Blood in Stool: Causes and Concerns for Your Health

Blood in the stool?

Hello Doctor: I would like to ask about a recent issue I’ve been experiencing.
I have been feeling sharp pain in my anus during bowel movements, and I have noticed bright red blood in my stool, appearing in small clots.
There is also a bit of blood when I wipe, but this only occurs when I experience pain during bowel movements; otherwise, my stools are normal and do not contain blood.
My bowel habits remain consistent, as I typically have 1 to 2 bowel movements daily, and my weight has not decreased.
I was diagnosed with hypertension at the age of 18, and during check-ups, I have also had instances of hematuria, which makes me concerned about potential issues.
My tests have generally been normal, except for slightly elevated blood pressure and two plus signs in my urine, with everything else being normal.
Am I experiencing hemorrhoids or an anal fissure? Thank you.

sue, 20~29 year old female. Ask Date: 2010/03/12

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello,
1.
Based on the symptoms, the likelihood of hemorrhoidal bleeding is the highest.
If there is persistent bleeding and anal pain, you should consult a colorectal surgeon.

2.
As for hematuria and hypertension, you can seek medical attention from a nephrologist.

Wishing you good health,
Dr.
Chi-Feng Chen, Taoyuan Hospital, Department of Health

Reply Date: 2010/03/12

More Info

Understanding blood in stool can be concerning, and it's important to address your symptoms with care. Based on your description, it seems you are experiencing bright red blood in your stool, along with pain during bowel movements. This can be indicative of several conditions, but the most common causes include hemorrhoids, anal fissures, or other gastrointestinal issues.

Hemorrhoids are swollen veins in the lower rectum or anus that can cause bleeding, especially during bowel movements. They can be internal or external, with external hemorrhoids often causing pain and discomfort. Bright red blood on the toilet paper or in the stool is a typical sign of hemorrhoids.

Anal fissures are small tears in the lining of the anus, which can occur due to passing hard stools or straining during bowel movements. They often cause sharp pain during and after bowel movements, along with bright red blood.

Given that you mentioned the blood appears only during painful bowel movements, it is quite possible that you are dealing with either hemorrhoids or anal fissures. However, other conditions, such as diverticular disease, inflammatory bowel disease (IBD), or even colorectal polyps or cancer, can also cause blood in the stool, though these are less common, especially in younger individuals.

Your history of high blood pressure and previous urinary issues adds complexity to your health profile, but it does not directly correlate with the symptoms you are experiencing. It's good to note that you have not experienced weight loss, which is often a concerning symptom when evaluating gastrointestinal bleeding.

Here are some steps you can take to address your symptoms:
1. Dietary Changes: Increasing your fiber intake can help soften your stools and reduce straining during bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying well-hydrated is also crucial.

2. Over-the-Counter Treatments: You might consider using over-the-counter creams or ointments designed for hemorrhoids or fissures. These can help alleviate pain and promote healing.

3. Warm Sitz Baths: Soaking in warm water can help relieve pain and discomfort associated with anal fissures or hemorrhoids.

4. Avoid Straining: When you feel the urge to go, try not to delay. Straining can worsen fissures and hemorrhoids.

5. Consult a Healthcare Provider: Given your symptoms and concerns, it is essential to consult a healthcare provider for a thorough evaluation. They may recommend a physical examination, and potentially a colonoscopy, to rule out any serious conditions.

6. Monitor Symptoms: Keep track of your symptoms, including the frequency of blood in your stool, any changes in bowel habits, and any new symptoms that may arise. This information will be valuable for your healthcare provider.

In conclusion, while your symptoms may suggest a benign condition like hemorrhoids or anal fissures, it is crucial to seek medical advice to rule out more serious conditions. Early diagnosis and treatment can help prevent complications and improve your quality of life. Don't hesitate to reach out to a healthcare professional for further evaluation and management of your symptoms.

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