Fresh Blood in Stool: Causes and Concerns

Blood in the stool?

Hello, doctor.
Recently, I've noticed fresh blood when I go to the bathroom.
I had a period of diarrhea before, and I underwent a colonoscopy last year, which showed no issues except for a small polyp that was removed.
However, my diarrhea persisted, and the doctor prescribed medication.
After taking it for a while, my diarrhea improved, but I became somewhat constipated, with hard stools.
Additionally, my stools have a foul odor, and aside from the initial dark color, they are mostly a clay-like yellow.
Sometimes, I have to exert effort to pass my stools.
About two weeks ago, I noticed fresh blood in the toilet, separate from the stool, and the amount was not much—about the volume of a mouthful of blood.
I monitored it for a few days and did not see any blood.
Four days later, when I went to the bathroom, I initially had to exert a lot of effort, and after passing some stool, I checked and saw no blood.
However, after continuing, I noticed fresh blood again, and there was a little bit on the stool, resembling a smear.
When I wiped, it was also fresh blood.
What could this be?

Mr. Li, 30~39 year old female. Ask Date: 2024/03/23

Dr. Zhang Shuhao reply Surgery

If a colonoscopy has recently been performed, the likelihood of tumors or polyps is lower.
If diarrhea is accompanied by mucus in the stool or blood in the stool, inflammatory bowel disease or ulcerative conditions should be considered.
If the stool is hard, requires straining, and there is a sensation of swelling or prolapse after bowel movements, this may indicate hemorrhoidal bleeding.
Regardless of the condition, it is advisable to seek medical attention promptly if symptoms persist for evaluation and treatment.
Early assessment can help determine the underlying cause of the problem and develop an appropriate treatment plan.

Reply Date: 2024/03/23

More Info

Experiencing fresh blood in your stool can be concerning, and it’s important to understand the potential causes and implications. Based on your description, it seems you have a history of gastrointestinal issues, including diarrhea and constipation, as well as a previous colonoscopy that revealed a small polyp. While the presence of fresh blood can be alarming, it is essential to consider various factors that could contribute to this symptom.

1. Potential Causes of Blood in Stool: Fresh blood in the stool can arise from several sources within the gastrointestinal tract. Common causes include:
- Hemorrhoids: Swollen veins in the rectum or anus that can bleed, especially during bowel movements.

- Anal Fissures: Small tears in the lining of the anus, often caused by passing hard stools, which can lead to bleeding.

- Diverticular Disease: Diverticula are small pouches that can form in the colon wall and may bleed.

- Colorectal Polyps or Cancer: Although you had a polyp removed, new growths can develop, and it’s crucial to monitor for any changes.

- Gastrointestinal Infections: Certain infections can cause inflammation and bleeding in the intestines.

2. Symptoms to Monitor: Since you mentioned that the blood was present intermittently and that you have experienced changes in your bowel habits, it’s important to monitor additional symptoms such as:
- Abdominal pain or cramping
- Changes in the frequency or consistency of your stools
- Weight loss
- Fatigue or weakness
- Any signs of anemia (e.g., paleness, shortness of breath)
3. Importance of Medical Evaluation: Given your history of gastrointestinal issues and the recent occurrence of fresh blood in your stool, it is advisable to consult a healthcare professional. A gastroenterologist would be the most appropriate specialist to evaluate your condition. They may recommend further diagnostic tests, such as:
- Repeat colonoscopy: To check for any new polyps or lesions.

- Imaging studies: Such as a CT scan to assess the colon and surrounding structures.

- Stool tests: To check for infections or blood.

4. Dietary and Lifestyle Considerations: In the meantime, consider the following lifestyle modifications to help manage your symptoms:
- Increase Fiber Intake: Incorporating more fruits, vegetables, and whole grains can help regulate bowel movements and prevent constipation.

- Stay Hydrated: Drinking plenty of fluids can help soften stools and reduce straining during bowel movements.

- Avoid Straining: If you experience constipation, try to avoid straining, as this can exacerbate issues like hemorrhoids or fissures.

5. When to Seek Immediate Care: If you experience significant bleeding (more than a small amount), severe abdominal pain, or any other alarming symptoms, seek immediate medical attention.

In summary, while fresh blood in your stool can be caused by various conditions, it is crucial to take this symptom seriously and seek medical evaluation. A gastroenterologist can provide a thorough assessment and guide you on the appropriate next steps for diagnosis and treatment. Remember, early intervention is key to managing gastrointestinal health effectively.

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