Orange-Red Water Near Stool: Is It a Sign of Bleeding?

There is orange-red liquid near the stool?

Hello Doctor, I occasionally notice orange-red water next to my stool after using the bathroom.
I would like to ask if this could be a sign of bleeding? This happened once today (I ate some carrot pieces last night), and a few weeks ago it happened again (I had pumpkin porridge for lunch the day before).
It has occurred sporadically before (I'm not sure if I had eaten similar colored foods).
In the past, I only had carrot residue.
During these recent instances, the appearance of my stool and the wiping only showed carrot residue, and the color was normal.
My stool is about 2-2.5 cm wide; is this width normal? (Typically, stool has black food residue, is that normal?) I had a colonoscopy three years ago (when I was 18), and I would like to know how often I should have a colonoscopy at my age, or if I still don't need to have it regularly? My weight is 103 kg and my height is 176 cm.
At that time, I was diagnosed with internal hemorrhoids, and the doctor suggested I have irritable bowel syndrome.
After the last occurrence of these symptoms, I consulted both a family medicine doctor and a traditional Chinese medicine doctor, and both believed it was just the effect of food coloring.
Lastly, do I need to undergo a fecal occult blood test for the orange-red water in my stool? I apologize for the many questions, thank you, Doctor.

Niming, 20~29 year old female. Ask Date: 2021/08/22

Dr. Ke Fangxu reply Surgery

Abnormal stool color is often caused by food residues, with common culprits including carrots, dragon fruit, tomatoes, and pumpkin.
Fruit seeds may also be a contributing factor.
It is advisable to temporarily avoid dark-colored foods.
If the issue persists, a consultation with a physician for a colonoscopy may be recommended.

Reply Date: 2021/08/22

More Info

The presence of orange-red water near your stool can indeed be concerning, but it is important to consider various factors before jumping to conclusions about potential bleeding or serious health issues. Based on your description, it seems that the color change may be related to the foods you have consumed, particularly carrots and pumpkin, which are known to contain pigments that can alter the color of your stool and the water in the toilet bowl.

When you consume foods rich in carotenoids, such as carrots, they can impart an orange hue to your stool. This is generally harmless and is simply a result of the pigments in the food. The fact that your stool itself appears normal in color and consistency, and that you have not observed any blood on the toilet paper, is reassuring. The width of your stool, at approximately 2-2.5 cm, falls within the normal range, as stool can vary in size and shape depending on diet and hydration levels.

Regarding your concerns about bleeding, it is important to note that if there were significant bleeding in the gastrointestinal tract, the color of the blood would typically be darker (like maroon or black) if it originates from higher up in the digestive system, or bright red if it comes from the lower gastrointestinal tract. Orange-red coloration is less likely to indicate fresh blood. However, if you notice any changes in your stool color that persist, or if you experience other symptoms such as abdominal pain, changes in bowel habits, or weight loss, it would be prudent to seek medical evaluation.

Given your history of internal hemorrhoids and irritable bowel syndrome (IBS), it is possible that these conditions could contribute to your symptoms, but they are not typically associated with the specific color changes you are observing. The fact that you had a colonoscopy three years ago, which showed only minor issues, suggests that significant pathology is less likely at this time. Generally, routine screening colonoscopies are recommended starting at age 45 for average-risk individuals, but your doctor may suggest earlier or more frequent screenings based on personal or family history.

As for the need for a stool occult blood test, it could be a reasonable step if you have ongoing concerns about potential bleeding. This test can help detect hidden blood in the stool, which may not be visible to the naked eye. If the test is positive, further evaluation, such as a repeat colonoscopy, may be warranted.

In summary, while the orange-red water near your stool is likely related to dietary factors, it is always wise to monitor your symptoms closely. If the discoloration persists or if you develop any new symptoms, consider consulting your healthcare provider for further assessment. Maintaining a healthy diet, staying hydrated, and managing your weight can also contribute positively to your gastrointestinal health.

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