Blood and Mucus in Stool: When to Seek Colonoscopy - Gastroenterology and Hepatology

Since the beginning of the year, there have been four instances of blood in the stool, and recently, the stool has also contained mucus?

In February and March of this year, as well as recently in September, I noticed blood-tinged mucus attached to my stool.
The amount was minimal, and it mostly appeared on one day without recurring.
At the beginning of October, I experienced a week where my stool consistently contained translucent, milky white mucus.
Initially, it was mixed with the stool, but later I could see a lump of milky mucus at the bottom of the toilet.
After an examination, the doctor initially diagnosed it as enteritis (he confirmed seeing the mucus through an anoscope and sigmoidoscope) and prescribed medication, advising me to observe for 2-3 weeks after finishing the treatment.
The mucus gradually changed and then disappeared.
However, on November 7 and November 16, I again noticed white mucus mixed with my stool in the morning.
This occurrence seems to happen every one to two weeks, with mucus settling at the bottom of the toilet or adhering to the stool, but it only lasts for one day and is not seen the following day.
This has caused me some concern, especially since I have intermittently observed blood-tinged mucus since the beginning of the year, and now I am experiencing mucus again.
Should I go directly for a colonoscopy? [Additional information] On the days when the mucus appeared, I did not have any gastrointestinal discomfort.
I have been having regular bowel movements every morning at a fixed time.
I am currently 36 years old.

Lin Xiaofen, 30~39 year old female. Ask Date: 2015/11/24

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, if mucus stools are accompanied by blood, one should consider the possibility of enteritis or tumors, and a colonoscopy may be warranted.
If it is just mucus stools, it could also indicate digestive dysfunction.
Sincerely, Dr.
Chi-Feng Chen, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/11/24

More Info

When it comes to the presence of blood and mucus in stool, it is essential to understand the underlying causes and when to seek further evaluation, such as a colonoscopy. Your situation, characterized by intermittent blood-streaked mucus and episodes of translucent white mucus in your stool, raises valid concerns that warrant careful consideration.

Firstly, the presence of blood in the stool can arise from various sources within the gastrointestinal tract, including hemorrhoids, anal fissures, diverticular disease, inflammatory bowel disease (IBD) such as ulcerative colitis or Crohn's disease, and even colorectal cancer. Mucus in the stool can also be a sign of inflammation or irritation in the intestines, which can occur in conditions like IBD or infections.

In your case, you have experienced blood-streaked mucus intermittently since early this year, along with episodes of translucent white mucus. The fact that these occurrences are not continuous and often resolve after a day is somewhat reassuring; however, the recurrence of symptoms over several months is concerning. Your physician's initial assessment of intestinal inflammation and subsequent treatment indicates that they are taking your symptoms seriously, which is a positive step.

The recommendation to observe your symptoms after treatment is standard practice. However, given that you have had multiple episodes of blood and mucus in your stool over several months, it is prudent to consider a colonoscopy for further evaluation. A colonoscopy allows for direct visualization of the colon and rectum, enabling the physician to identify any abnormalities, such as polyps, inflammation, or lesions, and to obtain biopsies if necessary.

The absence of gastrointestinal discomfort or changes in bowel habits is a good sign, but it does not entirely rule out the possibility of underlying pathology. The intermittent nature of your symptoms, particularly the blood and mucus, suggests that there may be an ongoing issue that requires further investigation.
In summary, while your symptoms may not indicate an immediate emergency, the persistence and recurrence of blood and mucus in your stool over several months warrant a thorough evaluation. A colonoscopy would provide valuable information regarding the health of your colon and rectum, helping to rule out serious conditions such as IBD or colorectal cancer. Given your age (36 years), it is essential to be proactive about your gastrointestinal health, especially with the symptoms you have described.
I recommend discussing your concerns with your healthcare provider and considering scheduling a colonoscopy for a comprehensive evaluation. Early detection and intervention are crucial in managing gastrointestinal issues effectively.

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