Blood in Stool: When to Seek Medical Attention - Gastroenterology and Hepatology

Blood in the stool?

Since starting college, I have been having bowel movements approximately once a week, and this has been the case for about half a semester.
However, I haven't felt constipated during this time.
Last week, I noticed some dark-colored blood when I had a bowel movement.
I thought it might be due to not eating enough vegetables and didn't think much of it.
But this week, I was really shocked when I saw a large amount of bright red blood.
When I wiped, the entire piece of toilet paper was covered in blood, and the blood was completely separate from the stool.
However, when I had another bowel movement that afternoon, there was no blood at all.
I did feel some tightness in my anus during the bowel movement, but there was no pain.
I would like to ask the doctor what these symptoms might indicate and if I need to get checked.

JO, 20~29 year old female. Ask Date: 2015/06/18

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, the presence of blood in the stool, with the stool and blood being separate, indicates a potential issue in the rectal or anal area.
Common causes include hemorrhoids, anal fissures, polyps, and tumors.
It is recommended to consult a colorectal specialist for an examination, including a digital rectal exam and anoscopy.
Wishing you peace and good health.
Sincerely, Dr.
Lin, Attending Physician, Gastroenterology Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2015/06/18

More Info

When it comes to blood in the stool, it is essential to take the situation seriously, as it can be indicative of various underlying health issues. Based on your description, the presence of dark blood followed by bright red blood, especially when it is separate from the stool, raises several possibilities that warrant further investigation.

Firstly, the dark blood you initially observed could suggest bleeding from higher up in the gastrointestinal tract, such as the stomach or small intestine. This type of bleeding often appears darker due to the time it takes for the blood to travel through the digestive system. In contrast, the bright red blood you noticed later is more commonly associated with bleeding from the lower gastrointestinal tract, such as the colon or rectum. This can occur due to several reasons, including hemorrhoids, anal fissures, diverticular disease, or even more serious conditions like colorectal cancer.

Given that you mentioned experiencing a tight feeling in the anus but no pain, it is possible that you might be dealing with hemorrhoids or an anal fissure. Hemorrhoids are swollen veins in the lower rectum and anus that can bleed, especially during bowel movements. An anal fissure is a small tear in the lining of the anus, which can also cause bleeding and discomfort. Both conditions can be exacerbated by infrequent bowel movements and straining during defecation, which seems to align with your experience of having a bowel movement only once a week.

However, it is crucial to note that while hemorrhoids and fissures are common and often benign, the presence of blood in the stool should not be dismissed. The fact that you have experienced significant bleeding, especially if it is bright red and separate from the stool, suggests that you should seek medical attention. A healthcare professional can perform a thorough evaluation, which may include a physical examination and possibly a colonoscopy, to determine the exact cause of the bleeding.

In addition to the physical examination, your doctor may ask about your dietary habits, bowel movement frequency, and any other symptoms you may be experiencing, such as abdominal pain, changes in bowel habits, or weight loss. These details can help guide the diagnosis and treatment plan.

If you notice any additional symptoms, such as persistent abdominal pain, dizziness, or fainting, it is crucial to seek immediate medical attention, as these could indicate a more severe condition requiring urgent care.

In summary, while the symptoms you describe could be related to common issues like hemorrhoids or anal fissures, the presence of blood in your stool is a sign that you should consult a healthcare provider. They can provide a proper diagnosis and recommend appropriate treatment options to address your symptoms and ensure your overall health. Remember, it is always better to err on the side of caution when it comes to your health, especially regarding symptoms like blood in the stool.

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