Blood in Stool: When to Worry About Internal Hemorrhoids

Blood in stool 2

The doctor previously asked about bowel movements due to urgency, holding it in, or walking for a long time.
Occasionally, there is blood at the end of the stool.
However, I have a history of internal hemorrhoids and underwent a full colonoscopy three years ago, which was normal.
Last year, I had a partial colonoscopy that was also normal.
In the past two days, I noticed blood once on the toilet paper and once at the end of the stool, with some blood mixed in.
The doctor mentioned that the likelihood of bleeding is mainly due to the internal hemorrhoids, but I am still concerned.
Do I need to undergo another colonoscopy?

Guang, 30~39 year old female. Ask Date: 2015/08/07

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, if there are blood streaks in the stool, and they are mixed within the feces, it indicates that the bleeding is from a higher location; if the blood is separate from the stool, it usually suggests bleeding near the anus, with hemorrhoids being the most common cause.
However, if the symptoms persist, it is important to consult a colorectal surgeon.
Sincerely, Dr.
Chi-Feng Chen, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/08/07

More Info

When it comes to understanding blood in stool, particularly in the context of internal hemorrhoids, it is essential to approach the situation with a clear understanding of the potential causes and when to seek further medical evaluation.

Internal hemorrhoids are swollen veins located inside the rectum, and they can often lead to bleeding during bowel movements. This bleeding is typically bright red and may appear on the toilet paper or mixed with stool. Given your history of internal hemorrhoids and previous colonoscopies that showed normal results, it is reasonable to consider that the blood you are observing could indeed be related to your hemorrhoids, especially if you have experienced straining during bowel movements or changes in your bowel habits.

However, it is crucial to remain vigilant. While hemorrhoids are a common cause of rectal bleeding, other conditions can also lead to similar symptoms, including anal fissures, diverticular disease, or even more serious conditions such as colorectal cancer. Given that you have had previous colonoscopies that were normal, the likelihood of a serious condition is lower, but it does not eliminate the need for caution.

In your case, since you have noticed blood on two separate occasions recently, it would be prudent to consult your healthcare provider. They may recommend a follow-up colonoscopy, especially if there are any changes in your symptoms, such as increased frequency of bleeding, changes in bowel habits, or any new symptoms like abdominal pain or weight loss. A repeat colonoscopy can help rule out any new developments or conditions that may have arisen since your last examination.

Additionally, if you are experiencing significant discomfort, changes in your bowel habits, or if the bleeding persists, these are all indicators that further investigation is warranted. Your healthcare provider may also consider other diagnostic tests, such as imaging studies or laboratory tests, to ensure a comprehensive evaluation of your gastrointestinal health.

In summary, while it is possible that the blood you are seeing is due to your known internal hemorrhoids, it is essential to monitor the situation closely. If the bleeding continues or if you have any concerns, do not hesitate to seek medical advice. Early intervention and thorough evaluation are key to ensuring that any potential issues are addressed promptly and effectively.

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