Blood in Stool: When to Seek Immediate Medical Attention

The stool is composed entirely of blood?

Hello doctor, I have been constipated for several days, only passing small, hard stools.
On the evening of January 18, I ate purple dragon fruit, and on January 19 at 8 PM, I suddenly started experiencing sharp pain in my lower left abdomen, which intensified.
I began to sweat profusely and felt faint, with my vision turning gray.
I quickly used an enema to relieve the constipation, and gradually, I was able to pass the impacted stool.
During this time, the pain in my lower left abdomen persisted for over an hour until I finally expelled watery stool that resembled the flesh and seeds of the dragon fruit.
At this point, the pain subsided, but my urine was completely purple.
I drank two 500 mL glasses of water, and afterward, I intermittently passed watery purple stools.
My urine remained purple until I finished and went to sleep at 2 AM on January 20.

When I woke up on January 20 at 6 AM, I passed watery dark red stools, and my urine had returned to a normal color.
However, when wiping, I noticed bright red blood.
I immediately went to see a doctor, who suspected that the bleeding was caused by hemorrhoids and scheduled me for a colonoscopy on February 3.
However, on January 20, I had four bowel movements (at 6 AM, 10 AM, 2 PM, and 8 PM), all of which were watery dark red with blood, and wiping continued to show bright red blood.
Throughout the day, I felt mild discomfort in my lower left abdomen.
Should I go to the emergency room immediately, or should I wait for the colonoscopy scheduled for February 3? Thank you, doctor, and I wish you a happy New Year.

Xiao Li, 40~49 year old female. Ask Date: 2023/01/21

Dr. Chen Shidian reply Gastroenterology and Hepatology

It may be due to food coloring; further observation is recommended.
If it is bright red, seek emergency care.

Reply Date: 2023/01/21

More Info

It sounds like you are experiencing a concerning situation with your gastrointestinal health, particularly with the presence of blood in your stool and changes in your urine color. Given the symptoms you've described, it's essential to take them seriously and understand when to seek immediate medical attention.

Firstly, the presence of blood in your stool can indicate several underlying issues, ranging from benign conditions like hemorrhoids to more serious concerns such as gastrointestinal bleeding or inflammatory bowel disease. The fact that you experienced severe abdominal pain, followed by the passage of watery stools that were dark red or purple, is particularly noteworthy. The purple color in your urine and stools could be related to the consumption of dragon fruit, which can sometimes cause temporary changes in stool and urine color due to its pigments. However, the presence of fresh red blood when wiping could indicate a more serious issue, such as hemorrhoids or anal fissures, especially if you have been straining due to constipation.

In your case, since you have already consulted a physician who suspects that the bleeding may be related to hemorrhoids, it is crucial to monitor your symptoms closely. However, the fact that you have experienced ongoing bleeding, especially if it is bright red, warrants immediate attention. Bright red blood typically indicates that the source of bleeding is closer to the rectum or anus, while darker blood may suggest a source higher up in the gastrointestinal tract.

Here are some guidelines on when to seek immediate medical attention:
1. Persistent or Worsening Symptoms: If you continue to have blood in your stool, especially if it is bright red, or if your abdominal pain worsens, you should seek immediate care.

2. Signs of Shock: If you experience symptoms such as fainting, dizziness, or severe weakness, these could be signs of significant blood loss, and you should go to the emergency room right away.

3. Changes in Urination: While the purple color in your urine may be related to the dragon fruit, any persistent changes in urination, especially if accompanied by pain or discomfort, should be evaluated.

4. Severe Abdominal Pain: If the pain becomes unbearable or is accompanied by other symptoms like fever, nausea, or vomiting, it is essential to seek immediate medical attention.

5. Increased Frequency of Bleeding: If you notice that the frequency of blood in your stool increases or if you have multiple episodes of bleeding in a short period, this is a cause for concern.

Given that you have a scheduled colonoscopy on February 3rd, it is advisable to keep that appointment, but do not hesitate to go to the emergency room if your symptoms escalate before then. It is better to err on the side of caution when it comes to gastrointestinal bleeding.

In the meantime, focus on staying hydrated and consider dietary adjustments to help alleviate constipation, such as increasing fiber intake and drinking plenty of fluids. Avoid straining during bowel movements, as this can exacerbate hemorrhoids or fissures.

Lastly, I wish you a happy and healthy new year, and I hope you find relief from your symptoms soon. Please take care of yourself and do not hesitate to seek help if you feel it is necessary.

Similar Q&A

Blood in Stool: Should You Seek Immediate Medical Attention?

I have been having smooth bowel movements these past few days, but previously I often sought medical attention due to constipation. Just now, when I tried to have a bowel movement, I suddenly couldn't pass anything. After straining, I was able to pass a small amount, but I a...

Dr. Ke Fangxu reply Surgery
This situation is likely indicative of 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. You may also con...

Sudden Severe Rectal Bleeding: When to Seek Medical Attention?

Dear Doctor: Recently, I experienced a sudden onset of heavy bleeding during bowel movements, which has persisted for several days. On the first day of these symptoms, I also had diarrhea. The amount of blood this time is unprecedented. For the following two to three days, I noti...

Dr. Chen Zhiping reply Gastroenterology and Hepatology
Hello: The sudden occurrence of fresh blood in the stool is indeed a concerning situation. The causes may include bleeding from hemorrhoids, lesions in the rectum or colon (which could be tumors or inflammation, as well as diverticula, polyps, or vascular abnormalities). A small ...

When to Seek Medical Attention for Blood in Stool

Doctor, I apologize for bothering you, but I would like to ask about my condition. For the past 2 to 3 months, I have experienced blood in my stool for a few days at a time. The color of the stool appears normal, but there is a small amount of mucus at the front of the stool that...

Dr. Chen Shidian reply Gastroenterology and Hepatology
It is likely internal hemorrhoid bleeding; seek medical attention for medication if necessary. In the meantime, increase your intake of fruits, vegetables, and fluids, and engage in regular exercise. After bowel movements, wash with water and dry thoroughly.

Understanding Blood in Stool: When to Seek Medical Attention

I would like to ask the doctor, I've been experiencing gastrointestinal discomfort for the past two days with persistent diarrhea. Initially, the diarrhea was not particularly abnormal, but on the second day, I started having difficulty passing stool and later noticed blood ...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: If you continue to have bloody diarrhea, it is recommended to seek medical attention from a gastroenterologist as soon as possible. Changhua Hospital cares about your health. Dr. Tsai An-Shun.