Blood in Stool: Is It Hemorrhoids or Colon Cancer?

Q: Blood in Stool: Is It Hemorrhoids or Colon Cancer?

Hello： In response to your question, anal pain accompanied by blood during wiping is generally a symptom of anal fissure. <br>In contrast, hemorrhoidal bleeding typically involves a larger volume of blood. <br>Considering your age of 24, the likelihood of colorectal cancer is ver

Blood in the stool, with a significant amount?

Doctor, I currently have a situation with rectal bleeding.
I've had some blood when wiping after using the bathroom for a while, and I've also experienced swelling and pain around the anal area.
However, for the past couple of days, I haven't had any abdominal pain, but I do feel the urge to use the restroom.
After having a bowel movement, there is bright red blood, and it seems to be quite a bit, as the toilet paper is covered in blood when I wipe.
Today, I had four bowel movements, and all of them had blood.
The fourth time, there was also a bit of dark red clotted blood.
Could this possibly be hemorrhoids, or could it be a symptom of colorectal cancer?

A Sheng, 20~29 year old female. Ask Date: 2010/08/31

Dr. Ke Fangxu reply Surgery

Hello: In response to your question, anal pain accompanied by blood during wiping is generally a symptom of anal fissure.
In contrast, hemorrhoidal bleeding typically involves a larger volume of blood.
Considering your age of 24, the likelihood of colorectal cancer is very low, although not zero.
It is generally recommended to first treat with hemorrhoid medications and to improve bowel habits and lifestyle.
If there is no improvement, then undergoing a colonoscopy would not be too late.

Reply Date: 2010/08/31

More Info

When it comes to the presence of blood in stool, it can be a concerning symptom that warrants careful evaluation. Based on your description, it seems you are experiencing rectal bleeding, which can arise from various causes, including hemorrhoids and more serious conditions like colorectal cancer.
From your account, the blood appears bright red and is present on the toilet paper after wiping, which is often indicative of bleeding from the lower gastrointestinal tract, such as the rectum or anus. Hemorrhoids, which are swollen veins in the rectal area, are a common cause of bright red blood in stool, especially if you have a history of anal discomfort and swelling. The pain and swelling you mentioned could also align with hemorrhoidal issues, particularly if you have been experiencing constipation or straining during bowel movements.

However, the presence of blood, especially if it is accompanied by other symptoms or if it occurs frequently, should not be dismissed lightly. The fact that you have noticed blackish-red blood could indicate a different issue, as darker blood may suggest bleeding from higher up in the gastrointestinal tract. While you mentioned that you do not have abdominal pain, it is essential to consider that some serious conditions, including colorectal cancer, can present with intermittent bleeding without significant pain.

Given your family history of colorectal cancer, it is prudent to be more vigilant. Individuals with a family history of colorectal cancer are at a higher risk, and it is generally recommended that they undergo screening earlier than the standard age of 45. The symptoms you describe, particularly the frequency of blood in your stool and the change in color, warrant further investigation.

I recommend that you schedule an appointment with a gastroenterologist for a thorough evaluation. They may suggest a fecal occult blood test to check for hidden blood in your stool, and if necessary, a colonoscopy to visualize the colon and rectum directly. This procedure can help identify any abnormalities, such as polyps or tumors, and allow for biopsies if needed.

In the meantime, it may be beneficial to monitor your diet and bowel habits. Increasing fiber intake through fruits, vegetables, and whole grains can help prevent constipation and reduce straining during bowel movements, which may alleviate some of the symptoms associated with hemorrhoids. Staying hydrated is also crucial for maintaining regular bowel movements.

In summary, while hemorrhoids could be a likely cause of your symptoms, the presence of blood in stool, especially with your family history, should be taken seriously. A medical evaluation is essential to rule out any serious conditions and to provide you with peace of mind. Please do not hesitate to seek medical attention, as early detection and intervention can significantly improve outcomes in cases of colorectal cancer.

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