Blood in Stool: Causes, Symptoms, and Treatment Options

Blood in the stool?

Recently, my stools have been loose and unformed.
After having a bowel movement, I often have watery stools that follow.
The color is mostly brown, sometimes quite dark.
I experienced rectal bleeding for the first time in January.
When I visited the doctor, I underwent a digital rectal exam and a sigmoidoscopy.
The doctor diagnosed me with internal hemorrhoids.
The second incident occurred on March 8, after experiencing severe abdominal pain and diarrhea, resulting in a large amount of blood on the toilet paper—about two large wipes worth.
The next day, I felt fine, but two days later, I had five episodes of diarrhea within a single day, with minimal blood.
When I consulted the doctor, he said it was acute gastroenteritis.

Today, during a bowel movement, I had the same experience: a large stool followed by watery diarrhea, and again there was a significant amount of blood on the toilet paper—several wipes worth, with the color being bright red and slightly dark.
I do not experience pain during bowel movements or when wiping.
Previously, I used a rectal suppository for about 4 to 5 days but stopped because there was no more bleeding.
Should I return to see the doctor, or should I continue using the suppository for a while longer to monitor my condition? Additionally, how long is it advisable to use the suppository for optimal safety and effectiveness?

Kai Ge, 20~29 year old female. Ask Date: 2014/04/02

Dr. Ke Fangxu reply Surgery

Based on your message, I also believe it is acute gastroenteritis.
The multiple episodes of diarrhea may have caused hemorrhoid swelling and bleeding.
If there is no bleeding after using the suppository, it should not be necessary to continue using it.
However, if there are recurring episodes of bleeding, you should seek medical attention again.

Reply Date: 2014/04/02

More Info

Understanding blood in stool can be alarming, and it is essential to approach this issue with a clear understanding of potential causes, symptoms, and treatment options. Based on your description, it seems you have been experiencing a series of gastrointestinal symptoms, including loose stools, abdominal pain, and episodes of rectal bleeding.

Causes of Blood in Stool
1. Hemorrhoids: One of the most common causes of blood in the stool, especially if the blood is bright red and appears on toilet paper or in the toilet bowl. Hemorrhoids can cause discomfort and bleeding during bowel movements.

2. Anal Fissures: Small tears in the lining of the anus can occur due to passing hard stools, leading to pain and bleeding.

3. Diverticular Disease: Diverticulosis and diverticulitis can cause bleeding and changes in bowel habits. This condition involves the formation of small pouches in the colon wall.

4. Gastrointestinal Infections: Acute gastroenteritis, which you mentioned, can lead to diarrhea and sometimes blood in the stool, especially if there is inflammation of the intestinal lining.

5. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic inflammation of the gastrointestinal tract, leading to symptoms like diarrhea, abdominal pain, and blood in the stool.

6. Polyps or Colorectal Cancer: While less common, especially in younger individuals, polyps can bleed, and colorectal cancer is a serious condition that can present with similar symptoms.

Symptoms to Monitor
- Color of Blood: Bright red blood usually indicates bleeding from the lower gastrointestinal tract, while dark or maroon blood may suggest bleeding from higher up in the digestive system.

- Associated Symptoms: Pay attention to other symptoms such as weight loss, fever, severe abdominal pain, or changes in bowel habits that persist.

Treatment Options
1. Medical Evaluation: Given your symptoms, it is crucial to follow up with your healthcare provider. They may recommend further diagnostic tests such as a colonoscopy to visualize the colon and identify any underlying issues.

2. Medications: Depending on the diagnosis, treatments may include anti-inflammatory medications for IBD, antibiotics for infections, or topical treatments for hemorrhoids and fissures.

3. Dietary Changes: A diet high in fiber can help regulate bowel movements and prevent constipation, which may alleviate some symptoms. Staying hydrated is also essential.

4. Use of Suppositories: If your doctor has prescribed suppositories, it is essential to follow their guidance on duration and frequency. Generally, they can be used until symptoms improve, but it is best to consult your doctor if you have concerns about prolonged use.

When to Seek Immediate Care
- If you experience significant amounts of blood in your stool, severe abdominal pain, or signs of dehydration (such as dizziness or decreased urination), seek medical attention immediately.

Conclusion
In summary, while some causes of blood in the stool can be benign, others may require more urgent medical intervention. It is advisable to return to your healthcare provider for a thorough evaluation, especially given your recent symptoms and the recurrence of blood in your stool. They can provide a tailored treatment plan based on your specific condition and ensure that any serious issues are addressed promptly.

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