Blood in Stool: When to Seek Surgical Consultation

Q: Blood in Stool: When to Seek Surgical Consultation

Hello： You can directly schedule an outpatient appointment with the colorectal department for a check-up. <br>The Fubor District Changhua Hospital cares about you.

Blood in stool, stool differs from usual?

I usually have bowel movements about three times a week.
The first time I noticed blood in my stool was after I held it in and then strained to have a bowel movement when I got home.
At that time, it wasn't very frequent; it only occasionally happened that I would see bright red streaks of blood during a bowel movement, which was alarming when I wiped.
Recently, after moving back home and starting my career, my stools have changed; they have become softer and more formed.
Sometimes they have bright red streaks of blood, and sometimes they don't.
I just want to know which specialist I should see for this issue.

SUSAN, 20~29 year old female. Ask Date: 2015/06/27

Dr. Yu Mingchang reply Surgery

Hello: You can directly schedule an outpatient appointment with the colorectal department for a check-up.
The Fubor District Changhua Hospital cares about you.

Reply Date: 2015/06/27

More Info

When it comes to the presence of blood in stool, it is essential to approach the situation with caution and seek appropriate medical advice. Blood in the stool can be indicative of various underlying conditions, some of which may require surgical intervention. Here’s a detailed breakdown of what you should consider and when to seek a surgical consultation.

Understanding Blood in Stool
Blood in the stool can manifest in different forms, such as bright red blood (hematochezia) or darker, tarry stools (melena). The color and consistency of the blood can provide clues about the source of the bleeding. Bright red blood typically suggests that the bleeding is occurring in the lower gastrointestinal tract, such as the rectum or colon, while darker blood may indicate bleeding from higher up in the digestive tract.

Common Causes
1. Hemorrhoids: One of the most common causes of bright red blood in the stool is hemorrhoids, which are swollen veins in the rectum or anus. They can cause pain, itching, and bleeding, especially during bowel movements.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain and bleeding during bowel movements.

3. Diverticular Disease: Diverticulosis and diverticulitis can cause bleeding in the colon. Diverticulosis involves the formation of small pouches in the colon wall, while diverticulitis is the inflammation of these pouches.

4. Colorectal Polyps or Cancer: Polyps are growths on the lining of the colon that can bleed. Some polyps can develop into colorectal cancer over time, making it crucial to monitor any changes.

5. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause inflammation in the gastrointestinal tract, leading to bleeding.

When to Seek Medical Attention
Given your symptoms of intermittent bright red blood in the stool, especially after changes in your bowel habits, it is advisable to consult a healthcare professional. Here are specific situations when you should seek medical attention:
- Persistent Symptoms: If the blood in your stool continues or worsens over time, it is essential to seek medical advice.

- Accompanying Symptoms: If you experience additional symptoms such as severe abdominal pain, weight loss, changes in appetite, or fatigue, these could indicate a more serious condition.

- Change in Bowel Habits: Any significant change in your bowel habits, such as the consistency of your stool or the frequency of bowel movements, warrants a consultation.

Which Specialist to See
For blood in the stool, the best initial step is to consult a gastroenterologist, a specialist in digestive system disorders. They can perform necessary evaluations, including:
- Physical Examination: A thorough examination to assess any external signs of hemorrhoids or fissures.

- Colonoscopy: This procedure allows direct visualization of the colon and rectum, enabling the doctor to identify and potentially treat any abnormalities.

- Imaging Studies: In some cases, imaging studies like a CT scan may be necessary to evaluate the gastrointestinal tract.

Surgical Consultation
If the gastroenterologist identifies a condition that may require surgical intervention, such as significant polyps, diverticulitis, or colorectal cancer, they will refer you to a surgeon. Signs that may indicate the need for surgical consultation include:
- Large or symptomatic polyps: If polyps are found during a colonoscopy, they may need to be removed surgically.

- Diverticulitis with complications: If diverticulitis leads to abscess formation or perforation, surgery may be necessary.

- Colorectal cancer: If cancer is diagnosed, surgical resection may be required as part of the treatment plan.

Conclusion
In summary, while occasional blood in the stool can be benign, it is crucial to take it seriously, especially with changes in bowel habits. Consulting a gastroenterologist is the best course of action to determine the underlying cause and appropriate treatment. If surgical intervention is necessary, they will guide you through the process and refer you to a qualified surgeon. Remember, early detection and treatment are key to managing any potential gastrointestinal issues effectively.

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