Blood in Stool: Is It Hemorrhoids or Something More Serious?

Occasionally, there may be blood in the stool?

1.
Before having a bowel movement, I sometimes feel a mild cramping sensation in my lower abdomen, just below the navel.
Occasionally, it feels slightly more intense, but it's not extremely painful.
Is this normal? I have a tendency towards constipation and usually take probiotics and lactobacillus plums to help with bowel movements.
Before each bowel movement, I experience the aforementioned sensation, but sometimes I don't feel much pain and only sense that the stool is ready to come out.
However, most of the time, I do experience mild cramping.
My stools are typically formed and cylindrical, sometimes thinner than usual, but never very large.
When I was 18 or 19 years old, my stools were thicker, and I once experienced very large stools that caused the toilet water to be stained red with blood.
This happened during a period when I was fond of eating fried chicken, and I briefly wondered if I might have colon cancer, but I didn't think too much about it since it only happened during that time.
After turning 20, I haven't experienced that situation again.

2.
I am currently 36 years old and have undergone gynecological examinations due to pregnancy and postpartum cervical checks.
The doctor mentioned that I have hemorrhoids, which I believe developed after I turned 30, as I can feel a noticeable external lump.
I haven't seen it myself, so I wasn't surprised when the doctor informed me, but I'm unsure if I have internal hemorrhoids since the gynecologist didn't clarify.
The issue is that, although I no longer experience the blood-stained toilet incidents like I did when I was younger, I occasionally have episodes of rectal bleeding, but not frequently—about once or twice every six months.
The bleeding does not stain the toilet; it usually appears at one end of the stool or in a specific area.
When I wipe, I sometimes see blood, but usually after the second wipe, there's little to no blood left.
Occasionally, if I feel some pain in the anal area, I suspect it might be hemorrhoids.
However, there are times when my stool is well-formed but not hard, and I don't feel any pain in the anal area.
Suddenly, I might see blood mixed with the stool on the toilet paper, but after wiping a second time, there's only a little or none at all, and by the third wipe, there's no blood.
When I check the stool, the blood is usually at one end or in a specific spot, and it doesn't appear dark red; it just looks red on the stool.
Last night, while showering, I felt the urge to have a bowel movement but couldn't push anything out, and since I didn't feel any abdominal pain, I decided to finish my shower and go to bed.
This morning, after about an hour, I felt some urge to go and had a bowel movement, producing a few pieces, not much—about the width of one and a half fingers, with a normal light brown color, and no blood when wiping.
Less than five minutes after leaving the bathroom, I suddenly felt a more pronounced cramping sensation and rushed back to the toilet.
During this process, I felt pain in my abdomen until the stool came out, which felt like passing gas.
Afterward, when I wiped for the first time, I saw blood mixed with the stool, which was darker than this morning's first bowel movement, resembling dark brown.
I couldn't tell if the blood was dark red or normal red since it was mixed with the stool.
After wiping a second time, there was only a little left, and on the third wipe, I couldn't find any blood.
I even tried to insert my finger to check further, but it didn't go in much, and the tissue tore, yet I still didn't see any blood.
The stool in the toilet was also dark brown and cylindrical, similar in width to this morning's, with blood visible on one end, which didn't appear dark red but rather red.
Since I turned 31, I've occasionally experienced this situation, about every six months or four to five months apart, and sometimes my anal area hurts, sometimes it doesn't.
Sometimes, even when I feel my stool isn't hard, I might suddenly see blood when wiping, and other times, even when I exert a lot of effort to pass stool, I don't see any blood.
Could this indicate symptoms of colon cancer, or is it just a hemorrhoid issue? I also don't know if I have internal hemorrhoids.
I really want to have a second child, and I'm currently not pregnant at 36 years old.
Today's events have made me feel very down, as if there is indeed an issue with my intestines, I wouldn't be able to prepare for pregnancy.

Bin, 30~39 year old female. Ask Date: 2020/06/20

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, I experience constipation and mild pain near the navel before bowel movements.
When I was 19, I had instances of blood in my stool, and I have hemorrhoids.
I experience rectal bleeding one to three times every six months, and recently I have felt that my bowel movements are incomplete.
Sometimes there is blood in my stool.
Common causes of blood in the stool include hemorrhoids, anal fissures, colitis, and tumors.
Recurrent bleeding from hemorrhoids may also lead to chronic anemia.
Although the blood in the stool is mild, it is important to identify the cause in order to provide appropriate care.
I recommend following up with a colorectal specialist or a gastroenterology clinic, and if necessary, arranging for a colonoscopy.
Wishing you safety and health! Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Department of Gastroenterology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2020/06/20

More Info

When it comes to blood in the stool, it can be a concerning symptom that warrants careful evaluation. Based on your description, there are several factors to consider, including your history of constipation, the presence of hemorrhoids, and the occasional occurrence of blood in your stool.

Firstly, the mild cramping sensation you experience in your lower abdomen before a bowel movement is not uncommon, especially in individuals with a history of constipation. This sensation can be attributed to the normal contractions of the intestines as they work to move stool through the digestive tract. However, if the cramping becomes severe or is accompanied by other symptoms such as significant pain, changes in bowel habits, or persistent blood in the stool, it would be prudent to seek medical attention.

The fact that you have been diagnosed with hemorrhoids is also relevant. Hemorrhoids can cause bleeding, especially during bowel movements, and this bleeding is often bright red, indicating that it is coming from the lower part of the gastrointestinal tract. The blood you see on the toilet paper or mixed with your stool could very well be related to your hemorrhoids, particularly if you notice it primarily when you are straining to have a bowel movement or if you feel discomfort in the anal area.

However, it is essential to differentiate between hemorrhoidal bleeding and other potential causes of blood in the stool, including more serious conditions such as colorectal cancer or other gastrointestinal disorders. Given your age and the history of blood in your stool, it is advisable to consult a healthcare professional for a thorough evaluation. This may include a physical examination, a review of your medical history, and possibly further diagnostic tests such as a colonoscopy to visualize the colon and rectum directly.

Colorectal cancer can present with symptoms such as changes in bowel habits, unexplained weight loss, persistent abdominal discomfort, and blood in the stool. While your symptoms may be more consistent with hemorrhoids, it is crucial to rule out any serious conditions, especially since you have experienced blood in your stool in the past.

In summary, while your symptoms may be indicative of hemorrhoids, the presence of blood in the stool should not be ignored. It is essential to consult with a healthcare provider who can perform the necessary evaluations and provide a definitive diagnosis. Early detection and intervention are key in managing any potential gastrointestinal issues, and addressing your concerns will also help alleviate any anxiety you may have regarding your health and future pregnancy plans.

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