Blood in Stool: Causes and When to Seek Help - Surgery

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Bowel Issues - Continuation


Hello Doctor, I am the one who asked about #192075 yesterday.
Today, when I went to the bathroom, I noticed a small piece of red in my stool, which is more noticeable than yesterday (the link below has a picture).
I would like to know if this could be due to the carrots and chili peppers I ate yesterday, or if it could be related to internal hemorrhoids or more serious bleeding in the colon.
I am 22 years old; should I go for a colonoscopy directly? Thank you for taking the time to respond.

Chen, 20~29 year old female. Ask Date: 2023/02/02

Dr. Zhang Shuhao reply Surgery


There are three common causes of rectal bleeding: 1.
Anal fissures or skin irritation causing minor 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 result in slightly more bleeding 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 presents with darker blood and may be associated with changes in bowel habits or abdominal symptoms, and is less common in younger individuals.
Based on your age and symptoms, causes 1 or 2 are more likely.
If you are genuinely concerned about gastrointestinal issues, you may also discuss with a gastroenterologist or a colorectal surgeon about the possibility of scheduling a colonoscopy.

Reply Date: 2023/02/02

More Info


When it comes to blood in the stool, it can be a concerning symptom that warrants careful evaluation. There are several potential causes for this condition, ranging from benign to serious. In your case, the presence of a small amount of red blood in your stool could be influenced by dietary factors, such as the consumption of carrots and chili peppers, which can sometimes cause changes in stool color. However, it is essential to consider other possibilities, including hemorrhoids (internal or external), anal fissures, diverticular disease, or even more serious conditions like colorectal polyps or cancer.

Given your age of 22, while it is less common for younger individuals to experience serious gastrointestinal issues, it is not impossible. Hemorrhoids and anal fissures are quite common in younger adults, especially if there are factors such as constipation or straining during bowel movements. If the blood is bright red and appears on the surface of the stool or in the toilet bowl, it is often indicative of a lower gastrointestinal source, such as hemorrhoids or anal fissures.

However, if the blood is mixed in with the stool or if you experience other symptoms such as abdominal pain, changes in bowel habits, weight loss, or fatigue, it is crucial to seek medical attention promptly. These could be signs of a more serious condition that requires further investigation.

In terms of whether you should undergo a colonoscopy, it ultimately depends on several factors, including the amount of blood, the presence of other symptoms, and your medical history. A colonoscopy is a valuable diagnostic tool that allows for direct visualization of the colon and rectum, and it can help identify any abnormalities such as polyps, inflammation, or tumors. If your symptoms persist or worsen, or if you have any concerning features, it would be prudent to consult with a healthcare provider who can assess your situation and determine the need for further testing.

In summary, while dietary factors can influence stool appearance, the presence of blood should not be ignored. If you are uncertain or if the symptoms persist, it is advisable to seek medical evaluation. A healthcare professional can provide a thorough assessment, which may include a physical examination, laboratory tests, and possibly imaging studies or a colonoscopy, to determine the underlying cause of the bleeding and recommend appropriate treatment. Remember, early detection and intervention are key to managing any potential gastrointestinal issues effectively.

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