Blood in Stool: Causes, Symptoms, and When to See a Doctor

Rectal bleeding

Hello doctor, I would like to ask about the issue of blood in my stool.
For the past two to three days, I have noticed blood in my stool, sometimes accompanied by pain that lasts for a few seconds, but other times there is no pain.
Two days ago, I had a significant amount of blood, similar to menstrual bleeding, and when I wiped with toilet paper, it was completely bright red.
The toilet water was also filled with blood, and there was a little blood on the stool as well.
However, today there was no blood in my stool.
I experienced similar bleeding during high school, but it stopped on its own, so I didn't see a doctor.
I'm not sure if this is hemorrhoids or if my stool is too hard.
Recently, I've been staying up late and feeling quite stressed.
Today, I bought hemorrhoid medication and ointment but haven't used them yet.
Could this be a hemorrhoid issue, or is it something else related to my intestines? Should I see a doctor? I searched online and found information about hemorrhoids, anal fissures, and colon cancer, which is quite frightening.
I hope you can help me with this.
Thank you.

A Ying, 20~29 year old female. Ask Date: 2021/05/07

Dr. Ke Fangxu reply Surgery

This situation likely indicates a higher possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Increasing dietary fiber intake can also be beneficial.
Warm sitz baths may help alleviate symptoms, and you can purchase hemorrhoid suppositories at the pharmacy.
It is best to avoid taking stool softeners indiscriminately.
Although the risk of developing colorectal cancer at the age of 20 is not zero, it is generally very low.
Based on your description, it seems more like hemorrhoidal bleeding.
It is advisable to maintain a light diet and a good lifestyle routine, avoiding spicy, irritating, and greasy foods.
If symptoms persist without improvement, you may consult a physician for medication or to undergo a colonoscopy.

Reply Date: 2021/05/07

More Info

Understanding blood in stool is a crucial aspect of gastrointestinal health, and it can be indicative of various underlying conditions. The presence of blood in your stool can stem from several causes, ranging from benign to serious. Given your description of the symptoms, it is essential to approach this matter with caution and seek medical advice.

Possible Causes of Blood in Stool
1. Hemorrhoids (痔瘡): This is one of the most common causes of blood in the stool, especially if the blood is bright red and appears on the toilet paper or in the toilet bowl. Hemorrhoids can be internal or external and may cause discomfort, itching, or pain during bowel movements.

2. Anal Fissures (肛裂): 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, which may explain the intermittent pain you experienced.

3. Diverticular Disease: Diverticulosis and diverticulitis can cause bleeding in the digestive tract. Diverticulosis involves the formation of small pouches in the colon wall, while diverticulitis occurs when these pouches become inflamed or infected.

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

5. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause significant inflammation in the intestines, leading to bleeding.

6. Polyps or Colorectal Cancer: While less common, polyps in the colon can bleed, and in some cases, they can be precursors to colorectal cancer. This is particularly concerning if you have a family history of colorectal cancer or if you are over the age of 50.

Symptoms to Monitor
- Frequency and Amount of Blood: Noting whether the blood is consistently present, the amount, and whether it is bright red or darker can provide clues about the source of the bleeding.

- Associated Symptoms: Pay attention to any accompanying symptoms such as abdominal pain, changes in bowel habits, weight loss, or fatigue.

When to See a Doctor
Given that you have experienced significant bleeding, especially if it resembles menstrual flow, it is advisable to consult a healthcare professional. While hemorrhoids and anal fissures are common and often manageable, the presence of blood can also indicate more serious conditions that require medical evaluation.

- Immediate Attention: If you experience severe pain, dizziness, or fainting, or if the bleeding persists, seek immediate medical attention.

- Routine Evaluation: Even if the bleeding subsides, it is wise to schedule an appointment with a gastroenterologist. They may recommend diagnostic tests such as a colonoscopy to visualize the colon and identify the source of bleeding.

Conclusion
While it is understandable to feel anxious about the potential causes of blood in your stool, it is crucial to approach this issue with a clear plan. Self-diagnosing based on online searches can lead to unnecessary worry. Instead, consult a healthcare professional who can provide a thorough evaluation and appropriate management. Early detection and treatment of any underlying conditions can significantly improve outcomes and alleviate symptoms.

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