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

Blood in the stool?

Previously, I had an episode of acute gastritis, and after it resolved, I experienced a week of bowel movements that were accompanied by a significant amount of fresh blood.
My bowel movement schedule is every three days, and during the times I had blood, my bowel movement frequency remained normal.
In recent weeks, I have not had any blood in my stools, but I have noticed a protrusion near the anus during cleaning.
Although I haven't had blood in my stools for several weeks, today I experienced a large amount of fresh blood again, along with a small black blood clot.
Could this be a ruptured hemorrhoid or another condition? I have a colonoscopy scheduled for next week, and I am a bit anxious because there is a family history of colon cancer, although only my grandmother has had it.

Angus, 20~29 year old female. Ask Date: 2022/04/29

Dr. Zhang Shuhao reply Surgery

Based on your age, the likelihood of bleeding related to colorectal cancer is relatively low.
It is more probable that the bleeding is caused by hemorrhoids triggered by irritation from gastroenteritis.
Enlarged hemorrhoidal tissue can easily bleed due to friction, and if deeper blood vessels bleed and clot, a thrombosis may form.
If the thrombosis ruptures, it can lead to more significant bleeding and small clots.
It is recommended to take warm sitz baths, use hemorrhoid ointments, and undergo a colonoscopy as scheduled, without excessive worry.

Reply Date: 2022/04/29

More Info

When it comes to the presence of blood in stool, it is essential to approach the situation with caution and seek medical advice. The symptoms you describe, including the presence of bright red blood and black clots, can be indicative of several conditions, ranging from benign to more serious issues.

Firstly, the presence of bright red blood in your stool is often associated with conditions affecting the lower gastrointestinal tract, such as hemorrhoids, anal fissures, or diverticular disease. Hemorrhoids, which are swollen veins in the rectal area, can cause bleeding during bowel movements, especially if there is straining involved. The fact that you have noted a protrusion near the anal area could suggest the presence of hemorrhoids, particularly if the bleeding occurs during or after a bowel movement.

On the other hand, the presence of black clots or dark blood can be more concerning. Dark blood in the stool may indicate bleeding from higher up in the gastrointestinal tract, such as the stomach or small intestine. Conditions such as peptic ulcers or gastrointestinal bleeding can lead to this type of bleeding. Given your history of acute gastritis, it is possible that there may be a connection, as gastritis can lead to ulceration and subsequent bleeding.

Your family history of colorectal cancer adds another layer of concern. While having a family history of colorectal cancer does not mean you will develop it, it does increase your risk. Therefore, it is prudent that you are scheduled for a colonoscopy. This procedure will allow your healthcare provider to visualize the inside of your colon and rectum, helping to identify any abnormalities such as polyps, tumors, or sources of bleeding.

In preparation for your colonoscopy, it is crucial to communicate all your symptoms to your healthcare provider, including the frequency and nature of your bowel movements, the characteristics of the blood, and any associated symptoms such as pain, changes in bowel habits, or weight loss. These details can help your doctor make a more accurate assessment.

While waiting for your colonoscopy, it is advisable to monitor your symptoms closely. If you experience increased bleeding, severe pain, or any signs of anemia (such as fatigue, weakness, or dizziness), you should seek immediate medical attention.

In summary, while hemorrhoids are a common cause of bright red blood in the stool, the presence of black clots and your family history necessitate a thorough evaluation. The upcoming colonoscopy will be a critical step in determining the cause of your symptoms and ensuring appropriate management. Remember, early detection and intervention are key in addressing any potential issues effectively.

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