Blood in Stool: Causes and Concerns for Patients

Having blood in the stool for several days?

Hello Dr.
Ke, I have a question.
Recently, I have noticed blood in my stool.
On the day of the onset, I initially experienced abdominal pain and diarrhea, but later that day, my stools were almost entirely bright red blood.
In the following days, my stools continued to have blood, but I did not experience any pain around the anus.
I have external hemorrhoids, but they do not cause any pain, even after sitting for long periods or riding a bike.
The only time I feel pain and see blood is when I strain during bowel movements, but this time I felt no pain, only a sensation of bloating in my lower left abdomen and a feeling of fullness in my abdomen.
Additionally, I have been feeling cold and experiencing cold extremities.
Last October, I had a bout of irritable bowel syndrome and visited the doctor several times, but they said it was mainly a gastric issue and prescribed medication for my stomach and anti-diarrheal medication.
I went to the hospital for an examination yesterday, but due to the holiday, I have to wait until the end of February for a gastroscopy and colonoscopy.
I am very worried and unsure of the cause.
Could you please give me a rough idea of what might be causing these symptoms? Could it be colon cancer or polyps? It's hard to bear this anxiety.
Thank you, doctor! P.S.
I had surgery to remove my uterus at the beginning of 101 (in the Taiwanese calendar), could this still be related to ovarian issues?

Lu Lu, 40~49 year old female. Ask Date: 2016/02/04

Dr. Ke Fangxu reply Surgery

Based on your description, it seems more like irritable bowel syndrome combined with hemorrhoidal bleeding.
It is recommended to maintain a light diet and good lifestyle habits.
If symptoms persist without improvement, you may consult a physician for medication.
A colonoscopy is necessary at this age, and accurate predictions cannot be made without it.
Generally, this condition is not related to the ovaries; however, it is advisable to consult a gynecologist for further diagnosis and examination.

Reply Date: 2016/02/04

More Info

Blood in stool can be a concerning symptom, and it’s understandable that you’re feeling anxious about it. There are several potential causes for the presence of blood in your stool, and while some may be benign, others could indicate more serious conditions that warrant further investigation.

1. Hemorrhoids: Given that you mentioned having external hemorrhoids, these could be a common cause of blood in the stool, especially if you experience bleeding during bowel movements. Hemorrhoids can cause bright red blood on the surface of the stool or on toilet paper.

2. Anal Fissures: Similar to hemorrhoids, anal fissures can occur due to straining during bowel movements, leading to sharp pain and bleeding. However, you noted that you haven’t experienced pain recently, which might make this less likely.

3. Gastrointestinal Infections: Your initial symptoms of abdominal pain and diarrhea could suggest an infection, which can lead to inflammation and bleeding in the gastrointestinal tract. This could be due to bacterial, viral, or parasitic infections.

4. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon, can lead to diverticulitis if these pouches become inflamed or infected. This condition can cause abdominal pain and bleeding.

5. Polyps or Colorectal Cancer: While it’s natural to worry about the possibility of colorectal cancer, especially given your symptoms, it’s important to note that not all cases of blood in the stool are cancerous. Polyps, which are benign growths, can also cause bleeding. However, given your age and medical history, it’s prudent to consider this as a potential cause that should be evaluated through a colonoscopy.

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

7. Other Causes: Less commonly, conditions such as gastrointestinal bleeding from ulcers, vascular malformations, or even systemic issues like clotting disorders can lead to blood in the stool.

Given your history of abdominal issues and the recent changes in your bowel habits, it’s crucial to follow up with your healthcare provider as soon as possible. The fact that you have a scheduled colonoscopy is a positive step, as this will allow for a direct examination of your colon and rectum to identify any abnormalities.

In the meantime, here are some recommendations:
- Monitor Symptoms: Keep track of any additional symptoms such as changes in bowel habits, weight loss, or changes in appetite, as these can provide important information to your healthcare provider.

- Dietary Adjustments: Consider a diet high in fiber to help with bowel regularity, but be cautious if you have diverticular disease, as certain foods may exacerbate symptoms.

- Hydration: Ensure you stay well-hydrated, especially if you are experiencing diarrhea.

- Avoid Straining: If you have hemorrhoids or fissures, try to avoid straining during bowel movements, as this can worsen bleeding.

While waiting for your colonoscopy, it’s normal to feel anxious about your symptoms. However, many causes of blood in the stool are treatable, and early intervention can lead to better outcomes. If your symptoms worsen or if you experience significant pain, fever, or changes in your overall health, seek immediate medical attention.

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