Blood in Stool: Gastrointestinal Health Concerns - Gastroenterology and Hepatology

Blood in the stool?

I have been experiencing gastrointestinal issues for over two months.
My recent health check report indicated that everything is normal except for elevated total bilirubin levels (CEA is normal).
However, this afternoon, I noticed blood in my stool; the blood was separate from the stool and surrounded by mucus.
There was no pain during bowel movements.
Could this be a sign of colon or rectal cancer? Thank you very much for your assistance.

Wang, 20~29 year old female. Ask Date: 2006/09/14

Dr. Cai Yaozhou reply Gastroenterology and Hepatology

Blood in the stool, when accompanied by no anal pain, is mostly due to hemorrhoidal bleeding.
If blood in the stool causes anal pain, it is likely due to anal fissures.
Occasional blood in the stool should raise concerns about hemorrhoids first, followed by tumors (polyps or cancer) or inflammation.
Since the colonoscopy did not reveal any issues in the intestines, the blood in the stool is likely due to hemorrhoids.
If hemorrhoids frequently bleed, they need to be managed (including medications, sclerotherapy, rubber band ligation, or surgery, among others).
Common symptoms of colorectal cancer include:
1.
Blood in the stool or rectal bleeding.

2.
Changes in bowel habits (constipation, diarrhea, or both).

3.
Narrowing of the stool.

4.
Abdominal bloating, pain, and gas.

5.
A feeling of incomplete bowel evacuation or urgency without being able to pass stool.

6.
Unexplained weight loss.

7.
Symptoms of anemia, such as dizziness and shortness of breath while walking.

8.
Abdominal masses.

9.
Persistent fatigue.
Detection methods for colorectal cancer include:
1.
Fecal occult blood test: This test can detect hidden blood in the stool that is not visible to the naked eye.

2.
Digital rectal examination: More than half of rectal cancer patients can have palpable masses.

3.
Sigmoidoscopy: Cancer located in the rectum (the end of the colon) can be detected through this examination.

4.
Colonoscopy: This allows for visualization of the entire colon.

5.
Lower gastrointestinal double-contrast barium enema: This primarily uses barium and air to perform X-ray examinations of the colon.

6.
Carcinoembryonic antigen (CEA): Some colorectal cancer patients may have elevated levels of this antigen, which can be detected through blood tests.

7.
Positron emission tomography (PET): This nuclear medicine examination can detect various cancers.
Many colorectal cancers develop from polyps, so early diagnosis and removal of colorectal polyps can prevent the occurrence of colorectal cancer.
Individuals with the aforementioned symptoms should seek medical attention promptly, and those in high-risk groups or without symptoms should also undergo regular check-ups at the hospital.
If colorectal cancer is detected and treated early, the five-year survival rate can exceed 75%.

Reply Date: 2006/09/14

More Info

Experiencing blood in your stool can be alarming, and it’s understandable to have concerns about potential gastrointestinal issues, including the possibility of colorectal cancer. However, it’s essential to approach this situation with a clear understanding of the various potential causes and the appropriate steps to take.

Firstly, the presence of blood in the stool can arise from several conditions, some of which are benign while others may require more urgent medical attention. Given your description of the blood being separate from the stool and surrounded by mucus, this could suggest several possibilities. Common causes of blood in the stool include hemorrhoids, anal fissures, diverticulosis, or inflammatory bowel diseases such as ulcerative colitis or Crohn's disease. Hemorrhoids and anal fissures are particularly common and can cause bright red blood, especially during bowel movements, without accompanying pain in the rectal area.

The fact that you have been experiencing gastrointestinal discomfort for over two months, along with elevated total bilirubin levels, suggests that there may be an underlying issue that needs to be addressed. Elevated bilirubin can indicate liver dysfunction or bile duct obstruction, which could contribute to gastrointestinal symptoms. While your CEA (Carcinoembryonic Antigen) levels are normal, which is a good sign as elevated levels can be associated with certain cancers, it does not completely rule out the possibility of colorectal cancer or other gastrointestinal malignancies.

Given your symptoms and medical history, it is crucial to seek medical evaluation promptly. A healthcare professional will likely recommend a thorough examination, which may include a colonoscopy, especially since you have a history of gastrointestinal issues. A colonoscopy allows for direct visualization of the colon and rectum, enabling the physician to identify any abnormalities such as polyps, inflammation, or tumors. If necessary, biopsies can be taken during this procedure for further analysis.

In addition to a colonoscopy, your doctor may also consider other diagnostic tests, such as imaging studies or blood tests, to assess liver function and rule out other potential causes of your symptoms. It’s important to communicate all your symptoms, including any changes in bowel habits, weight fluctuations, and dietary habits, as these details can provide valuable insights into your condition.

While it’s natural to worry about serious conditions like cancer, many causes of blood in the stool are treatable and not life-threatening. Early intervention is key, so do not delay in seeking medical attention. Your healthcare provider will be able to guide you through the necessary steps to diagnose and manage your symptoms effectively.

In summary, while the presence of blood in your stool can be concerning, it is essential to approach this issue with a comprehensive evaluation by a healthcare professional. They will be able to determine the underlying cause of your symptoms and recommend an appropriate treatment plan. Remember, timely medical intervention can significantly improve outcomes and provide peace of mind.

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