Bright Red Blood in Stool: Should You Worry About Your Symptoms? - Gastroenterology and Hepatology

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Bright red blood in the stool can be concerning, and it's understandable that you're worried about your symptoms. Based on your description, it seems that you have experienced bright red blood on the toilet paper and in the toilet bowl after a bowel movement, while the stool itself appears normal. This situation can arise from several potential causes, and I'll outline some of them below.

Firstly, the presence of bright red blood typically indicates that the source of the bleeding is from the lower gastrointestinal tract, which includes the rectum and anus. Given that you have a history of hemorrhoids (痔瘡), it is quite possible that the bleeding is related to this condition. Hemorrhoids can become inflamed or irritated, especially after prolonged sitting or straining during bowel movements, leading to bright red blood. The fact that you mentioned feeling discomfort and a sensation of fullness in the rectal area could further support this possibility.

Another potential cause of bright red blood could be anal fissures, which are small tears in the lining of the anus. These can occur due to passing hard stools or straining, and they often cause sharp pain during bowel movements, along with bleeding. However, you mentioned that your bowel movements were not painful, which makes this less likely.

While hemorrhoids and anal fissures are common causes of bright red blood, it is essential to consider other possibilities as well. Conditions such as diverticulosis, inflammatory bowel disease (IBD), or even colorectal polyps can also lead to rectal bleeding. However, since you had a colonoscopy last year that showed no polyps, the likelihood of polyps being the cause is reduced, especially if there have been no significant changes in your bowel habits or symptoms since then.

Regarding your question about whether you need another colonoscopy, it depends on several factors. If the bleeding persists, worsens, or is accompanied by other symptoms such as abdominal pain, changes in bowel habits, or weight loss, it would be prudent to consult with your healthcare provider. They may recommend further evaluation, which could include another colonoscopy, especially if there are concerns about other underlying conditions.

In the meantime, here are some recommendations:
1. Monitor Your Symptoms: Keep track of any changes in your symptoms, including the frequency and amount of bleeding, any associated pain, and changes in bowel habits.

2. Diet and Hydration: Ensure you are consuming a high-fiber diet and staying well-hydrated to help prevent constipation and reduce straining during bowel movements.

3. Avoid Prolonged Sitting: If you suspect that sitting for long periods may be contributing to your discomfort, try to take breaks and move around periodically.

4. Consult Your Doctor: If the bleeding continues or if you develop new symptoms, make an appointment with your healthcare provider to discuss your concerns and determine the best course of action.

In conclusion, while bright red blood in the stool can be alarming, it is often related to benign conditions such as hemorrhoids or anal fissures. However, it is essential to remain vigilant and consult with a healthcare professional if symptoms persist or worsen. Your health and peace of mind are important, so don't hesitate to seek further evaluation if needed.