Blood in Stool: Is It Hemorrhoids or Something Else? - Surgery

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Rectal bleeding


Hello doctor, for the past two to three days, I have experienced some pain in the bladder area when I feel the urge to have a bowel movement.
After I go, there is blood, which is bright red in color, and my stool is darker.
Could this be a hemorrhoid flare-up? The anus is not very painful.
Thank you.

Niming, 20~29 year old female. Ask Date: 2015/09/22

Dr. Xu Kaixi reply Surgery


The most common cause of rectal bleeding is hemorrhoidal bleeding.
To rule out other possible causes, a fecal occult blood test should be performed, and based on the results, the necessity for further colonoscopy should be considered.

Reply Date: 2015/09/22

More Info


When it comes to the presence of blood in stool, it can be concerning and warrants careful consideration of various potential causes. Based on your description, you are experiencing pain in the bladder area when you have the urge to defecate, followed by the passage of bright red blood after bowel movements, while your stool appears darker in color.
The bright red blood you are seeing can often be associated with conditions affecting the lower gastrointestinal tract, such as hemorrhoids, anal fissures, or diverticular disease. Hemorrhoids, which are swollen veins in the lower rectum or anus, can cause bright red blood during bowel movements, especially if there is straining involved. They may not always be painful, which aligns with your observation that your anal area is not very painful.

On the other hand, the darker color of your stool could indicate that there is bleeding occurring higher up in the gastrointestinal tract, such as in the stomach or small intestine. This type of bleeding can lead to the stool appearing darker due to the blood being digested. However, since you mentioned that the blood is bright red, it is more likely localized to the lower part of the digestive system.

Given your symptoms, it is essential to consider other potential causes as well. Conditions such as inflammatory bowel disease (IBD), colorectal polyps, or even colorectal cancer can also present with similar symptoms, particularly if there is a change in bowel habits or if you notice any additional symptoms such as weight loss, changes in appetite, or abdominal pain.

To address your concerns, it is advisable to seek medical attention promptly. A healthcare provider will likely perform a thorough history and physical examination, and may recommend further diagnostic tests such as a colonoscopy, which allows for direct visualization of the colon and rectum, and can help identify any abnormalities. Additionally, stool tests may be conducted to check for the presence of blood or other indicators of gastrointestinal issues.

In the meantime, it is important to monitor your symptoms closely. Note any changes in the frequency or consistency of your bowel movements, any additional symptoms such as fever or weight loss, and whether the blood persists or changes in appearance. Avoiding straining during bowel movements, staying hydrated, and maintaining a high-fiber diet can help manage symptoms if they are indeed related to hemorrhoids.

In summary, while your symptoms may suggest hemorrhoids, it is crucial to rule out other potential causes of rectal bleeding. Seeking medical evaluation will provide clarity and ensure that any necessary treatment is initiated promptly. Remember, early intervention is key in managing gastrointestinal health effectively.

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