Blood in Stool: Causes and When to Seek Help - Gastroenterology and Hepatology

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When it comes to the presence of blood in stool, it can understandably cause concern and anxiety. Blood in stool can arise from various causes, some benign and others more serious. The bright red blood you observed on the stool's surface could indicate several potential issues, and understanding these can help you determine when to seek medical attention.


Common Causes of Blood in Stool
1. Hemorrhoids: One of the most common causes of bright red blood on the stool or toilet paper is hemorrhoids. These are swollen veins in the lower rectum or anus that can bleed, especially during bowel movements.

2. Anal Fissures: Small tears in the lining of the anus can occur, often due to passing hard stools. This can result in sharp pain and bright red blood.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can lead to diverticulitis, where these pouches become inflamed or infected, sometimes causing bleeding.

4. Polyps or Colorectal Cancer: While less common, polyps (growths on the colon lining) can bleed, and in some cases, they can be precursors to colorectal cancer. Given your history of normal screenings, this is less likely but still a consideration.

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


When to Seek Medical Help
Given your previous normal screening results (like the stool test and CEA levels), it’s reassuring, but it’s still essential to monitor your symptoms closely. Here are some guidelines on when to seek medical attention:
- Persistent or Worsening Symptoms: If the blood in your stool continues or worsens, or if you experience significant pain, changes in bowel habits, or other concerning symptoms, it’s crucial to consult a healthcare provider.

- Accompanying Symptoms: If you experience symptoms such as dizziness, fainting, severe abdominal pain, or changes in your bowel habits (like diarrhea or constipation), seek medical help promptly.

- Family History: If you have a family history of colorectal cancer or other gastrointestinal diseases, it’s wise to be more vigilant and discuss your symptoms with a doctor.

- Age Considerations: If you are over 50 or have risk factors for colorectal cancer, it’s advisable to have regular screenings and consult a doctor if you notice any changes.


Conclusion
In summary, while the presence of bright red blood in your stool can be alarming, it is often due to benign conditions like hemorrhoids or anal fissures. However, given your medical history and the fact that you have had recent screenings, it is still essential to monitor your symptoms. If the bleeding persists or you develop additional symptoms, do not hesitate to seek medical advice. It’s always better to err on the side of caution when it comes to your health. If you feel uncertain about your symptoms, consider scheduling an appointment with a gastroenterologist who can provide a thorough evaluation and guide you on the next steps.