Blood in Stool: Causes and When to Seek Help

Blood in the stool

Doctor, after I had a bowel movement yesterday, I noticed bright red blood when I wiped (only blood, nothing else), and there was also a bit of blood on the stool, but I didn't feel any tearing sensation.
I have experienced rectal bleeding before (with tearing sensation), but this time the amount of blood is more than before.
Today, after my bowel movement, I also wiped and found bright red blood (only blood, nothing else), and there was a bit of blood on the stool as well.
The stool I passed today was smaller (thinner) and darker in color.
Additionally, I have felt slight pain in my lower abdomen (my menstrual period is also approaching).
I currently suffer from chronic insomnia and have been eating irregularly, only having 1-2 meals a day (mostly just dinner and a late-night snack).
I researched online and feel that my symptoms resemble both hemorrhoids and colorectal cancer, which makes me worried about the possibility of colorectal cancer.
Do I need to undergo a colonoscopy?

Li Zi, 10~19 year old female. Ask Date: 2016/01/26

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.
You can also purchase over-the-counter hemorrhoidal suppositories for use.
If bleeding persists, it is best to consult a physician.
Although the likelihood of developing colorectal cancer at the age of 19 is not zero, it is generally very low.
Based on your description, the probability of irritable bowel syndrome seems higher.
It is advisable to maintain a light diet and a good lifestyle routine.
If symptoms continue to persist without improvement, you may ask your doctor for medication.
If there is still no improvement or if you are very worried, you can arrange for a colonoscopy.

Reply Date: 2016/01/26

More Info

When you notice fresh red blood in your stool, it can understandably cause concern, especially with your history of previous rectal bleeding. The presence of blood can be indicative of several conditions, ranging from benign to more serious issues. In your case, the symptoms you describe—bright red blood on toilet paper, blood mixed with stool, and abdominal discomfort—could suggest a few potential causes.

One common cause of bright red blood in the stool is hemorrhoids. Hemorrhoids are swollen blood vessels in the rectal area that can bleed during bowel movements, especially if there is straining or constipation involved. Given that you mentioned changes in your diet and possibly irregular bowel habits, this could be a plausible explanation. However, the fact that you also describe a change in the shape of your stool (narrow or thin) and the presence of abdominal pain raises additional concerns.

Another possibility is anal fissures, which are small tears in the lining of the anus that can occur due to passing hard stools. These can cause sharp pain and bleeding during bowel movements. However, the absence of a tearing sensation this time might make this less likely.

On the more serious end of the spectrum, conditions such as diverticulosis, inflammatory bowel disease (IBD), or colorectal cancer could also present with similar symptoms. Colorectal cancer, in particular, can lead to changes in bowel habits, blood in the stool, and abdominal pain. The fact that you are experiencing these symptoms, along with your concerns about your diet and overall health, makes it essential to take this seriously.

Given your symptoms and the potential range of causes, it is advisable to seek medical attention promptly. A colonoscopy is a valuable diagnostic tool that allows for direct visualization of the colon and rectum, and it can help identify any abnormalities, including polyps, tumors, or signs of inflammation. Early detection is key, especially when it comes to conditions like colorectal cancer, which can be more effectively treated when caught early.

In addition to a colonoscopy, your healthcare provider may recommend blood tests to check for anemia, which can occur if there is significant blood loss. They may also inquire about your dietary habits, lifestyle factors, and any other symptoms you may be experiencing.

It is also worth noting that your long-standing insomnia and irregular eating patterns can contribute to gastrointestinal issues. Stress and anxiety can exacerbate digestive problems, so addressing these factors may also be beneficial for your overall health.

In summary, while hemorrhoids or anal fissures could explain your symptoms, the presence of blood in the stool, especially with changes in stool shape and abdominal pain, warrants a thorough evaluation. I strongly encourage you to consult with a healthcare professional who can perform the necessary examinations and provide you with a definitive diagnosis. Early intervention can make a significant difference in outcomes, so do not hesitate to seek help.

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