Unusual Stool Colors: When to Worry About Health Risks

Q: Unusual Stool Colors: When to Worry About Health Risks

There are three common causes of rectal bleeding： 1. <br>Anal fissures or skin irritation leading to bleeding, characterized by a small amount of blood accompanied by a sharp pain at the site of the injury. <br>2. <br>Ruptured thrombosed hemorrhoids, which typically produce sligh

Abnormal stool color?

Hello Doctor, I used to have poor eating and sleeping habits, which often led to constipation.
About a month ago, I noticed fresh blood on the toilet paper and went to see a doctor.
The doctor suggested it might be an anal fissure and prescribed some fiber supplements and ointment.
After taking them, my constipation improved.
However, yesterday, after using the restroom, I saw fresh blood on the toilet paper again, but it was only a drop or two.
The stool did not have any blood streaks and appeared normal, and the toilet water was also normal.
This situation is similar to what I experienced a month ago.
When I slightly touched inside the anal area, I felt a sharp pain, but the blood was only present after one wipe and I did not feel any pain during bowel movements.

Today at noon, after using the restroom, I noticed that half of my stool was somewhat hard and had a pinkish color resembling flesh, while the other half was loose and yellow.
I even broke apart the pinkish stool, and the inside was a lighter brown color, similar to my previous stools.
I would like to ask the doctor: 1.
Is it possible that this situation could be caused by colon polyps or even colon cancer? 2.
Can intestinal bleeding present with a pink exterior and normal internal color? 3.
If my stool color returns to normal over the next week, can we rule out the possibility of colon polyps or colon cancer? My grandmother has a history of colon cancer, so I am very worried and hope the doctor can clarify these concerns for me.

Lu Tongxue, 10~19 year old female. Ask Date: 2022/09/02

Dr. Zhang Shuhao reply Surgery

There are three common causes of rectal bleeding: 1.
Anal fissures or skin irritation leading to bleeding, characterized by a small amount of blood accompanied by a sharp pain at the site of the injury.
2.
Ruptured thrombosed hemorrhoids, which typically produce slightly more blood than the first cause, usually occurring after straining during bowel movements, and may be painless or cause only mild discomfort.
3.
Gastrointestinal bleeding related to conditions such as polyps, ulcers, or tumors, which tends to be darker in color and may be associated with changes in bowel habits or abdominal symptoms; this is less common in younger individuals.
Your situation seems more consistent with bleeding related to anal fissures or hemorrhoids, but even if the stool color returns to normal, the possibility of polyps or colorectal cancer cannot be completely ruled out, as polyps or early-stage colorectal cancer may not present any symptoms.
If you are concerned, you can consult a colorectal specialist who can arrange appropriate colonoscopy follow-up based on your age, symptoms, and family history.

Reply Date: 2022/09/02

More Info

When it comes to unusual stool colors and the presence of blood, it's essential to understand the potential implications for your health. Based on your description, you have experienced a few concerning symptoms, including the presence of bright red blood on toilet paper and changes in stool consistency and color. Let's address your questions and provide some context regarding these symptoms.

1. Could this be caused by colorectal polyps or even colorectal cancer?
While the presence of blood in your stool can be alarming, it is not always indicative of serious conditions like colorectal cancer. Bright red blood typically suggests that the bleeding is occurring in the lower gastrointestinal tract, such as the rectum or anus, rather than higher up in the colon. Conditions like hemorrhoids, anal fissures, or diverticular disease are more common causes of bright red blood. Given your history of constipation and the fact that you have previously been diagnosed with an anal fissure, it is plausible that the blood you are seeing is related to that issue rather than a more serious condition. However, since you have a family history of colorectal cancer, it is prudent to remain vigilant and consult a healthcare professional for further evaluation.

2. Can intestinal bleeding present with a pink exterior and normal internal color?
Yes, it is possible for stool to appear pinkish or have a different hue due to the presence of blood mixed with the stool. The color of the stool can vary based on several factors, including diet, hydration levels, and the presence of blood. If the blood is fresh and bright red, it typically indicates that it is coming from a source close to the anus, while darker blood suggests a source higher up in the gastrointestinal tract. The fact that your stool has a normal color internally but appears pink externally could indicate that the blood is superficial, possibly from a fissure or hemorrhoid.

3. If my stool returns to normal color over the next week, can I rule out the possibility of colorectal polyps or cancer?
While a return to normal stool color may be reassuring, it does not entirely rule out the possibility of colorectal polyps or cancer. The presence of blood, even if it resolves, warrants further investigation, especially given your family history. It is essential to monitor your symptoms closely. If you continue to see blood, experience changes in bowel habits, or have any new symptoms such as weight loss, abdominal pain, or changes in appetite, you should seek medical attention promptly. A healthcare provider may recommend a colonoscopy or other diagnostic tests to evaluate your colon's health.

In summary, while your symptoms may be related to less severe conditions like hemorrhoids or anal fissures, it is crucial to remain vigilant due to your family history of colorectal cancer. Regular screenings and consultations with a healthcare provider are essential for maintaining gastrointestinal health, especially if you notice any persistent changes or concerning symptoms. Always prioritize your health and do not hesitate to seek medical advice when in doubt.

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