Blood in Stool: Causes and Concerns for Digestive Health

Blood in the stool?

Hello, at the end of August this year, I experienced a period of constipation, and after my bowel movements became more regular, I noticed fresh blood.
I consulted a doctor who diagnosed it as an anal fissure.
After my bowel movements improved, I didn't have any bleeding.
However, last week I had constipation again, and for the past two days, my stools have been thinner, accompanied by bloating and abdominal pain.
Today, my stools became thicker, but there was blood again (with drops of blood in the toilet and fresh blood when wiping).
My abdomen continues to feel bloated (it feels like I'm in between needing to pass gas and having diarrhea, but I have neither).
Last September, I had a colonoscopy due to severe abdominal pain, which revealed mild rectal ulcers (no medication was prescribed), and inflammation and swelling at the beginning of the colon, which was treated with antibiotics.
A month later, I experienced abdominal pain again and was diagnosed with appendicitis, leading to an appendectomy.
I would like to know if my current situation is related to my previous conditions.
I have been under the impression that since I had a colonoscopy only a year ago, there shouldn't be any serious issues, but the recurring blood in my stool is concerning...
Thank you!

Bella, 20~29 year old female. Ask Date: 2015/10/11

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Ms.
Bella, based on your condition, it is advisable to consider either an anal fissure or hemorrhoids.
You should monitor the situation for 3-5 days, and if the bleeding persists, we will arrange for a colonoscopy.
Changhua Hospital is concerned about your health.

Reply Date: 2015/10/11

More Info

Understanding blood in stool can be concerning, especially when it’s accompanied by symptoms like abdominal pain and changes in bowel habits. Based on your description, it seems you have experienced a few episodes of rectal bleeding, which has been attributed to anal fissures in the past. However, the recurrence of blood in your stool, along with abdominal discomfort, warrants further investigation.

Firstly, it’s important to recognize that blood in the stool can arise from various sources within the gastrointestinal tract. The most common causes include hemorrhoids, anal fissures, diverticular disease, and inflammatory bowel disease (IBD). Given your history of anal fissures and a previous diagnosis of mild rectal ulceration, it’s plausible that these could still be contributing factors. However, the presence of fresh blood, especially if it appears again after a period of normalcy, raises the possibility of other underlying conditions.

The fact that you have experienced changes in your bowel habits, such as alternating between constipation and diarrhea, along with abdominal bloating and pain, could suggest a functional gastrointestinal disorder, such as irritable bowel syndrome (IBS), or it could indicate a more serious condition like IBD, which includes Crohn’s disease and ulcerative colitis. These conditions can lead to inflammation, ulceration, and bleeding in the gastrointestinal tract.

Your previous colonoscopy findings of mild rectal ulceration and inflammation are also significant. While it is true that a colonoscopy performed a year ago may not reveal new issues, it is still possible for conditions to develop or worsen in a relatively short period. The fact that you had appendicitis and subsequent surgery could also be relevant, as surgical changes can sometimes lead to alterations in bowel habits or new gastrointestinal symptoms.

Given your symptoms, it is crucial to consult with a healthcare professional who can perform a thorough evaluation. This may include a repeat colonoscopy or other imaging studies to assess the current state of your gastrointestinal tract. Additionally, laboratory tests may be necessary to check for signs of infection, inflammation, or anemia, which can occur with significant blood loss.

In the meantime, managing your diet and hydration can help alleviate some symptoms. Increasing fiber intake can assist with constipation, but it’s essential to do so gradually to avoid exacerbating bloating. Staying well-hydrated is also important for overall digestive health.

In summary, while your previous diagnosis of anal fissures may explain some of the bleeding, the recurrence of blood in your stool, along with abdominal pain and changes in bowel habits, necessitates further investigation. It’s essential to follow up with your healthcare provider to rule out any serious conditions and to receive appropriate treatment. Early diagnosis and management are key to maintaining digestive health and preventing complications.

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