Blood in Stool: When to Seek Further Evaluation

Blood in the stool?

I apologize for interrupting your valuable time.
Last week, I noticed dark red blood in my stool.
The next day, I didn't have a bowel movement, but when I did two days later, I passed black stools, and then I didn't have any the following day.
In February of this year, I visited a colorectal surgeon who performed a digital rectal exam and a colonoscopy.
The fecal occult blood test was positive, and I was diagnosed with hemorrhoids.
Later, I consulted a hepatobiliary and gastroenterology specialist who performed an upper endoscopy and found gastroesophageal reflux disease and a gastric ulcer.
Could you please explain why I experienced the situation last week? Is it necessary for me to undergo a colonoscopy?

Dugu, 30~39 year old female. Ask Date: 2015/11/18

Dr. Ke Fangxu reply Surgery

At the age of 37, if a colonoscopy has been performed within the past year, there is generally no need for a repeat examination.
The cause of black stools may be related to food and should not be a cause for excessive concern.

Reply Date: 2015/11/18

More Info

When it comes to blood in the stool, it is essential to understand the potential causes and when to seek further evaluation. The presence of dark red blood on the stool or black, tarry stools can indicate various underlying conditions, some of which may require immediate medical attention.

From your description, it seems that you have experienced episodes of blood in your stool, which can be alarming. The fact that you have a history of hemorrhoids (痔瘡) is relevant, as hemorrhoids can often cause bright red blood on the stool or toilet paper. However, the presence of black stools (melena) can indicate bleeding from a higher part of the gastrointestinal tract, such as the stomach or duodenum, where the blood has had time to be digested, resulting in a dark color.

Given your previous evaluations, including a colonoscopy and an upper endoscopy (胃鏡), it is crucial to consider the following points:
1. Recent Symptoms: The dark red blood and black stools you experienced last week could be related to your known conditions, such as hemorrhoids or gastric ulcers. However, any new or worsening symptoms should be taken seriously. If the blood is persistent or accompanied by other symptoms like abdominal pain, weight loss, or changes in bowel habits, further evaluation is warranted.

2. Need for Further Evaluation: Since you have already undergone a colonoscopy and upper endoscopy, it may be beneficial to discuss your recent symptoms with your healthcare provider. They may recommend repeating the colonoscopy if there are concerns about new lesions or if your symptoms persist. Additionally, they might consider other diagnostic tests, such as imaging studies or lab tests, to rule out other potential causes of gastrointestinal bleeding.

3. Potential Causes: Besides hemorrhoids and gastric ulcers, other potential causes of blood in the stool include diverticulosis, inflammatory bowel disease (IBD), colorectal polyps, or even colorectal cancer. Given your history of gastrointestinal issues, it is essential to monitor your symptoms closely.

4. Lifestyle and Management: In the meantime, maintaining a healthy diet rich in fiber can help manage hemorrhoids and promote regular bowel movements. Staying hydrated and avoiding straining during bowel movements can also be beneficial. If you are experiencing significant discomfort or changes in your symptoms, do not hesitate to reach out to your healthcare provider for guidance.

5. When to Seek Immediate Help: If you experience significant bleeding (more than a small amount), dizziness, fainting, or severe abdominal pain, seek emergency medical attention immediately. These could be signs of a more serious condition requiring urgent care.

In summary, while your previous evaluations provide some context, the new symptoms you are experiencing warrant a discussion with your healthcare provider. They can help determine whether further investigation, such as a repeat colonoscopy, is necessary based on your current symptoms and medical history. Remember, early detection and intervention are key in managing gastrointestinal issues effectively.

Similar Q&A

Understanding Blood in Stool: When to Seek Further Medical Evaluation

Hello Doctor: Sometimes I notice blood when I use the restroom, but I had a comprehensive health check last October that indicated no issues. I typically have a bowel movement once every 1 to 2 days. Occasionally, I experience abdominal pain, but I haven't had diarrhea. Sinc...

Dr. Xu Kaixi reply Surgery
Hello: Blood in the stool is considered an abnormal symptom and can range from common conditions like hemorrhoids to more serious gastrointestinal diseases. Based on your description, the likelihood of hemorrhoidal bleeding is highest. It is recommended that you visit a hospital&...

Understanding Blood in Stool: When to Seek Further Evaluation

Hello Doctor, I have recently noticed blood in my stool at times. Just now, there was blood on the stool, and there was also blood around my anus. It might be hemorrhoids. A particular situation I experienced was once seeing dark red mucus on the stool, but that only happened onc...

Dr. Ke Fangxu reply Surgery
This situation is likely indicative of a higher possibility of hemorrhoidal bleeding, although anal fissures can also cause anal pain. As long as there is no further bleeding, it should not be a major concern. It is recommended to avoid constipation during this period and to shor...

Understanding Blood in Stool: When to Seek Medical Attention

Hello Doctor: I recently visited the doctor due to discomfort in my stomach. The doctor conducted blood tests, an ultrasound, and a fecal occult blood test, all of which were normal. However, over the past two days, I have noticed a small amount of blood at the tip of my stool, a...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: If new symptoms arise, you can return for further evaluation. However, the more likely conditions are anal fissures, hemorrhoids, or proctitis, with cancer being a very rare possibility. Changhua Hospital cares about your health. Dr. Tsai An-shun.

Blood in Stool: Should You See a Doctor or Wait and Observe?

I previously had irritable bowel syndrome, and recently, due to stress, I've experienced a recurrence along with constipation (occasionally, my stool has been very hard, and I've noticed a small amount of blood on the toilet paper). Yesterday, I suddenly had a strong ur...

Dr. Ke Fangxu reply Surgery
In this situation, it is recommended to maintain a light diet and a good daily routine. Spicy, irritating, and greasy foods should be avoided. If symptoms persist without improvement, you may consult a physician for medication or undergo a colonoscopy.