Blood in Stool: Causes, Symptoms, and When to Seek Help

Blood in the stool with clots?

Hello Doctor, I have been experiencing a sense of urgency and heaviness during bowel movements, going several times a day.
Today, I had three bowel movements; the first was formed, but the latter ones were somewhat loose.
I have pain around the anus, and the toilet was filled with bright red blood.
Sometimes, the blood sticks to the toilet and doesn't flush down easily.
During the third bowel movement today, I noticed small dark red clots.
I'm wondering if this could be related to anemia, as I feel very dizzy and heavy-headed.
Occasionally, my stools are not bloody but have become much thinner, and sometimes they contain mucus.
I have previously experienced rectal bleeding and have undergone two polypectomies, approximately every two years, but due to the pandemic and my pregnancy, I haven't had one since 2021.
I exercise very little, sit for long periods without standing, often drink sugary beverages and eat out, and rarely drink water.
Recently, I seem to have an issue with swollen lymph nodes; during a health check, it was noted that I had lymphadenopathy in my neck, and recently I discovered a hard, non-painful lump about one centimeter in size in my groin that does not move.
Is it possible that this could be colon cancer?

Mei, 30~39 year old female. Ask Date: 2024/01/14

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is recommended to visit a gastroenterology clinic for an examination.
Additionally, investigate the cause of the lymphadenopathy.

Reply Date: 2024/01/14

More Info

When it comes to the presence of blood in stool, it is essential to understand the potential causes, symptoms, and when to seek medical attention. The symptoms you describe, including the presence of bright red blood in the toilet, pain during bowel movements, and the occurrence of dark red blood clots, can be concerning and warrant further investigation.

Causes of Blood in Stool:
1. Hemorrhoids: One of the most common causes of bright red blood in the stool is hemorrhoids, which are swollen veins in the rectum or anus. They can cause pain, itching, and bleeding, especially during bowel movements.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain and bleeding.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can lead to diverticulitis, causing inflammation and bleeding.

4. Polyps or Colorectal Cancer: Given your history of polyp removal, it is crucial to monitor for new growths. Polyps can bleed, and in some cases, they can be precursors to colorectal cancer.

5. Gastrointestinal Infections: Infections can cause inflammation and bleeding in the gastrointestinal tract.

6. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can lead to bloody stools and other gastrointestinal symptoms.

Symptoms to Watch For:
- Bright red blood in the stool or on toilet paper.

- Dark red or maroon blood, which may indicate bleeding higher up in the gastrointestinal tract.

- Abdominal pain or cramping.

- Changes in bowel habits, such as diarrhea or constipation.

- Unexplained weight loss.

- Fatigue or weakness, which could indicate anemia.

When to Seek Help:
You should seek medical attention immediately if you experience:
- Significant or persistent bleeding.

- Severe abdominal pain.

- Symptoms of anemia, such as dizziness, fatigue, or shortness of breath.

- Changes in bowel habits that last more than a few days.

- Any new lumps or swelling, such as the lymph nodes you mentioned.

Given your symptoms, including the blood in your stool, the pain during bowel movements, and the recent discovery of a hard lump in your groin, it is crucial to consult a healthcare professional as soon as possible. They may recommend a colonoscopy to examine the colon and rectum for any abnormalities, including polyps or signs of cancer.
Additionally, your history of polyps and the fact that you have not had a colonoscopy in over two years, especially during a time when you have experienced significant changes in your bowel habits, makes it even more important to get evaluated.
Lifestyle Considerations:
Your lifestyle factors, such as a sedentary lifestyle, low water intake, and a diet high in processed foods, can contribute to constipation and straining during bowel movements, which may exacerbate hemorrhoids or fissures. Increasing your water intake, consuming a high-fiber diet, and engaging in regular physical activity can help improve your bowel health.

In summary, while there are several potential causes for blood in your stool, the combination of your symptoms and medical history necessitates a thorough evaluation by a healthcare provider. Early diagnosis and treatment are key to addressing any underlying conditions effectively.

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