Blood-Like Substances in Stool: Causes and Concerns

Stool with blood-like substances attached?

Hello, Dr.
Ke.
I apologize for bothering you, but I would like to ask for your advice.
I am currently taking Biyikui and two weeks ago I sought medical attention due to diarrhea lasting nearly a week, during which I noticed blood streaks in my stool.
At that time, a fecal occult blood test was performed, and the doctor indicated that although there was blood on the surface, there was no reaction of red or white blood cells in the stool, leading to a preliminary diagnosis of enteritis.
After taking medication and observing for over a week, I no longer have diarrhea, but I occasionally experience unexplained pain in the lower abdomen, primarily on the right side.
I have also noticed that there are sometimes brownish-red or dark red substances and traces resembling blood attached to the surface of the stool (I don't recall eating any similarly colored foods).
However, when I wipe, the toilet paper appears normal with no blood stains.
I would like to ask if this condition is still likely due to enteritis, or could it be hemorrhoids (though there is no pain during bowel movements), or is there a possibility of a more serious underlying issue that may require a colonoscopy? Thank you for your response, doctor.

Rong, 20~29 year old female. Ask Date: 2021/02/08

Dr. Ke Fangxu reply Surgery

Red-colored stool does not necessarily indicate the presence of blood in the stool.
Fecal occult blood testing should be evaluated based on whether it is a chemical method or an immunological method.
If it is a chemical method, an immunological test targeting red blood cells can be performed.
If the immunological test is positive, a colonoscopy can be arranged.

Reply Date: 2021/02/08

More Info

Understanding blood-like substances in stool can be concerning, and it's important to approach this issue with a thorough understanding of potential causes and the necessary steps for diagnosis and treatment. Based on your description, it seems you have experienced some gastrointestinal distress, including diarrhea and the presence of blood-like substances in your stool.
Firstly, the presence of blood in the stool can arise from various conditions, ranging from benign to more serious issues. Given that you have already consulted a physician and undergone a fecal occult blood test, which indicated the presence of blood but no red or white blood cells, it suggests that the bleeding may not be originating from the lower gastrointestinal tract, such as the colon or rectum. Instead, it could be related to the upper gastrointestinal tract or even a result of inflammation in the intestines, as your doctor suggested with the diagnosis of enteritis.

The fact that you have experienced diarrhea for a week and are now recovering is a positive sign. However, the ongoing discomfort in your lower right abdomen and the occasional presence of brownish or dark red substances in your stool warrant further investigation. While the absence of pain during bowel movements makes hemorrhoids (or "痔瘡") less likely, it does not completely rule them out, especially if there is any swelling or irritation in the anal area that might not be immediately painful.

Other potential causes for your symptoms could include:
1. Irritable Bowel Syndrome (IBS): This condition can cause abdominal pain and changes in bowel habits, including diarrhea and mucus in the stool.

2. Infectious Colitis: This is an inflammation of the colon caused by infection, which could lead to diarrhea and blood in the stool.

3. Diverticulitis: This condition occurs when small pouches in the colon become inflamed or infected, potentially causing pain and changes in bowel habits.

4. Polyps or Colorectal Cancer: While less likely given your age and the nature of your symptoms, any persistent changes in bowel habits or blood in the stool should be evaluated to rule out these serious conditions.

Given your symptoms, it would be prudent to follow up with your healthcare provider. They may recommend a colonoscopy, especially if the symptoms persist or worsen. A colonoscopy allows for direct visualization of the colon and can help identify any abnormalities, such as polyps, inflammation, or other issues that may require treatment.

In the meantime, it is essential to monitor your symptoms closely. Keep track of any changes in your bowel habits, the presence of blood, and any new symptoms such as weight loss, fever, or significant changes in appetite. These details will be valuable for your healthcare provider in determining the next steps for your care.

In conclusion, while your symptoms may be related to a benign condition like enteritis or IBS, it is essential to remain vigilant and seek further evaluation if your symptoms do not resolve or if you experience new or worsening symptoms. Early diagnosis and treatment are key to managing gastrointestinal issues effectively.

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