Blood in Stool: Causes and When to Seek Help - Gastroenterology and Hepatology

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Rectal bleeding


Hello doctor, I am 16 years old.
I recently noticed blood in my stool.
Yesterday, the blood was separated from the stool and was bright red, but today it was mixed in and dark red in some areas, with some parts appearing black.
However, today’s bowel movement was more normal and did not resemble the constipation I had experienced before.
Am I at risk of cancer?

Qing Shui You, 10~19 year old female. Ask Date: 2021/03/18

Dr. Chen Shidian reply Gastroenterology and Hepatology


It is likely not cancer; it may be bleeding due to friction of microvessels near the anus.
If bleeding persists, a rectoscopy (approximately 10 cm) or a sigmoidoscopy (approximately 60 cm) can be performed for examination.
Please adjust your diet to include more fruits and vegetables, exercise regularly, and avoid constipation.

Reply Date: 2021/03/18

More Info


Seeing blood in your stool can be alarming, especially at a young age, and it’s important to understand the potential causes and when to seek medical help. Blood in the stool can appear in various forms, such as bright red blood, dark red blood, or even black, tarry stools. Each of these colors can indicate different underlying issues.

Bright Red Blood: This typically suggests that the bleeding is occurring in the lower gastrointestinal tract, such as the rectum or anus. Common causes include hemorrhoids, anal fissures, or diverticular disease. In younger individuals, conditions like inflammatory bowel disease (IBD), such as Crohn's disease or ulcerative colitis, can also be responsible.

Dark Red Blood or Black Stools: Dark red blood mixed with stool or black, tarry stools usually indicates bleeding from higher up in the gastrointestinal tract, such as the stomach or small intestine. This can be due to ulcers, gastritis, or even more serious conditions like tumors.

Given your age and the symptoms you’ve described, it’s crucial to consider several factors. If the blood is bright red and separate from the stool, it may be less concerning than if it’s mixed in or if you have black, tarry stools. However, the presence of blood in any form warrants a medical evaluation, especially if it persists.

When to Seek Help: You should seek medical attention if:
- The bleeding continues or worsens.

- You experience significant abdominal pain.

- You have changes in your bowel habits, such as persistent diarrhea or constipation.

- You notice other symptoms like weight loss, fatigue, or fever.

Potential Causes: While it’s natural to worry about serious conditions like cancer, it’s important to remember that many causes of blood in the stool are benign, especially in younger individuals. Conditions like hemorrhoids or anal fissures are quite common and can often be treated effectively. However, more serious conditions, including IBD or gastrointestinal tumors, should be ruled out by a healthcare professional.

Next Steps: I recommend that you schedule an appointment with a healthcare provider as soon as possible. They may perform a physical examination, take a detailed medical history, and possibly recommend tests such as blood tests, stool tests, or imaging studies to determine the cause of the bleeding. In some cases, a referral to a gastroenterologist may be necessary for further evaluation, including a colonoscopy.

In conclusion, while the presence of blood in your stool can be concerning, many potential causes are treatable. It’s essential to consult with a healthcare professional to get a proper diagnosis and appropriate care. Don’t hesitate to reach out for help; early intervention can make a significant difference in your health outcomes.

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