Blood in Stool: When to Seek Colonoscopy Evaluation

Q: Blood in Stool: When to Seek Colonoscopy Evaluation

Hello： Generally speaking, blood in the stool is a fairly common issue, and whether further examination is needed depends on several related factors： 1. <br>Age： If the patient is over 50 years old, as this is the age group where colorectal cancer is more prevalent, a colonoscopy

Hemorrhagic stool

First, I would like to describe my recent health condition.
At the beginning of October, I experienced rectal bleeding due to hard stools for about two weeks.
After improving my diet, this issue resolved.
On the evening of October 23, I suddenly developed a fever.
I had taken a hot drink for a cold before going to bed, during which I experienced persistent fever and sweating.
By the morning, the fever had subsided.
I visited a doctor at 8 AM, and I felt normal on the 24th and 25th.
However, on the morning of the 26th, I suddenly experienced pain in my abdomen and lower abdomen.
I saw a family medicine doctor on the morning of the 27th, who said it was caused by a cold.
After taking medication, my condition improved.
Between the 28th and 31st, I had no significant issues, just some mild abdominal discomfort (which I felt was not impactful).
My diet during this time was normal, and I did not consume anything unusual.
My bowel habits were also normal (once or twice in the morning), and my stools were unremarkable.
On the evening of November 1, around 9 PM, I suddenly felt the urge to have a bowel movement.
The stool was watery and contained blood, with a deep red color and a considerable amount.
The following morning, I had two more bowel movements at 4 AM and 7 AM, and the situation was the same.
On November 2, I consulted a colorectal surgeon, who performed an anoscopy but found no significant issues.
The doctor recommended scheduling a colonoscopy to determine the potential causes.
On the morning of November 3, my bowel movement was normal (no watery stools), with the front part being deep red with black (due to the previous day's bloody watery stools) and the back part being dark green.
This morning, November 4, my bowel movement was normal in color (golden yellow) and shape.
Dr.
Ke, do you think this situation warrants a colonoscopy, or should I continue to observe? Thank you very much for taking the time to respond amidst your busy schedule.

bic, 20~29 year old female. Ask Date: 2009/11/04

Dr. Ke Fangxu reply Surgery

Hello: Generally speaking, blood in the stool is a fairly common issue, and whether further examination is needed depends on several related factors: 1.
Age: If the patient is over 50 years old, as this is the age group where colorectal cancer is more prevalent, a colonoscopy is recommended.
2.
Symptoms: If there are accompanying symptoms related to colorectal cancer, such as tenesmus, weight loss, changes in bowel habits, anemia, abdominal pain, elevated tumor markers, or persistent symptoms, further examination is also advised.
3.
Level of concern: If you are truly unable to feel at ease, it is best to go ahead with the examination, as this is the only way to definitively determine if there is a problem.
It can help alleviate your worries.
Based on your description, it is likely that there may not be an issue, but as I mentioned earlier, if you are genuinely concerned, muster the courage to get checked.
Living in constant worry is not a solution, wouldn't you agree?

Reply Date: 2009/11/04

More Info

When it comes to understanding blood in the stool, it is crucial to recognize the potential underlying causes and the appropriate steps to take. Based on your description, you have experienced episodes of rectal bleeding, changes in stool consistency, and abdominal discomfort, which raises valid concerns about your gastrointestinal health.

Firstly, the presence of blood in the stool can stem from various sources, including hemorrhoids, anal fissures, diverticular disease, inflammatory bowel disease (IBD) such as ulcerative colitis or Crohn's disease, and even colorectal polyps or cancer. Given your history of rectal bleeding, it is essential to consider these possibilities seriously.

In your case, the initial episodes of bleeding associated with hard stools could indicate hemorrhoids or anal fissures, which are common and often benign causes of rectal bleeding. However, the sudden onset of watery stools mixed with blood, especially if it is deep red, suggests that there may be a more significant issue at play. The fact that you experienced abdominal pain and fever could indicate an underlying infection or inflammatory process.

You mentioned that you have already undergone a digital rectal examination and an anoscopy, which did not reveal any significant findings. However, these procedures may not be sufficient to rule out deeper issues within the colon. A colonoscopy is a more comprehensive examination that allows for direct visualization of the entire colon and rectum, and it can also facilitate biopsies if necessary.

Given your symptoms, including the recent episodes of bloody diarrhea and abdominal discomfort, it is advisable to proceed with the colonoscopy as recommended by your physician. This procedure can help identify any potential sources of bleeding, such as polyps, inflammation, or other abnormalities that may not be visible through less invasive examinations. Additionally, if there is a concern for IBD or other serious conditions, a colonoscopy can provide critical information for diagnosis and management.

It is also important to note that while some causes of rectal bleeding are benign, others can be serious and require prompt intervention. Therefore, it is better to err on the side of caution and undergo the colonoscopy, especially since you have experienced significant changes in your bowel habits and the presence of blood.

In summary, based on your symptoms and medical history, it is appropriate to proceed with the colonoscopy. This examination will provide valuable insights into your gastrointestinal health and help determine the cause of your symptoms. If you have any further concerns or questions, do not hesitate to discuss them with your healthcare provider, as they can offer personalized advice and support throughout this process. Remember, early detection and intervention are key to managing gastrointestinal issues effectively.

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