Blood in Stool: Causes and When to Seek Help

Rectal bleeding

I previously had issues with blood in my stool and consulted a doctor, who performed a visual examination and found nothing wrong.
After taking medication, the problem resolved.
However, today I noticed blood again; the length and color of the stool are normal, but there is visible blood on one side and at the end, and there is blood when wiping.
I also experience pain in the anal area, along with a significant amount of mucus but no blood streaks in the stool.
After applying medication to the painful area, I still have discomfort.
My appetite and weight are normal, but recently I have been eating spicy food, sitting for long periods while studying, and only drinking about 1000cc of water a day.
Could the presence of blood be related to these factors? I would like to inquire about what might be happening.
Is it hemorrhoids, anal fissures, or could it be cancer? Should I schedule a colonoscopy? Thank you for taking the time to respond, doctor.

Xiao Lin, 10~19 year old female. Ask Date: 2021/07/19

Dr. Ke Fangxu reply Surgery

The likelihood of developing colorectal cancer at the age of 17 can be considered negligible.
Based on your description, it seems more indicative of an anal fissure, which typically presents with pain during bowel movements accompanied by slight bleeding.
The common causes are often constipation or diarrhea.
The fundamental treatment involves addressing the bowel movement issues, along with warm sitz baths.
Warm sitz baths can help alleviate pain, maintain cleanliness, and promote blood circulation.
Over-the-counter hemorrhoid suppositories can also be purchased for use.
A colonoscopy is likely unnecessary; however, if symptoms persist without improvement, it is advisable to consult a physician for further evaluation.

Reply Date: 2021/07/19

More Info

Blood in stool can be a concerning symptom, and it’s essential to understand the potential causes and when to seek medical attention. Based on your description, it sounds like you have experienced visible blood in your stool, along with pain in the anal area and the presence of mucus. While you have previously consulted with a doctor and received treatment, the recurrence of these symptoms warrants further investigation.

Possible Causes of Blood in Stool
1. Hemorrhoids: One of the most common causes of blood in the stool, especially if the blood is bright red and appears on the surface of the stool or on toilet paper. Hemorrhoids can cause pain and discomfort, particularly during bowel movements.

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, and the blood is usually bright red.

3. Diverticular Disease: Diverticulosis and diverticulitis can cause bleeding in the digestive tract. This condition is more common in older adults and can lead to complications if not managed properly.

4. Colorectal Polyps or Cancer: While less common, the presence of blood in the stool can be a sign of polyps or colorectal cancer, especially if accompanied by other symptoms such as changes in bowel habits, unexplained weight loss, or persistent abdominal pain.

5. Gastrointestinal Infections: Certain infections can cause inflammation and bleeding in the gastrointestinal tract, leading to blood in the stool.

6. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause significant gastrointestinal symptoms, including bleeding.

When to Seek Help
Given your symptoms, it is advisable to seek medical attention, especially if:
- The bleeding persists or worsens.

- You experience significant pain or discomfort.

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

- There is a change in the color or consistency of your stool.

- You experience any other concerning symptoms, such as fever, weight loss, or fatigue.

Diagnostic Approach
A thorough evaluation by a healthcare professional is essential. They may recommend:
- Physical Examination: A digital rectal exam can help assess for hemorrhoids or fissures.

- Colonoscopy: This is a crucial diagnostic tool that allows direct visualization of the colon and rectum. It can help identify polyps, tumors, or other abnormalities.

- Imaging Studies: In some cases, imaging studies like a CT scan may be necessary to evaluate the gastrointestinal tract.

Lifestyle Considerations
You mentioned that you have been consuming spicy foods, sitting for long periods, and drinking limited water. These factors can contribute to digestive issues:
- Diet: A diet high in fiber and adequate hydration can help prevent constipation and reduce the risk of hemorrhoids and fissures.

- Hydration: Aim to drink more water throughout the day to stay hydrated, which can help soften stools and make bowel movements easier.

- Activity Level: Regular physical activity can improve bowel function and reduce the risk of constipation.

Conclusion
While conditions like hemorrhoids and anal fissures are common and often treatable, it is essential to rule out more serious issues, especially given the recurrence of your symptoms. Scheduling an appointment with a gastroenterologist for a comprehensive evaluation, including a possible colonoscopy, would be a prudent next step. Early diagnosis and treatment can significantly improve outcomes and provide peace of mind.

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