Symptoms: Blood, Mucus, and Discomfort in Bowel Movements

Frequent difficulty in cleaning after bowel movements, and recently there has been blood and mucus?

Hello, doctor.
Previously, my bowel movements were very smooth and I didn't have any major issues.
However, in the past two to three months, I've started experiencing hard stools that can be somewhat painful, and I've noticed a little bit of blood on the toilet paper after wiping.
After a bowel movement, I feel itchy, and when I wipe, I find that I haven't cleaned thoroughly, even though I thought I did.
Sometimes, my stools have some mucus, but I can't tell if it's from vaginal discharge or from the stool, so I haven't paid much attention to it.
Two days ago, during a bowel movement, I suddenly passed a lot of clear mucus and blood that looked like spider webs; this time it didn't hurt, but I felt a sensation of incomplete evacuation.
I've also noticed that I've been passing very foul-smelling gas lately.
My uncle was diagnosed with colon cancer six months ago, and my father has polyps in his colon.
I've been worried these past couple of days because I'm abroad and I'm not sure if this is serious or if I need to seek medical attention.
Doctor, could this possibly be colon cancer, colitis, or some other disease? Should I seek medical help? Thank you!

Wang, 20~29 year old female. Ask Date: 2016/02/03

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.
Although the risk of developing colorectal cancer at the age of 20 is not zero, it is generally very low.
It is recommended to avoid constipation during this period and to shorten the time spent on the toilet.
Warm sitz baths may also help alleviate symptoms.
Over-the-counter hemorrhoidal suppositories can be used, but laxatives should not be taken indiscriminately.
At this age, increasing dietary fiber and fluid intake should be sufficient.
If symptoms persist without improvement, it is advisable to consult a physician for medication.
If there is significant concern, a colonoscopy can be arranged.

Reply Date: 2016/02/03

More Info

Based on the symptoms you've described, it sounds like you may be experiencing a combination of issues that could be related to your gastrointestinal health. The presence of blood in your stool, mucus, and discomfort during bowel movements can be concerning, especially given your family history of colorectal cancer and polyps.
First, let's break down the symptoms:
1. Blood in Stool: The presence of blood can be caused by several factors. In your case, it could be due to hemorrhoids, anal fissures, or even more serious conditions such as inflammatory bowel disease (IBD) or colorectal cancer. Given your family history, it is essential to take this symptom seriously.

2. Mucus in Stool: Mucus can be a normal component of stool, but an increase in mucus production can indicate irritation or inflammation in the intestines. This can occur in conditions like IBD, irritable bowel syndrome (IBS), or infections.

3. Discomfort and Itching: Pain during bowel movements, especially if accompanied by blood, can indicate anal fissures or hemorrhoids. The itching could also be a sign of irritation from wiping or a skin condition.

4. Foul-smelling Gas: Excessive gas can be a sign of malabsorption or changes in gut flora, often related to dietary changes or gastrointestinal disorders.

Given these symptoms, it is advisable to seek medical attention. A healthcare provider may recommend several diagnostic tests, including:
- Colonoscopy: This is the gold standard for evaluating the colon and can help identify polyps, tumors, or inflammatory conditions.

- Stool Tests: These can check for infections, blood, or other abnormalities.

- Blood Tests: These can help assess for anemia or signs of inflammation.

Family History Consideration
Your family history of colorectal cancer and polyps is significant. Individuals with a family history of colorectal cancer are often advised to begin screening at an earlier age than the general population. The typical recommendation is to start screening at age 45, but if there’s a strong family history, your doctor may suggest starting even earlier.

Lifestyle and Dietary Considerations
In addition to seeking medical advice, consider the following lifestyle and dietary changes that may help alleviate some symptoms:
- Increase Fiber Intake: A diet rich in fiber can help soften stools and reduce straining during bowel movements, which may alleviate some discomfort and prevent hemorrhoids.

- Stay Hydrated: Drinking plenty of water can help keep stools soft.

- Regular Exercise: Physical activity can promote regular bowel movements and overall digestive health.

- Avoid Irritants: Certain foods can exacerbate gastrointestinal symptoms. Keeping a food diary may help identify any triggers.

Conclusion
While your symptoms could be related to benign conditions like hemorrhoids or IBS, the combination of blood in your stool, mucus, and your family history necessitates a thorough evaluation by a healthcare professional. It is crucial not to ignore these symptoms, as early detection and treatment of any potential issues can significantly improve outcomes. Please consider scheduling an appointment with a gastroenterologist as soon as possible to discuss your symptoms and undergo appropriate testing. Your health is paramount, and addressing these concerns early can lead to better management and peace of mind.

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