Blood in Stool: Causes and Concerns for Patients

Rectal bleeding

Hello doctor, I have been experiencing slight bleeding during bowel movements for about 2 to 3 years.
I remember the initial incident was when I had a hard stool that caused the bleeding.
Since then, I have had pain and bleeding during bowel movements, but a few months later, even when the pain subsided, there was still mild bleeding.
Sometimes, even with softer stools, I still experience bleeding.
The color of my stool tends to be coffee-colored or earthy yellow, and there are still instances of bleeding.
Occasionally, I notice some blood when wiping, and there is sometimes a slight reddish tint in the toilet, but it is always in small amounts and not every time.
Most of the time, the bleeding is more noticeable after wiping, but it is usually just a little bit.
Currently, I do not experience significant discomfort during or after bowel movements.
I generally consume more fruits and vegetables than meat, and I can complete a bowel movement in just a few seconds, at least once a day.
What could be the possible cause of this?

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

Dr. Yu Mingchang reply Surgery

Hello; for anal fissures or minor internal hemorrhoid bleeding, it is recommended to consume more vegetables and fruits.
Changhua Hospital, Ministry of Health and Welfare, cares about you.

Reply Date: 2016/03/10

More Info

Blood in stool can be a concerning symptom, and it's important to understand the potential causes and implications. Based on your description, it seems that you have been experiencing intermittent rectal bleeding for the past 2 to 3 years, often associated with bowel movements. Initially, you noted that the bleeding occurred after passing a hard stool, which is a common trigger for rectal bleeding due to the potential for anal fissures or hemorrhoids.

Possible Causes of Blood in Stool
1. Hemorrhoids: These are swollen veins in the lower rectum or anus that can cause bleeding during bowel movements, especially if the stool is hard or if there is straining involved. The blood is usually bright red and may appear on the toilet paper or in the toilet bowl.

2. Anal Fissures: A fissure is a small tear in the lining of the anus, often caused by passing hard stools. This can lead to sharp pain during bowel movements and may result in bleeding.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can lead to diverticulitis if these pouches become inflamed or infected. This condition can cause bleeding as well.

4. Colorectal Polyps or Cancer: Although less common, polyps (which can be benign or precancerous) or colorectal cancer can also present with blood in the stool. The blood may be darker or mixed with the stool, depending on the location of the bleeding.

5. Gastrointestinal Infections: Certain infections can cause inflammation and bleeding in the gastrointestinal tract, leading to blood in the stool.

6. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic inflammation of the gastrointestinal tract, resulting in symptoms such as diarrhea, abdominal pain, and rectal bleeding.

When to Seek Medical Attention
Given that you have experienced this symptom for an extended period, it is crucial to consult a healthcare professional for a thorough evaluation. While occasional bleeding from hemorrhoids or fissures may not be serious, persistent or recurrent bleeding warrants further investigation to rule out more serious conditions, such as polyps or cancer.

Diagnostic Approach
Your doctor may recommend several diagnostic tests, including:
- Physical Examination: A thorough examination of the anal and rectal area to check for hemorrhoids or fissures.

- Colonoscopy: This procedure allows the doctor to visualize the entire colon and rectum, helping to identify any abnormalities, such as polyps or signs of cancer.

- Stool Tests: These can help identify infections or blood in the stool that may not be visible.

Management and Treatment
The treatment will depend on the underlying cause of the bleeding. For hemorrhoids or fissures, lifestyle changes such as increasing fiber intake, staying hydrated, and using stool softeners can help alleviate symptoms. In some cases, medical treatments or procedures may be necessary.

Conclusion
In summary, while there are several potential causes for blood in the stool, it is essential to seek medical advice to determine the exact cause and appropriate treatment. Early diagnosis and management can significantly improve outcomes and address any underlying health concerns. Please do not hesitate to reach out to a healthcare provider for further evaluation and guidance.

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