Blood on Toilet Paper: When to Seek Medical Advice - Gastroenterology and Hepatology

Blood on toilet paper after wiping?

Hello Doctor: I have a habit of having a bowel movement every morning.
Recently, I have noticed traces of blood on the toilet paper after wiping, although there is no visible blood in the stool itself.
Sometimes the stool appears dark brown, and other times it is light brown.
Could you please advise me on what might be the issue? Should I visit a clinic?

xiangqiong, 20~29 year old female. Ask Date: 2015/09/19

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, based on the symptoms, the likelihood of hemorrhoidal bleeding is the highest.
It may not necessarily be accompanied by pain.
Please increase your intake of fruits and vegetables, and reduce the consumption of spicy and irritating foods.
If necessary, consider warm sitz baths.
If there is no improvement, please consult a colorectal surgeon at the Gastroenterology Department of Taoyuan Hospital, Ministry of Health and Welfare.
Sincerely, Dr.
Chi-Feng Chen.

Reply Date: 2015/09/19

More Info

When you notice blood on toilet paper after a bowel movement, it can understandably cause concern. The presence of blood, even in small amounts, should not be ignored, as it can indicate various underlying health issues. In your case, since you mentioned that the blood is not visible in the stool itself but appears on the toilet paper, there are a few potential causes to consider.

1. Hemorrhoids: One of the most common causes of blood on toilet paper is hemorrhoids. These are swollen veins in the lower rectum or anus that can bleed during bowel movements, especially if you are straining or if the stool is hard. The blood from hemorrhoids is usually bright red and may be seen on the toilet paper or on the surface of the stool.

2. Anal Fissures: Another possibility is an anal fissure, which is a small tear in the lining of the anus. This can occur due to passing hard stools or straining during bowel movements. Like hemorrhoids, anal fissures can cause bright red blood on toilet paper.

3. Diverticular Disease: Diverticulosis, a condition where small pouches form in the colon wall, can also lead to bleeding. This bleeding may not always be visible in the stool but can result in blood on toilet paper.

4. Gastrointestinal Issues: Other gastrointestinal issues, such as inflammatory bowel disease (IBD), polyps, or even colorectal cancer, can cause bleeding. However, these conditions often present with other symptoms, such as abdominal pain, changes in bowel habits, or weight loss.

5. Dietary Factors: Sometimes, dietary factors can lead to changes in stool color. For instance, consuming foods high in iron or certain medications can cause dark stools, which may be mistaken for blood.

Given that you have been experiencing this symptom regularly, it is advisable to seek medical attention. A healthcare provider can perform a thorough evaluation, which may include a physical examination, a review of your medical history, and possibly diagnostic tests such as a colonoscopy or imaging studies to determine the cause of the bleeding.

In summary, while minor bleeding can sometimes be attributed to benign causes like hemorrhoids or anal fissures, it is essential to consult with a healthcare professional to rule out more serious conditions. Early diagnosis and treatment can prevent complications and provide peace of mind. If you notice any additional symptoms, such as significant pain, changes in bowel habits, or persistent bleeding, do not hesitate to seek medical advice promptly.

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