with your stool, resembling strawberry jam, along with a burning sensation in the anal area. Given your history of hemorrhoids (internal hemorrhoids, as mentioned), it is plausible that the bleeding could be related to this condition rather than colon cancer.

Hemorrhoids are swollen veins in the lower rectum or anus that can cause discomfort, itching, and bleeding, especially during bowel movements. The blood from hemorrhoids is typically bright red and may appear on the toilet paper or in the toilet bowl. The burning sensation you are experiencing could also be attributed to irritation from the hemorrhoids, particularly if you are experiencing softer stools or diarrhea, which can lead to increased friction and discomfort.

On the other hand, while colon cancer can present with blood in the stool, it is often accompanied by other symptoms such as changes in bowel habits, unexplained weight loss, abdominal pain, or fatigue. Your recent negative fecal occult blood test (FOBT) five months ago is also a reassuring factor, as this test is designed to detect hidden blood in the stool, which can be an early sign of colorectal cancer.
It is important to note that the appearance of blood in the stool can vary based on several factors, including diet, the consistency of the stool, and underlying conditions. For instance, certain foods, particularly those high in red pigments (like beets) or spicy foods, can sometimes cause changes in stool color that may be mistaken for blood. Additionally, if you have been experiencing diarrhea, the rapid transit of stool through the intestines may not allow for proper absorption of blood, leading to the appearance of blood mixed with stool.

Given your history of hemorrhoids and the recent episodes of blood in your stool, it would be prudent to consider the following steps:
1. Monitor Symptoms: Keep track of your bowel movements, noting any changes in color, consistency, and the presence of blood. Pay attention to any accompanying symptoms such as pain, changes in appetite, or weight loss.

2. Dietary Adjustments: Ensure you are consuming a balanced diet rich in fiber, which can help regulate bowel movements and prevent constipation, a common trigger for hemorrhoids. Staying hydrated is also essential.

3. Consult a Healthcare Provider: Since you have a history of hemorrhoids and are experiencing new symptoms, it would be wise to consult with a healthcare provider. They may recommend a physical examination, possibly including a digital rectal exam or a colonoscopy, to rule out any serious conditions and to assess the state of your hemorrhoids.

4. Consider Treatment Options: If hemorrhoids are confirmed as the cause of your symptoms, your healthcare provider may suggest treatments ranging from lifestyle changes and topical treatments to more invasive procedures if necessary.

In conclusion, while your symptoms could be related to hemorrhoids, it is essential to remain vigilant and consult a healthcare professional for a thorough evaluation. Early detection and management of any gastrointestinal issues are crucial for maintaining your overall health.

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