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

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Blood in stool can be a concerning symptom, and understanding its potential causes is crucial for determining when to seek medical help. The presence of blood can indicate a variety of conditions, ranging from benign to serious. Given your situation, where you have noticed blood on the toilet paper after wiping but not in the stool itself, there are several possible explanations.


Common Causes of Blood in Stool
1. Hemorrhoids: One of the most common causes of blood on toilet paper is hemorrhoids, which are swollen veins in the lower rectum or anus. They can cause bright red blood during bowel movements, especially if you are experiencing constipation and straining.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain and bleeding during bowel movements.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon, can lead to diverticulitis if these pouches become inflamed. This condition can cause bleeding.

4. Gastrointestinal Infections: Certain infections can lead to inflammation and bleeding in the gastrointestinal tract. This is often accompanied by other symptoms like diarrhea, abdominal pain, and fever.

5. Polyps or Colorectal Cancer: Although less common, polyps (growths on the lining of the colon) or colorectal cancer can cause bleeding. This is more likely if you have other risk factors, such as a family history of colorectal cancer or if you are over the age of 50.


When to Seek Help
You should seek medical attention if you experience any of the following:
- Persistent Bleeding: If the bleeding continues or worsens over several days.

- Large Amounts of Blood: If you notice a significant amount of blood in your stool or toilet bowl.

- Accompanying Symptoms: If you experience other symptoms such as severe abdominal pain, changes in bowel habits, weight loss, or fatigue.

- Age and Risk Factors: If you are over 50 or have a family history of gastrointestinal diseases, it is advisable to consult a healthcare provider sooner rather than later.


Diagnostic Approach
When you visit a healthcare professional, they may perform several diagnostic tests, including:
- Physical Examination: A thorough examination, including a digital rectal exam, to check for hemorrhoids or fissures.

- Blood Tests: To check for anemia or signs of infection.

- Colonoscopy: This procedure allows the doctor to view the inside of your colon and rectum, helping to identify any abnormalities such as polyps or tumors.


Conclusion
While blood on toilet paper can often be attributed to benign causes like hemorrhoids or anal fissures, it is essential to monitor your symptoms closely. Given your history of constipation, it is advisable to address this issue as well, as straining can exacerbate bleeding. Increasing fiber intake, staying hydrated, and possibly using stool softeners can help alleviate constipation.

If the bleeding persists or you have any concerns, do not hesitate to reach out to a healthcare provider for further evaluation. Early diagnosis and treatment are key to managing any underlying conditions effectively.