Blood in Stool: Concerns and Insights for Patients - Gastroenterology and Hepatology

The presence of bright red blood in my stool has made me anxious?

Hello Doctor… I have a family history of colorectal cancer, so I have a colonoscopy every three years.
I had a normal colonoscopy in May last year, but I have issues with internal hemorrhoids.
Three weeks ago, after consuming a large amount of burdock daily, my stool started to appear pink (similar to the color of field mustard stems).
I noticed this and immediately stopped eating it, but my stool has continued to look this way.
Two weeks ago, I visited a doctor; he mentioned that since I had a colonoscopy just a year ago, there shouldn't be any intestinal issues.
After performing a digital rectal exam, the doctor said the bleeding was due to internal hemorrhoids… He prescribed a hemorrhoidal suppository and medication, but for the past two days, every time I have a bowel movement, there is bright red blood, and sometimes there are large clots… My stool also has bright red blood.
Given that I had a colonoscopy a year ago, is there a possibility of tumor growth since then? The suppository prescribed was for a week's supply, but I haven't been using it daily; could this be related?

Yue, 30~39 year old female. Ask Date: 2015/06/22

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, although there is a family history of colorectal cancer, it is currently not recommended to undergo a colonoscopy immediately.
The most likely cause of the blood in the stool is hemorrhoids, so it is advisable to first consult a colorectal surgeon for treatment.
Wishing you safety and good health.
Sincerely, Dr.
Chi-Feng Chen, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/06/22

More Info

When it comes to the presence of blood in stool, especially for patients with a family history of colorectal cancer, it is essential to approach the situation with caution and thorough understanding. Your concern about the bright red blood in your stool, particularly after a recent history of internal hemorrhoids, is valid and warrants careful evaluation.

Firstly, the fact that you have a family history of colorectal cancer is significant. Regular screenings, such as colonoscopies, are crucial for early detection of any potential issues, including polyps or tumors. You mentioned that your last colonoscopy was normal, which is reassuring; however, it does not completely rule out the possibility of new developments since then. The typical recommendation is to have a follow-up colonoscopy every 10 years if no risk factors are present, but given your family history, your healthcare provider may suggest more frequent screenings.

The bright red blood you are experiencing could indeed be related to your internal hemorrhoids, which are known to cause bleeding during bowel movements. Hemorrhoids can lead to fresh blood on the stool or toilet paper, and the fact that you have been diagnosed with this condition supports this possibility. However, the presence of blood in the stool should never be dismissed, especially if it is a new symptom or has changed in character.

You mentioned that you have been experiencing this issue for about two weeks and that the blood appears bright red and in large amounts. This could indicate a more significant issue, such as a fissure, a more severe hemorrhoidal condition, or even other gastrointestinal issues. The fact that you have been consuming a large amount of burdock root (牛蒡) could also contribute to changes in your bowel habits and stool appearance, but it is unlikely to be the sole cause of the bleeding.

Regarding the medication prescribed by your doctor, it is essential to follow the treatment plan as directed. If you have not been using the suppositories daily as recommended, it may affect their efficacy in managing your symptoms. Consistency in treatment is crucial for conditions like hemorrhoids, as it allows for proper healing and symptom management.

Given your symptoms and the potential for serious underlying conditions, it is advisable to follow up with your healthcare provider. You may need a repeat colonoscopy or additional diagnostic tests to rule out any new developments in your colon, especially since you have a family history of colorectal cancer. It is also important to communicate any changes in your symptoms, such as the amount of blood, any associated pain, or changes in bowel habits.

In summary, while your symptoms may be related to hemorrhoids, the presence of bright red blood in stool, especially with your family history, should be taken seriously. Regular follow-ups and adherence to your treatment plan are essential. If symptoms persist or worsen, do not hesitate to seek further medical evaluation to ensure your health and peace of mind.

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