Blood in Stool: Causes and Concerns for Patients - Gastroenterology and Hepatology

Blood in the stool?

Hello Doctor, yesterday I noticed blood in my stool.
There were three pieces of stool; the first and third were normal in color, but the second piece had blood at the front end, which looked like it was smeared on.
I also found a little bit of blood on the toilet paper when I wiped.
The stool felt soft during the bowel movement, and there was no pain.
I'm not sure what the issue could be.
Why is there blood only on the middle piece? (I have previously experienced symptoms of anal fissures.) Thank you, Doctor.

Kunrao de ren, 20~29 year old female. Ask Date: 2010/08/28

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, based on the bleeding condition, it appears to be rectal bleeding near the anal area.
The most common causes are anal fissures or hemorrhoidal bleeding.
If you are concerned, you may visit a colorectal surgeon or a gastroenterologist for further evaluation.
Wishing you good health, Dr.
Chen Qifeng, Taoyuan General Hospital, Department of Health.

Reply Date: 2010/08/28

More Info

When a patient notices blood in their stool, it can understandably cause concern and anxiety. The presence of blood can be indicative of various underlying conditions, some of which may require immediate medical attention. In your case, the observation of blood only on a specific segment of the stool, along with the absence of pain and the presence of soft stools, provides some clues to potential causes.

One common reason for blood in the stool, especially if it is bright red, is hemorrhoids. Hemorrhoids are swollen blood vessels in the rectal area that can bleed during bowel movements, particularly if there is straining or if the stool is hard. However, since you mentioned that your stool was soft and there was no pain, this may not be the primary cause.

Another possibility is an anal fissure, which is a small tear in the lining of the anus. Given your history of experiencing symptoms related to anal fissures, this could be a plausible explanation for the blood you observed. Fissures can cause bleeding, especially during bowel movements, and may not always be accompanied by severe pain, particularly if the tear is small or healing.

In some cases, blood in the stool can also be a sign of more serious conditions, such as diverticulosis, inflammatory bowel disease (IBD), or even colorectal cancer. However, these conditions typically present with additional symptoms, such as abdominal pain, changes in bowel habits, or weight loss. The fact that you are experiencing soft stools and no pain makes these more serious conditions less likely, but they cannot be completely ruled out without further evaluation.

It is also worth noting that the appearance of blood only on a specific segment of the stool could suggest that the source of the bleeding is localized, such as from the rectum or lower part of the colon. This localized bleeding is often less concerning than bleeding that originates from higher up in the gastrointestinal tract, which may result in darker, tarry stools.

Given your previous experience with anal fissures, it would be prudent to monitor your symptoms closely. If the bleeding persists, increases in volume, or is accompanied by other symptoms such as pain, changes in bowel habits, or weight loss, it is essential to seek medical attention promptly. A healthcare provider may recommend a physical examination, and possibly a colonoscopy, to determine the exact cause of the bleeding.

In summary, while the presence of blood in your stool can be alarming, the specific characteristics of your symptoms suggest that it may be related to a benign condition such as hemorrhoids or an anal fissure. However, due to the potential for more serious underlying issues, it is advisable to consult with a healthcare professional for a thorough evaluation and appropriate management. Early diagnosis and treatment are crucial in addressing any gastrointestinal concerns effectively.

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