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

Noticing blood in the stool?

Hello, doctor.
Recently, I've been under a lot of academic pressure and often stay up late.
Today, after having a bowel movement, I noticed dark red blood clots on the toilet paper that resembled dried nasal blood.
The amount was small and powdery; after wiping once, it was almost gone, and after a second wipe, it was nearly nonexistent.
I often sit for long periods and have not been very active until I recently started weight training.
My sleep has not been sufficient, and I typically have a bowel movement every two days, which is smooth and painless.
However, today, after noticing the blood in my stool, I felt some itching around the anus, which I wonder if it's just psychological.
Additionally, when I nap at school and wake up, my stomach feels bloated, and I often feel the urge to pass gas.
I'm not sure if this is hemorrhoids or colon cancer, and I'm a bit scared...
Thank you for your response, doctor!

Mr. Wang, 10~19 year old female. Ask Date: 2023/03/24

Dr. Chen Shidian reply Gastroenterology and Hepatology

Mild internal hemorrhoid bleeding is still considered normal.
Increase your intake of fruits and vegetables, stay hydrated, exercise more, and avoid prolonged sitting.

Reply Date: 2023/03/24

More Info

When it comes to the presence of blood in the stool, it can understandably cause concern, especially for someone who is experiencing increased stress and changes in lifestyle. The symptoms you describe—dark red blood resembling dried nasal blood, minimal quantity, and the absence of pain during bowel movements—can be indicative of several conditions, some of which are benign while others may require medical attention.

Firstly, the appearance of dark red blood in the stool can often be associated with hemorrhoids, particularly if you have been experiencing increased straining during bowel movements or prolonged sitting. Hemorrhoids are swollen veins in the lower rectum or anus that can bleed, especially during bowel movements. The fact that you mentioned a feeling of itchiness around the anus could further suggest the presence of hemorrhoids or anal fissures, which are small tears in the lining of the anus that can also cause bleeding.

Another possibility is that the blood could be from the upper gastrointestinal tract, which can lead to dark, tarry stools (melena). However, since you described the blood as being bright red and in small amounts, it is more likely to be localized to the lower gastrointestinal tract, such as the rectum or anus.

Given your recent lifestyle changes—such as increased stress, lack of sleep, and a new exercise regimen—these factors could contribute to gastrointestinal issues. Stress can affect digestion and may lead to conditions like irritable bowel syndrome (IBS), which can cause bloating and discomfort. Additionally, insufficient hydration and fiber intake, especially with a new weightlifting routine, can lead to constipation and straining, which may exacerbate hemorrhoids.

While the symptoms you describe may not immediately indicate a serious condition like colorectal cancer, it is essential to be vigilant. Colorectal cancer is more common in individuals over the age of 50, but it can occur in younger individuals, especially if there is a family history of the disease or other risk factors. Symptoms of colorectal cancer can include changes in bowel habits, persistent abdominal discomfort, and unexplained weight loss, among others.

Given your situation, here are some recommendations:
1. Monitor Your Symptoms: Keep track of any changes in your bowel habits, the frequency and appearance of blood, and any accompanying symptoms such as pain, weight loss, or changes in appetite.

2. Increase Fiber and Hydration: Ensure that you are consuming a diet rich in fiber (fruits, vegetables, whole grains) and staying well-hydrated. This can help prevent constipation and reduce straining during bowel movements.

3. Seek Medical Attention: It is advisable to consult a healthcare professional, especially if the bleeding persists, worsens, or is accompanied by other concerning symptoms. A doctor may recommend a physical examination, and possibly a colonoscopy, to rule out any serious conditions.

4. Manage Stress and Sleep: Addressing your stress levels and ensuring adequate sleep can have a positive impact on your overall health and may help alleviate some gastrointestinal symptoms.

In summary, while your symptoms may be related to benign conditions such as hemorrhoids or anal fissures, it is crucial to seek medical advice to ensure proper diagnosis and treatment. Early intervention can lead to better outcomes and peace of mind.

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