Blood in Stool: Causes and When to Seek Help - Surgery

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There is bright red blood during bowel movements?


Hello, doctor! I occasionally experience constipation, and on March 11 (Friday), while straining during a bowel movement, I noticed fresh blood when wiping.
However, there was no blood in the toilet.
The next day, in the afternoon, my stool was soft, but I found a pool of blood when wiping, and there was also blood in the toilet.
On the third day, my stool was still soft, but there was a little blood again.
Could you please explain what might be happening over these three days? I'm feeling a bit anxious and scared.
After the bowel movements, I feel a tightness and slight stinging around the anus, but it's not very painful.
What do you think these symptoms indicate, doctor?

Migo, 20~29 year old female. Ask Date: 2016/03/13

Dr. Yu Mingchang reply Surgery


Hello: Eating more vegetables and fruits can soften your stool, which may improve your condition.
The Changhua Hospital of the Ministry of Health and Welfare cares about you.

Reply Date: 2016/03/13

More Info


Blood in stool can be a concerning symptom, and it’s understandable that you feel anxious about it. There are several potential causes for the presence of blood when you wipe after a bowel movement, and it’s important to consider these in the context of your overall health.

1. Hemorrhoids: One of the most common causes of blood in the stool, especially if the blood is bright red, is hemorrhoids. These are swollen veins in the lower rectum or anus that can cause bleeding, particularly during bowel movements. If you have been experiencing constipation, straining during bowel movements can exacerbate hemorrhoids, leading to bleeding.

2. Anal Fissures: Another possibility is an anal fissure, which is a small tear in the lining of the anus. This can occur due to passing hard stools or straining. Symptoms often include sharp pain during bowel movements and blood on the toilet paper or in the stool.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can also lead to bleeding. This is less common but can occur, especially in older adults.

4. Gastrointestinal Conditions: Other gastrointestinal conditions, such as inflammatory bowel disease (IBD), colorectal polyps, or even colorectal cancer, can cause blood in the stool. However, these conditions are usually accompanied by other symptoms, such as abdominal pain, changes in bowel habits, or weight loss.

Given that you have experienced blood on three consecutive days, it is advisable to seek medical attention. While hemorrhoids and fissures are common and often not serious, persistent bleeding should be evaluated by a healthcare professional to rule out more serious conditions.

When to Seek Help
You should seek medical attention if:
- The bleeding persists or worsens.

- You experience significant pain or discomfort.

- You notice changes in your bowel habits, such as diarrhea or constipation that lasts more than a few days.

- You experience other symptoms such as weight loss, fatigue, or changes in appetite.


What to Expect at the Doctor's Office
When you visit a healthcare provider, they will likely ask about your symptoms, medical history, and any medications you are taking. They may perform a physical examination, including a rectal exam, to check for hemorrhoids or fissures. Depending on the findings, they may recommend further tests, such as a colonoscopy, to investigate the source of the bleeding.


Management and Prevention
If hemorrhoids or fissures are diagnosed, treatment may include dietary changes to increase fiber intake, stool softeners, topical treatments, or in some cases, surgical interventions. Staying hydrated and maintaining regular bowel habits can help prevent constipation and reduce the risk of straining.

In summary, while blood in the stool can be caused by relatively benign conditions like hemorrhoids or fissures, it is essential to consult a healthcare professional for a thorough evaluation. Early diagnosis and treatment can help manage symptoms effectively and address any underlying issues.

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