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

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

Hello： When experiencing hard stools, there is pain at the anal opening, accompanied by some bleeding. <br>Taking stool softeners leads to diarrhea, and applying ointment provides some relief, but there are still streaks of blood in the stool. <br>The presence of blood in the sto

Blood in the stool?

During bowel movements, I feel significant pain closer to the anus, and I notice fresh blood on the toilet paper.
My mother checked and said it doesn't seem like anything is wrong with the anus, but I'm unsure if it could be internal hemorrhoids.
In the first week, my stool was long and golden yellow, and there was intense pain when the stool passed, with blood separating from the stool in the toilet, floating on the water in a large drop, like it was diffusing.
There was bright red blood the size of a ten-dollar coin on the toilet paper.
Whenever the stool is hard, it continues to be like this.
I once took a stool softener, and the stool became very soft, which alleviated the pain and there was no blood, but the next day I had diarrhea, so I was hesitant to continue taking the stool softener.
Now, in the third week, after applying an ointment, there is slight pain when the stool comes out (it feels less intense than initially, but it still hurts).
However, this time the stool in the toilet is also long and brown, but the end of the stool is mixed with bright red streaks of blood, which is different from the blood being separated from the stool in the first week.
The toilet paper also has a thin streak of bright red blood.
I don't understand why the blood has changed from being separated from the stool to being mixed with the end of the stool.
The only thing I know for sure is that the blood is very bright red, similar to what comes out when I cut my hand.
Could this be colon cancer, or is it more likely to be hemorrhoids? Has this been going on for over three weeks considered a long time?

Xiao Chen, 30~39 year old female. Ask Date: 2021/07/17

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello: When experiencing hard stools, there is pain at the anal opening, accompanied by some bleeding.
Taking stool softeners leads to diarrhea, and applying ointment provides some relief, but there are still streaks of blood in the stool.
The presence of blood in the stool commonly suggests hemorrhoids or anal fissures, but colorectal cancer cannot be ruled out.
Is three weeks considered a long duration? It is important to monitor for signs of anemia.
It is recommended to consult a colorectal or gastroenterology specialist for examination.
Wishing you peace and health.
Sincerely, Dr.
Lin Ming-Hui, Attending Physician, Department of Gastroenterology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2021/07/17

More Info

When it comes to the presence of blood in stool, it can be a concerning symptom that warrants careful evaluation. Based on the description you've provided, it seems that you are experiencing rectal bleeding, which can be caused by a variety of conditions, ranging from benign to more serious issues.
The fact that you are noticing bright red blood on toilet paper and in the toilet bowl, particularly after having hard stools, suggests that the bleeding is likely originating from the lower gastrointestinal tract, specifically the rectum or anus. This is often associated with conditions such as hemorrhoids or anal fissures. Hemorrhoids, which are swollen veins in the rectal area, can cause bright red blood during bowel movements, especially if the stool is hard and requires straining. Similarly, an anal fissure, which is a small tear in the lining of the anus, can also lead to sharp pain and bleeding during bowel movements.

The transition from seeing blood that is separate from the stool to blood mixed with the stool can indicate a change in the nature of the bleeding. While this can still be consistent with hemorrhoids or fissures, it is essential to consider other potential causes as well. Conditions such as diverticular disease, inflammatory bowel disease (IBD), or even colorectal polyps and cancer can also present with rectal bleeding. However, these conditions often come with additional symptoms such as changes in bowel habits, abdominal pain, weight loss, or changes in appetite.

Given that your symptoms have persisted for over three weeks, it is advisable to seek medical attention. While hemorrhoids and fissures are common and often treatable, the duration and nature of your symptoms warrant a thorough evaluation to rule out more serious conditions. A healthcare provider may recommend a physical examination, which could include a digital rectal exam, and possibly further diagnostic procedures such as a colonoscopy. A colonoscopy allows for direct visualization of the colon and rectum, and it can help identify any abnormalities such as polyps, inflammation, or tumors.

In terms of management, if hemorrhoids or fissures are diagnosed, treatment may include dietary modifications to ensure softer stools, topical treatments to alleviate pain and inflammation, and in some cases, surgical interventions if conservative measures fail. If a more serious condition is identified, the treatment plan would depend on the specific diagnosis.

In summary, while hemorrhoids are a likely cause of your symptoms, it is crucial to consult a healthcare professional for a comprehensive evaluation. Early diagnosis and treatment are key to managing any underlying conditions effectively. Please do not delay in seeking medical advice, especially since the symptoms have persisted for an extended period.

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