Blood in Stool: Is It a Sign of Hemorrhoid Recurrence?

After the stool sits for a while, the surrounding water turns light red?

Hello Dr.
Chang, I have some questions regarding suspected recurrence of hemorrhoids that I would like to ask you, thank you: I am a 47-year-old male.
In early April 2021, I developed internal hemorrhoids, which improved after undergoing rubber band ligation and using suppositories, along with daily warm sitz baths.
Since then, I have maintained daily warm sitz baths, increased my water intake, and consumed more vegetables, ensuring regular bowel movements every morning, typically within 10 minutes.
About a month and a half ago, as my condition improved, I started drinking 2-3 small glasses of red wine daily and eating a small amount of peanuts (I stopped both two weeks ago).
About a month ago, I noticed that after my bowel movements, the water in the toilet would gradually turn light red, resembling watercolor paint in water.
Currently, my bowel movements are regular, the stool shape is normal, there is no constipation, and the stool color is either light or dark brown.
I have no abdominal pain or bloating, no fever, my weight has not changed significantly, and my appetite is normal.
Since noticing the above situation, I purchased a hemorrhoid suppository from the pharmacy.
Initially, after using the suppository for three days, the redness in the toilet water decreased or disappeared.
However, after stopping for two days, the redness returned.
As of yesterday, I have been using the suppository for seven consecutive days, and the situation has improved; in the last two days, there has been no redness, and today there is a slight amount.
I plan to finish the remaining five doses of the suppository and see how it goes.
Dr.
Chang, I have a few questions: 1.
Are these early signs of a hemorrhoid recurrence? I vaguely remember having similar symptoms before my diagnosis in April, but it's been a while, so I'm not sure.
2.
Can hemorrhoids cause symptoms like the ones described above? 3.
In the past three to four months, I have been eating half a dragon fruit after dinner two to three times a week, but I recall that previously, eating dragon fruit would only cause the toilet water to turn red the next day, not persist for several days.
Could this be related to the dragon fruit? 4.
Or do you think it could be indicative of another condition? I apologize for the many questions, and thank you.

Mr. Wu, 40~49 year old female. Ask Date: 2021/11/12

Dr. Zhang Shuhao reply Surgery

Isolated internal hemorrhoids can cause bleeding, but it is more common to see bright red blood mixed with normal-colored stool or a larger amount of bleeding due to the rupture of a hemorrhoid during straining.
Depending on the severity of the hemorrhoids, symptoms such as prolapse and pain may also occur.
The described phenomenon of water turning red is less common in isolated internal hemorrhoids and should be differentiated from gastrointestinal bleeding that causes bloody stools.
Consuming dragon fruit can sometimes result in red stools that resemble blood.
If there are concerns, a colonoscopy can be arranged to rule out gastrointestinal issues.
In addition to fecal occult blood, abdominal pain, bloating, and changes in bowel habits, unexplained bloody stools are also common indications for a colonoscopy.
It is recommended to consult a gastroenterologist or a colorectal specialist for further evaluation if symptoms persist.
Wishing you a speedy recovery.

Reply Date: 2021/11/12

More Info

Hello! Thank you for your detailed questions regarding your concerns about potential hemorrhoid recurrence and the presence of blood in your stool. Let's address your inquiries one by one.

1. Is this an early sign of hemorrhoid recurrence?
Given your history of internal hemorrhoids and the recent observation of red discoloration in the toilet water after bowel movements, it is indeed possible that this could be an early sign of hemorrhoid recurrence. Hemorrhoids can cause bleeding, especially if there is straining during bowel movements, even if you are currently maintaining regular bowel habits. The fact that you have previously experienced similar symptoms before your diagnosis in April may suggest a pattern. However, it is essential to consider other factors that could contribute to rectal bleeding.

2. Can hemorrhoids cause symptoms like this?
Yes, hemorrhoids can cause bright red blood in the stool or on the toilet paper, especially if they become inflamed or irritated. The bleeding is typically bright red, indicating that it is coming from the lower gastrointestinal tract, such as the rectum or anus. If the bleeding is consistent and accompanied by discomfort or changes in bowel habits, it is advisable to consult a healthcare provider for a thorough evaluation.

3. Could the consumption of dragon fruit be related to the symptoms?
Dragon fruit is high in fiber, which can be beneficial for digestive health. However, if you are consuming it in large quantities, it may lead to changes in your bowel movements or stool consistency. While it is less common for dragon fruit to cause prolonged bleeding, if you notice a correlation between its consumption and the appearance of blood in your stool, it may be worth discussing with your doctor. It’s also possible that the fiber content could be affecting your bowel habits, leading to irritation if you are not adequately hydrated.

4. Could this be indicative of other conditions?
While hemorrhoids are a common cause of rectal bleeding, other conditions could also be responsible. These include anal fissures, diverticular disease, colorectal polyps, or even more serious conditions such as colorectal cancer. Given your age and the persistence of the symptoms, it is crucial to rule out these possibilities. If the bleeding continues or worsens, or if you experience any new symptoms such as significant pain, changes in bowel habits, or weight loss, you should seek medical attention promptly.

In summary, while your symptoms may suggest a recurrence of hemorrhoids, it is essential to consider other potential causes of rectal bleeding. I recommend continuing to monitor your symptoms closely and completing the treatment with the suppositories you have been using. If the bleeding persists or you have any concerns, please consult a healthcare professional for a comprehensive evaluation, which may include a physical examination and possibly further diagnostic tests such as a colonoscopy to ensure that there are no underlying issues that need to be addressed.

Thank you for your questions, and I hope this information helps you in understanding your situation better!

Similar Q&A

Understanding Recurring Hemorrhoids: Symptoms and Solutions

Hello Dr. Lin! I would like to ask you something. I had hemorrhoid surgery six months ago and recovered very well, but recently, this past week, I noticed bright red blood on my stool and around my anus when I go to the bathroom. While taking a shower at night, I noticed that whe...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Rectal bleeding is commonly caused by hemorrhoids and anal fissures. You can consult a colorectal specialist for evaluation. Wishing you good health.

Understanding Blood in Stool: Signs of Hemorrhoids or Serious Conditions?

Doctor, I would like to ask about something. Recently, for the past few months, I have noticed that sometimes there are small traces of blood on the toilet paper after I have a bowel movement, and my anus hurts. I often feel discomfort in the anal area. I have been monitoring thi...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello: It is recommended to schedule an examination with a colorectal or gastroenterology specialist to determine the cause of the rectal bleeding. Common causes of rectal bleeding include hemorrhoids, anal fissures, colorectal cancer, polyps, and inflammatory bowel disease. Recu...

Understanding Blood in Stool: Is It Hemorrhoids or Colon Cancer?

I have been experiencing constipation frequently, and sometimes there is blood in my stool, although it doesn't happen every time. This occurs approximately every 2-3 weeks. The bleeding situation involves the toilet water being bright red, and when I wipe, there is fresh bl...

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. Warm sitz baths may als...

Understanding Blood in Stool: Causes and When to Seek Help

Hello Doctor: Today during bowel movement, the entire toilet was filled with blood, and there was blood on the toilet paper when I wiped, which took about two wipes before it stopped. The stool was slightly hard, but I did not strain excessively during the bowel movement. I exper...

Dr. Chen Shidian reply Gastroenterology and Hepatology
It is likely a recurrence of bleeding from internal hemorrhoids; please seek medical attention again.