Occasional Blood on Toilet Paper: Should You Worry?

Occasionally, there is blood in the stool?

After bowel movements, there are small traces of blood on the toilet paper, but no blood in the stool.
Occasionally, there is a small red piece appearing on the toilet paper (it seems there is no blood in the toilet).
Could this be colon cancer or hemorrhoids? It occurs about once or twice a week.

Xiao Wu, 10~19 year old female. Ask Date: 2016/02/05

Dr. Xu Kaixi reply Surgery

Blood in the stool or changes in bowel habits can range from common conditions like hemorrhoids to more serious gastrointestinal diseases.
It is recommended to visit a hospital's gastroenterology or surgical department for further evaluation.

Reply Date: 2016/02/05

More Info

When it comes to finding blood on toilet paper after wiping, it can understandably cause concern. Blood in the stool or on toilet paper can be indicative of various conditions, some of which may require medical attention. Here’s a detailed overview of what you might consider regarding this situation.

Possible Causes of Blood on Toilet Paper
1. Hemorrhoids: One of the most common causes of blood on toilet paper is hemorrhoids. These are swollen veins in the lower rectum or anus that can bleed during bowel movements, especially if you are straining or have constipation. The blood is usually bright red and may be seen on the toilet paper or on the surface of the stool.

2. Anal Fissures: Another common cause is an anal fissure, which is a small tear in the lining of the anus. This can occur due to passing hard stools and can cause sharp pain and bleeding during bowel movements.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can also lead to bleeding. This is more common in older adults and may require further evaluation if bleeding occurs.

4. Polyps or Colorectal Cancer: While less common, blood on toilet paper can also be a sign of polyps or colorectal cancer, especially if it is accompanied by other symptoms such as changes in bowel habits, unexplained weight loss, or persistent abdominal pain.
5. Gastrointestinal Conditions: Other gastrointestinal issues, such as inflammatory bowel disease (IBD) or infections, can also cause bleeding.

When to Seek Medical Attention
Given that you are experiencing blood on toilet paper once or twice a week, it is advisable to consult a healthcare professional. While it may be something benign like hemorrhoids or fissures, it is essential to rule out more serious conditions. A doctor may recommend a physical examination, and possibly a colonoscopy, especially if you are over the age of 50 or have a family history of colorectal cancer.

Diagnostic Approach
During your visit, the doctor will likely ask about your symptoms, including:
- The color and amount of blood
- Any associated symptoms such as pain, changes in bowel habits, or weight loss
- Your dietary habits and any recent changes in your lifestyle
They may perform a rectal examination to check for hemorrhoids or fissures and may recommend further tests if necessary.

Conclusion
In summary, while occasional blood on toilet paper can be due to benign conditions like hemorrhoids or anal fissures, it is crucial to take it seriously and seek medical evaluation, especially given the frequency of your symptoms. Early diagnosis and treatment can prevent potential complications and provide peace of mind. Remember, it is always better to err on the side of caution when it comes to health concerns.

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