Blood in Stool: Hemorrhoids or Something More Serious?

Q: Blood in Stool: Hemorrhoids or Something More Serious?

Hello： Based on the symptoms, there are two issues： 1. <br>hematochezia (blood in stool) 2. <br>gastrointestinal dysfunction. <br>It is recommended to undergo a routine stool examination and a barium enema or colonoscopy. <br>If no abnormalities are found, it may be hemorrhoids a

Blood in the stool?

Hello doctor, about 7 years ago, I experienced rectal bleeding (the toilet had noticeable blood stains).
I was later diagnosed with internal hemorrhoids.
However, since that bleeding incident, I have not experienced any severe bleeding again for the past 7 years, which makes me wonder if I truly have hemorrhoids.
Aren't hemorrhoids supposed to bleed continuously? I've heard they can also cause anemia.
After that incident 7 years ago, I had a fecal occult blood test that was negative, and the doctor suggested it might be irritable bowel syndrome.
My symptom is that I feel like I haven't completely emptied my bowels after a bowel movement, so I use a handheld shower to rinse inside the anus to help expel any remaining stool.
During that time 7 years ago, I sometimes noticed mucus in my stool, but now I have no symptoms, and I don't experience anal itching or pain.
After a bowel movement, I usually don't feel pain, although sometimes my stool is thin, and other times it is thicker.
I haven't seen any blood.
Occasionally, I feel a dull pain in my lower right abdomen.
Two days ago, while using the handheld shower again during a bowel movement, I felt pain in the anal area the next day.
When I looked in the mirror at home, I noticed a small growth near my anus.
I initially tried to push it back in but failed, and in frustration, I pushed harder, and it went inside.
Am I suffering from colon cancer or hemorrhoids? If it is hemorrhoids, what grade could it be? I plan to go to the hospital for an examination soon, but I hope to understand some answers beforehand.
P.S.
I have never had a colonoscopy.

Mr. Wang, 10~19 year old female. Ask Date: 2014/11/12

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello: Based on the symptoms, there are two issues: 1.
hematochezia (blood in stool) 2.
gastrointestinal dysfunction.
It is recommended to undergo a routine stool examination and a barium enema or colonoscopy.
If no abnormalities are found, it may be hemorrhoids and irritable bowel syndrome (IBS), in which case dietary adjustments should be made.
Wishing you peace and health.
Sincerely, Dr.
Chi-Feng Chen, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2014/11/12

More Info

Understanding blood in stool can be a concerning issue, and it's essential to approach it with careful consideration of the symptoms and medical history. Based on your description, it seems you have experienced a range of gastrointestinal symptoms over the past seven years, including a significant episode of rectal bleeding diagnosed as internal hemorrhoids. Since then, you have not had any severe bleeding, which is a positive sign, but your ongoing symptoms warrant further investigation.

Hemorrhoids, or piles, are swollen veins in the lower rectum and anus that can cause discomfort, itching, and bleeding, especially during bowel movements. It is common for hemorrhoids to bleed, particularly if they become thrombosed or inflamed. However, not all cases of rectal bleeding are due to hemorrhoids. Other potential causes include anal fissures, diverticular disease, inflammatory bowel disease (IBD), and, in more serious cases, colorectal cancer.

Your history of a negative fecal occult blood test is reassuring, as it suggests that there was no hidden blood in your stool at that time. However, it is important to note that this test is not definitive, and symptoms can change over time. The fact that you have experienced changes in your bowel habits, such as the sensation of incomplete evacuation and the presence of mucus, could indicate a functional gastrointestinal disorder like irritable bowel syndrome (IBS), which is often characterized by abdominal pain and altered bowel habits.

The pain you mentioned in your lower right abdomen, along with the recent discovery of a small growth near the anus, raises some concerns. While it could be related to hemorrhoids or a skin tag, it is crucial to have it evaluated by a healthcare professional. The presence of a new growth, especially if it is painful or changing, should not be ignored.

Given your symptoms and medical history, it is highly advisable to schedule a visit with a gastroenterologist. They may recommend a colonoscopy, which is a procedure that allows direct visualization of the colon and rectum. This examination can help rule out any serious conditions, including colorectal cancer, and provide a definitive diagnosis for your symptoms.

In summary, while your previous diagnosis of hemorrhoids may still be valid, the changes in your symptoms and the new growth require further evaluation. It is essential to consult a healthcare professional who can perform the necessary examinations and provide you with a clear diagnosis. Early detection and treatment of any gastrointestinal issues are crucial for maintaining your health and peace of mind. Please do not hesitate to seek medical attention, as it is always better to err on the side of caution when it comes to your health.

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