Diarrhea with Blood and Mucus: Causes and Concerns

Diarrhea with blood and mucus?

Hello Doctor: Around May, I noticed mucus on the toilet paper when wiping after using the restroom, and there was a small streak of blood about 2 millimeters long.
After that, I experienced some bleeding for about three days.
In late August, I noticed light red color on the toilet paper, and around September, I had a day when I felt pain near the anus while walking.
I also experienced diarrhea, but the stool was black and watery (I had two bowel movements that day, the first one was normal).
This week, I found a very small spot of red on the toilet paper (the stool was normal).
Today, my first bowel movement was formed (thicker than a 50-cent coin), and there was just a small spot of blood on the toilet paper.
However, I later experienced abdominal pain and diarrhea, going to the restroom three times.
On the third time, it seemed like there were some streaks of blood in the mucus (the toilet paper was clean, but the color was slightly orange).
During this time, my stool occasionally had mucus, and the formed stools have been quite thick.

Lu Jia-hong, 10~19 year old female. Ask Date: 2015/11/21

Dr. Ke Fangxu reply Surgery

This situation likely indicates a higher possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
If bleeding persists, it is advisable to consult a physician for evaluation.

Reply Date: 2015/11/21

More Info

Understanding diarrhea with blood and mucus can be concerning, and it’s essential to approach this issue with careful consideration of the symptoms and potential underlying causes. Based on your description, it seems you have experienced a range of gastrointestinal symptoms, including the presence of blood and mucus in your stool, changes in stool consistency, and abdominal pain.
The presence of blood in the stool, especially when accompanied by mucus, can indicate several conditions. Some possible causes include:
1. Hemorrhoids: Swollen blood vessels in the rectal area can cause bleeding, especially during bowel movements. This bleeding is usually bright red and may be accompanied by mucus.

2. Anal Fissures: Small tears in the lining of the anus can occur due to passing hard stools, leading to pain and bleeding during bowel movements.

3. Infections: Bacterial infections (such as those caused by E. coli, Salmonella, or Shigella) can lead to diarrhea with blood and mucus. These infections often present with abdominal cramps, fever, and sometimes vomiting.

4. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause inflammation in the gastrointestinal tract, leading to symptoms such as diarrhea, abdominal pain, and the presence of blood and mucus in the stool.

5. Diverticulitis: Inflammation or infection of small pouches that can form in the walls of the colon may cause symptoms including abdominal pain, fever, and changes in bowel habits, including diarrhea with blood.

6. Colorectal Polyps or Cancer: Although less common, the presence of blood in the stool can sometimes indicate polyps or colorectal cancer, especially in individuals over 50 or those with a family history of colorectal disease.

Given the complexity of your symptoms, including the changes in stool color (black, which may indicate upper gastrointestinal bleeding), it is crucial to seek medical attention promptly. Black, tarry stools (melena) can suggest bleeding from the upper gastrointestinal tract, which requires immediate evaluation.

In addition to the physical examination, your healthcare provider may recommend diagnostic tests such as:
- Stool Tests: To check for infections or the presence of blood.

- Colonoscopy: This procedure allows direct visualization of the colon and rectum and can help identify any abnormalities such as polyps, inflammation, or tumors.

- Imaging Studies: Such as CT scans, to evaluate the abdominal organs.

While waiting for your appointment, it is advisable to monitor your symptoms closely. Note any changes in the frequency or consistency of your bowel movements, the presence of pain, and any other associated symptoms like fever or weight loss. Avoid self-medicating, especially with over-the-counter anti-diarrheal medications, as these can sometimes worsen certain conditions.

In summary, the symptoms you are experiencing warrant a thorough evaluation by a healthcare professional. Early diagnosis and treatment are crucial in managing any underlying conditions effectively. Please ensure you communicate all your symptoms clearly to your doctor, as this will aid in determining the appropriate course of action.

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