Blood in Stool: Causes and When to Seek Help

Blood in the stool?

On February 13th, I experienced my first major rectal bleeding, which was noticeable on the toilet paper after wiping.
After that, there was no more bleeding, but I had significant pain during bowel movements.
For the next few days, my stools were hard, small, and pellet-like, and I experienced pain during bowel movements (about every two days).
After drinking a lot of water, my stools became more regular.
However, today I noticed blood again on the toilet paper, and I experienced severe pain at the moment of passing the stool.
Could this be colon cancer? I rarely eat vegetables but consume a lot of fruit.
Last year, I had sweet potatoes for lunch for several months.
Am I getting enough fiber?

Chengcheng, 10~19 year old female. Ask Date: 2016/03/09

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.
The anal pain is probably caused by an anal fissure.
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 used, but laxatives should not be taken indiscriminately.
At this age, increasing dietary fiber and hydration should be sufficient.
Although the risk of developing colorectal cancer at 17 years old is not zero, it is generally very low.
If bleeding persists, it is advisable to consult a physician.
Fiber supplementation should be a daily practice, and consuming more sweet potatoes and fruits is beneficial; however, not eating vegetables is not a normal dietary pattern.

Reply Date: 2016/03/09

More Info

Understanding blood in stool can be concerning, and it's important to approach this issue with a clear understanding of potential causes and when to seek medical help. Based on your description, it seems you have experienced rectal bleeding, pain during bowel movements, and changes in your stool consistency. Let's break down the possible causes and the appropriate steps to take.

Possible Causes of Blood in Stool
1. Hemorrhoids: One of the most common causes of blood on toilet paper is hemorrhoids, which are swollen veins in the lower rectum or anus. They can cause pain and bleeding, especially during bowel movements.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain and bleeding, particularly during or after a bowel movement.

3. Diverticular Disease: Diverticulosis, which involves small pouches forming in the colon wall, can sometimes lead to diverticulitis, causing inflammation and bleeding.

4. Gastrointestinal Infections: Certain infections can cause inflammation in the intestines, leading to blood in the stool.

5. Polyps or Colorectal Cancer: While less common, polyps (growths on the colon lining) can bleed, and in some cases, they can be precursors to colorectal cancer. Given your concern about colorectal cancer, it's important to consider this, especially if you have risk factors such as a family history of the disease.

When to Seek Medical Help
You should seek medical attention if you experience any of the following:
- Persistent Bleeding: If the bleeding continues or worsens, it's crucial to consult a healthcare provider.

- Severe Pain: Intense pain during bowel movements that does not improve may indicate a more serious condition.

- Changes in Bowel Habits: If you notice significant changes in your bowel habits, such as diarrhea or constipation lasting more than a few days.

- Other Symptoms: Accompanying symptoms like fever, weight loss, or fatigue should prompt an immediate evaluation.

Dietary Considerations
You mentioned that you eat a lot of fruits but consume very few vegetables. While fruits are a good source of fiber, vegetables are also essential for a balanced diet. A diet low in fiber can lead to hard stools, which may contribute to anal fissures or hemorrhoids. Increasing your fiber intake through a combination of fruits, vegetables, and whole grains can help soften stools and promote regular bowel movements.

Conclusion
Given your symptoms of blood in the stool and pain during bowel movements, it is advisable to consult a healthcare professional for a thorough evaluation. They may recommend tests such as a colonoscopy to rule out serious conditions like colorectal cancer, especially if you have risk factors or if your symptoms persist. Early diagnosis and treatment are key to managing any underlying issues effectively.
In summary, while hemorrhoids and anal fissures are common causes of blood in the stool, it is essential to rule out more serious conditions. Improving your diet to include more fiber-rich foods can also help alleviate some of the discomfort you are experiencing. Please prioritize seeing a healthcare provider to address your concerns.

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