Blood in Stool: When to Seek Medical Attention - Gastroenterology and Hepatology

Recently, there has been blood in the stool?

1.
About 8 years ago, during my university years, I experienced symptoms of rectal bleeding.
After seeking medical attention at Kaohsiung Medical University, I underwent a colonoscopy, and the doctor indicated that there were polyps, but they were small and removed.
2.
Approximately 3 years ago, after entering the workforce, I again experienced blood in my stool.
I visited a clinic where the doctor diagnosed me with anal fissures due to a tighter anal sphincter.
Since then, I have had intermittent episodes of blood in my stool, usually lasting 3 to 5 days.
Initially, there would be blood when wiping, and after a couple of days, the stool would fill the toilet with blood.
I also experience a burning sensation and slight pain in the anal area.
Regarding my bowel movements, since I can remember (since university), my stools have been unformed; they are not in a long, continuous shape but rather fragmented, often appearing in pieces or unable to form properly.
I typically have bowel movements about three times a day, and I almost always need to use the restroom within 30 minutes after eating.
I would like to know if further medical evaluation is necessary.
Thank you.

Danxin de ren, 30~39 year old female. Ask Date: 2020/06/02

Dr. Chen Shidian reply Gastroenterology and Hepatology

Please avoid hard stools to prevent anal fissures or bleeding from hemorrhoids.

Reply Date: 2020/06/02

More Info

When it comes to blood in the stool, it is essential to take this symptom seriously, as it can indicate a range of underlying health issues, some of which may require immediate medical attention. Based on your history, it seems you have experienced intermittent episodes of rectal bleeding over the years, with previous diagnoses of polyps and anal fissures. However, given the recurrence and the nature of your symptoms, it is advisable to seek further evaluation from a healthcare professional.

Understanding Blood in Stool
Blood in the stool can manifest in different forms, such as bright red blood (often indicating bleeding from the lower gastrointestinal tract) or dark, tarry stools (which may suggest bleeding from the upper gastrointestinal tract). The presence of blood can be alarming, and while some causes may be benign, others can be serious.

1. Possible Causes:
- Hemorrhoids: Swollen veins in the lower rectum or anus can cause bleeding, especially during bowel movements.

- Anal Fissures: Small tears in the lining of the anus can lead to pain and bleeding, particularly if the stool is hard or large.

- Diverticular Disease: Diverticula are small pouches that can form in the colon wall and may become inflamed or bleed.

- Polyps: As you have experienced before, polyps can be benign but may also have the potential to develop into colorectal cancer.

- Colorectal Cancer: Blood in the stool can be a symptom of colorectal cancer, especially in individuals over 50 or those with a family history of the disease.

- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause inflammation and bleeding in the gastrointestinal tract.

2. When to Seek Medical Attention:
- Persistent Symptoms: If you experience blood in your stool that lasts more than a few days, it is crucial to consult a healthcare provider.

- Severe Pain: If you have significant abdominal pain or discomfort accompanying the bleeding, seek medical attention immediately.

- Changes in Bowel Habits: Any significant change in your bowel habits, such as increased frequency or consistency changes, should be evaluated.

- Additional Symptoms: If you experience other symptoms such as weight loss, fatigue, or changes in appetite, these could indicate a more serious condition.

3. Recommended Actions:
- Consult a Gastroenterologist: Given your history of polyps and recurrent bleeding, it would be wise to see a gastroenterologist for a comprehensive evaluation. They may recommend a colonoscopy to assess the current state of your colon and identify any new issues.

- Document Symptoms: Keep a record of your symptoms, including the frequency of blood in your stool, any associated pain, and changes in bowel habits. This information will be helpful for your healthcare provider.

- Dietary Considerations: Since you mentioned having unformed stools, consider discussing your diet with a nutritionist or your doctor. A high-fiber diet may help improve stool consistency and reduce straining during bowel movements, which can alleviate some symptoms.

Conclusion
In summary, while some causes of blood in the stool may be benign, the recurrence of your symptoms, especially with a history of polyps, warrants further investigation. It is crucial to consult a healthcare professional who can provide a thorough evaluation and appropriate management. Early detection and intervention can significantly improve outcomes, especially concerning conditions like colorectal cancer. Don't hesitate to seek help; your health is paramount.

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