Blood in Stool: Signs and Concerns for Colon Health

Rectal bleeding

Hello, doctor.
Since early May of last year, I have noticed about 1-2 mm of blood streaks on toilet paper after bowel movements.
Occasionally, I see blood on the toilet paper, but it is always bright red.
The occurrence of blood in my stool is infrequent, mostly seen on the toilet paper.
Recently, I have been having bowel movements 2-3 times a day, but generally, I still go once a day.
I have a history of frequent abdominal pain that leads me to the bathroom, and it seems to be happening more often now.
A few months ago, I lost 3-4 kg, but I regained it after the New Year.
For a period, I was eating sweet potato leaves with rice twice a week.
Around January, after a bowel movement, I passed gas, and while wiping, there was no blood in the stool, but I noticed bright red blood on the toilet paper.
A few days later, I experienced itching in the anal area, and upon wiping again, I found blood (which I did not see during the previous wipe).
Could this be a sign of colorectal cancer? Thank you.

A-Dai, 10~19 year old female. Ask Date: 2016/02/23

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.
Warm sitz baths may also help alleviate symptoms.
Over-the-counter hemorrhoidal suppositories can be purchased for use.
If bleeding persists, it is advisable to consult a physician.
Although the likelihood of developing colorectal cancer at the age of 15 is not zero, it is generally very low.
It is suggested to maintain a light diet and a good daily routine.
If symptoms continue without improvement, a physician can prescribe medication.
If there is still no improvement or if there are significant concerns, a colonoscopy can be arranged.

Reply Date: 2016/02/23

More Info

When it comes to the presence of blood in stool, it is essential to approach the situation with caution and seek medical evaluation. The symptoms you describe, such as the occasional presence of bright red blood on toilet paper or in your stool, can be indicative of several conditions, some of which may require prompt attention.

Firstly, the bright red color of the blood typically suggests that the bleeding is occurring in the lower gastrointestinal tract, such as the rectum or anus. Common causes of such bleeding include hemorrhoids, anal fissures, or diverticular disease. Hemorrhoids, which are swollen veins in the rectal area, can cause bleeding, especially during bowel movements. Anal fissures, which are small tears in the lining of the anus, can also lead to pain and bleeding. Both conditions are often exacerbated by constipation or straining during bowel movements.

In your case, the fact that you have experienced changes in bowel habits, including an increase in frequency and occasional abdominal pain, raises some concerns. While these symptoms can be associated with benign conditions, they can also be indicative of more serious issues, including inflammatory bowel disease (IBD) or even colorectal cancer, especially considering your weight loss and changes in bowel habits.

It is important to note that while the presence of blood in the stool can be alarming, it does not automatically indicate cancer. However, given your symptoms and history, it is crucial to undergo further evaluation. A colonoscopy is often recommended for individuals with rectal bleeding, especially if they have risk factors such as a family history of colorectal cancer or if they are over the age of 50. This procedure allows for direct visualization of the colon and rectum and can help identify any abnormalities, such as polyps or tumors.

Regarding your concern about the potential for colorectal cancer, it is essential to consider other risk factors, including age, family history, and any other gastrointestinal symptoms you may be experiencing. The fact that you have had episodes of abdominal pain and changes in your bowel habits warrants a thorough evaluation by a healthcare professional.

In addition to a colonoscopy, your doctor may recommend other tests, such as blood tests to check for anemia or inflammation, stool tests to rule out infections, or imaging studies if necessary. It is also important to discuss your dietary habits and any recent changes, as these can impact gastrointestinal health.

In summary, while the presence of blood in your stool can be concerning, it is essential to approach the situation with a comprehensive evaluation. Given your symptoms, it is advisable to consult with a gastroenterologist who can guide you through the necessary diagnostic steps and provide appropriate management based on the findings. Early detection and intervention are key to addressing any potential issues effectively.

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