Blood in Stool: Causes and Concerns for Your Health

Stool with orange-red clumps and bleeding upon wiping?

Hello, Dr.
Ke.
A week ago, I experienced constipation, and at that time, there was no fresh blood.
However, recently I have noticed slight fresh blood when wiping after several bowel movements.

1.
On April 24 and 25, the stools were thick and dark brown.
Although there was no visible blood on the stool, I noticed slight fresh blood when wiping.
2.
On April 26, after breakfast, I felt the urge to have a bowel movement, but it was somewhat difficult.
The stool was also thick and dark brown, but there were two pieces of orange-colored material stuck to it.
Upon inspection, one piece resembled a chili pepper, while the other was a spreadable orange substance.
There was more bright red blood when wiping compared to the first two instances.
3.
Later that day, after eating some light porridge for lunch, my stool was yellow-brown but thinner than before.
Upon inspection, I found some food remnants and chili pepper pieces, similar to the morning's stool, which had an orange-red tint.
There was blood mixed in, which made me quite anxious.
4.
Even when having bowel movements or just urinating, there has been no dripping blood, yet I consistently notice slight fresh blood when wiping.
It feels as if there is a lump outside the anus, and occasionally I experience some sharp pain.
What could this indicate? Is the thinner stool due to eating less that day? I am very concerned that this might be a sign of something serious, like colorectal cancer.

Yuanzi, 20~29 year old female. Ask Date: 2015/04/26

Dr. Ke Fangxu reply Surgery

At 28 years old, these symptoms are likely indicative of mild hemorrhoidal bleeding.
The presence of food remnants in the stool suggests a lower risk of colorectal cancer.
It is recommended to increase the intake of fiber-rich foods and to temporarily avoid red fruits and vegetables.
If symptoms do not recur after a period of observation, that would be satisfactory.
However, if the symptoms persist, it is advisable to undergo a colonoscopy.

Reply Date: 2015/04/26

More Info

Understanding blood in stool can be a concerning issue, and it’s important to approach it with a clear understanding of potential causes and necessary actions. Based on your description, it seems you have experienced a few episodes of bright red blood on toilet paper after bowel movements, along with changes in stool consistency and color.
Firstly, the presence of bright red blood typically indicates that the source of bleeding is in the lower gastrointestinal tract, such as the rectum or anus. Common causes of this type of bleeding include hemorrhoids, anal fissures, or diverticular disease. Hemorrhoids are swollen veins in the rectal area that can bleed during bowel movements, especially if the stool is hard or if there is straining involved. Anal fissures are small tears in the lining of the anus, often caused by passing hard stools, which can also lead to bleeding and pain.

The dark brown color of your stool could suggest that the stool is older, which is often the case when there is bleeding higher up in the gastrointestinal tract. However, since you mentioned that the blood is bright red and appears after wiping, it is more likely related to issues in the lower tract rather than a serious condition like colorectal cancer.
The fact that you have experienced some discomfort or a feeling of something being "stuck" in the anal area could indicate the presence of hemorrhoids or an anal fissure. The orange-colored material you mentioned could be remnants of food, such as peppers, which can sometimes appear in the stool, especially if they are not fully digested.

While it is understandable to be concerned about the possibility of colorectal cancer, especially with changes in bowel habits and the presence of blood, it is essential to remember that many benign conditions can cause similar symptoms. However, it is crucial to take these symptoms seriously.
Here are some recommendations for you:
1. Consult a Healthcare Provider: It is important to see a doctor or a gastroenterologist for a thorough evaluation. They may recommend a physical examination, and possibly a colonoscopy, to rule out any serious conditions and to get a clear diagnosis.

2. Dietary Adjustments: Ensure you are consuming a high-fiber diet to help soften your stools and reduce straining during bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying hydrated is also essential.

3. Monitor Symptoms: Keep track of any changes in your symptoms, including the frequency of bleeding, the consistency of your stools, and any associated pain. This information will be helpful for your healthcare provider.

4. Avoid Straining: If you are experiencing constipation, try to avoid straining during bowel movements, as this can exacerbate conditions like hemorrhoids and fissures.

5. Over-the-Counter Remedies: If you suspect hemorrhoids, over-the-counter creams or suppositories may provide relief. However, consult with your doctor before starting any treatment.

6. Follow-Up: If your symptoms persist or worsen, ensure to follow up with your healthcare provider promptly.

In summary, while the presence of blood in your stool can be alarming, many causes are benign. However, it is essential to seek medical advice to rule out any serious conditions and to receive appropriate treatment. Your health is paramount, and addressing these symptoms early can lead to better outcomes.

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