Blood in Stool: Gastrointestinal Concerns Explained

Q: Blood in Stool: Gastrointestinal Concerns Explained

Hello： If the stool color is normal but there is fresh blood on the stool, the most common cause is hemorrhoidal bleeding. <br>If there is no blood on the toilet paper after wiping, the likelihood of internal hemorrhoids is high. <br>However, less common conditions such as procti

Bowel issues!!

Hello doctor, I have been experiencing persistent pain in my upper and lower abdomen for over a year.
I have undergone stool tests, gastroscopy, liver and gallbladder ultrasound, and barium enema examinations, all of which returned normal results.
Last Friday, I had two bowel movements, and both times the stool had a red, streaked appearance with blood.
Almost the entire surface of the stool appeared to be blood, but when I wiped with toilet paper, there was no blood on it.
Doctor, I would like to ask why, despite having normal results from my stool tests, gastroscopy, liver and gallbladder ultrasound, and barium enema within the past year, I am experiencing blood in my stool? I made an appointment to see a gastroenterologist, but they said that since I had already undergone a barium enema, a colonoscopy was not necessary.
Why is that?

BB, 20~29 year old female. Ask Date: 2012/10/29

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: If the stool color is normal but there is fresh blood on the stool, the most common cause is hemorrhoidal bleeding.
If there is no blood on the toilet paper after wiping, the likelihood of internal hemorrhoids is high.
However, less common conditions such as proctitis or rectal polyps could also present with these symptoms.
It is recommended to increase physical activity to reduce prolonged sitting and to alleviate constipation, as well as to take warm sitz baths.
If the condition does not improve, it is advisable to seek medical attention.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2012/10/29

More Info

Understanding blood in stool can be a concerning issue, especially when it has been persistent and accompanied by other gastrointestinal symptoms. In your case, you have experienced long-term abdominal pain for over a year, and despite undergoing various diagnostic tests—including stool tests, endoscopy, abdominal ultrasound, and barium enema—all of which returned normal results, you are now noticing bright red blood on the surface of your stool. This situation raises several important considerations.

Firstly, the presence of blood in the stool can originate from various parts of the gastrointestinal (GI) tract. Bright red blood typically indicates that the bleeding is occurring in the lower GI tract, such as the colon or rectum. This could be due to several reasons, including hemorrhoids, anal fissures, diverticular disease, or even more serious conditions like colorectal polyps or cancer. Given that you have had a year of normal test results, it is essential to consider that some conditions may not be easily detectable through standard imaging or endoscopic procedures.

The fact that you are experiencing blood on the surface of your stool but not on the toilet paper could suggest that the blood is coming from a source close to the rectum, such as hemorrhoids or fissures, rather than from deeper within the colon. However, it is crucial to rule out more serious conditions, especially since you have a history of abdominal pain.

Regarding your concern about the necessity of a colonoscopy after having a barium enema, it is important to understand that while barium studies can provide valuable information about the structure of the colon, they may not detect all abnormalities, particularly those related to mucosal lesions or early-stage cancers. A colonoscopy allows for direct visualization of the colon and the opportunity for biopsy if any suspicious lesions are found. Therefore, if your symptoms persist or worsen, it would be prudent to advocate for a colonoscopy, even if the previous tests were normal.

In addition to the physical examination and history, your healthcare provider may consider additional tests such as stool studies for occult blood, inflammatory markers, or imaging studies like a CT scan of the abdomen to further investigate the cause of your symptoms.
It is also worth noting that lifestyle factors, dietary habits, and stress can significantly impact gastrointestinal health. If you have made any recent changes to your diet or lifestyle, these could also contribute to your symptoms.
In conclusion, while your previous tests have returned normal results, the presence of blood in your stool warrants further investigation. It is essential to communicate openly with your healthcare provider about your ongoing symptoms and advocate for the necessary tests to ensure a comprehensive evaluation. Early detection and diagnosis are key to managing any potential gastrointestinal issues effectively. If you feel that your concerns are not being adequately addressed, seeking a second opinion from another gastroenterologist may also be beneficial. Your health and peace of mind are paramount, and it is important to pursue answers until you feel confident in your diagnosis and treatment plan.

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