Blood in Stool: Causes, Concerns, and Solutions - Gastroenterology and Hepatology

Rectal bleeding

On the morning of May 20, after having a bowel movement, I noticed blood in the toilet, but the stool was normal and there were no abnormalities.
The blood was bright red, which startled me.
However, there was no blood on the toilet paper when I wiped.
In the afternoon, I had another bowel movement, and this time there was no blood, so I thought everything was fine.
On the morning of May 21, I had a bowel movement again, and I noticed blood at the end of the process.
The stool was normal, and I felt no discomfort, but there was a noticeable amount of bright red blood on the toilet paper when I wiped.

1.
I read online that a large amount of blood would not be visible in the stool.
I can see the blood, but it seems like a significant amount.
How do you differentiate between a large and a small amount of blood?
2.
Is it possible that I could have rectal cancer, colon cancer, or stomach cancer?
3.
What could be causing this situation? For example, could it be hemorrhoids?
4.
What are some ways to improve this condition?
Thank you for taking the time to answer my questions.
I appreciate your help.

Ting, 10~19 year old female. Ask Date: 2015/05/21

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, the presence of bright red blood in the stool, separated from the feces, is mostly indicative of bleeding from the anal or rectal area.
The most common cause of this phenomenon is hemorrhoids (which can be internal, external, or mixed), and there is no specific correlation with the amount of blood.
If the bleeding persists, please consult a colorectal specialist.
Wishing you safety and health.
Sincerely, Dr.
Chen Chi-Feng, Attending Physician, Gastroenterology Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2015/05/21

More Info

Blood in the stool can be a concerning symptom, and it's important to understand its potential causes, implications, and the appropriate steps to take. Based on your description, you have experienced fresh red blood during bowel movements, which can be alarming. Let's address your questions systematically.

1. Distinguishing Between Large and Small Amounts of Blood: The distinction between large and small amounts of blood can be somewhat subjective. Generally, a small amount of blood may be just a few drops or streaks on the toilet paper or in the toilet bowl, while a larger amount may involve more significant bleeding that could fill the toilet bowl or be mixed with the stool. If you can see the blood clearly and it seems to be more than just a few drops, it may be considered a larger amount. However, any noticeable blood should be taken seriously, regardless of the quantity.

2. Concerns About Cancer: While the presence of blood in the stool can be alarming and may raise concerns about serious conditions such as colorectal cancer, it is important to note that there are many potential causes of rectal bleeding. Conditions like hemorrhoids, anal fissures, diverticular disease, and inflammatory bowel disease (IBD) can also lead to blood in the stool. That said, any persistent or recurrent bleeding should be evaluated by a healthcare professional to rule out serious conditions, including cancer.

3. Possible Causes: As you mentioned, hemorrhoids are a common cause of bright red blood during bowel movements, especially if there is straining involved. Other potential causes include:
- Anal fissures: Small tears in the lining of the anus, often due to passing hard stools.

- Diverticulosis: Pouches that can form in the colon wall and may bleed.

- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause bleeding.

- Polyps: Benign growths in the colon that can bleed.

- Infections: Certain infections can cause inflammation and bleeding in the gastrointestinal tract.

4. Improvement and Next Steps: To address the bleeding, it is crucial to consult a healthcare provider. They may recommend a physical examination, a digital rectal exam, or further diagnostic tests such as a colonoscopy to visualize the colon and identify the source of the bleeding. In the meantime, here are some general suggestions:
- Increase fiber intake: A diet rich in fiber can help soften stools and reduce straining during bowel movements, which may alleviate symptoms if hemorrhoids or fissures are present.

- Stay hydrated: Drinking plenty of water can help maintain stool consistency.

- Avoid straining: Try to relax during bowel movements and avoid prolonged sitting on the toilet.

- Over-the-counter treatments: If hemorrhoids are suspected, topical treatments or sitz baths may provide relief.

In summary, while the presence of blood in your stool can be concerning, it is essential to seek medical advice to determine the underlying cause. Early evaluation and intervention can lead to better outcomes and peace of mind. Please do not hesitate to reach out to a healthcare professional for a thorough assessment and appropriate management.

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