Blood in Stool: Possible Causes and Solutions

Blood in the stool?

I have been experiencing bright red blood on toilet paper almost every day after bowel movements for the past month.
There is no pain during defecation.
I even noticed blood stains in my underwear from the morning bowel movement until my evening shower, and I have no abdominal pain, diarrhea, or constipation; everything seems normal.
I later bought a hemorrhoid cream, which helped reduce the blood stains in my underwear, but I still see bright red blood on the toilet paper after bowel movements.
Sometimes there is blood, and sometimes there isn't.
In the morning, there is less blood or none at all, while in the evening before bed, the amount of blood is greater.
When I drink more water during the day, there is less blood, and when I drink less water, there is more blood.
What could this condition be?

Wen, 50~59 year old female. Ask Date: 2016/03/16

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.
You can purchase over-the-counter hemorrhoidal suppositories for use.
It is best not to take stool softeners indiscriminately; at your age, increasing dietary fiber and hydration should be sufficient.
However, if bleeding persists, it is advisable to consult a physician.
Considering your age, it would be best to undergo a colonoscopy to rule out the possibility of malignancy.

Reply Date: 2016/03/16

More Info

Blood in stool can be a concerning symptom, and it’s important to understand the potential causes and appropriate responses. Based on your description, the presence of bright red blood on toilet paper after bowel movements, without accompanying pain, suggests that the source of the bleeding is likely from the lower gastrointestinal tract, particularly the rectum or anus. Here are some possible causes and solutions:

Possible Causes
1. Hemorrhoids: One of the most common causes of bright red blood in stool is hemorrhoids, which are swollen veins in the lower rectum or anus. They can cause bleeding during bowel movements, especially if there is straining involved. Hemorrhoids can be internal or external, and while they can be painful, they may not always cause discomfort.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to bleeding and may cause sharp pain during bowel movements, although in some cases, the pain may not be significant.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can lead to diverticulitis if these pouches become inflamed. This condition can cause bleeding, although it is often accompanied by other symptoms such as abdominal pain.

4. Colorectal Polyps or Cancer: While less common, polyps (growths on the colon lining) or colorectal cancer can also cause rectal bleeding. These conditions may not present with pain initially, but they require medical evaluation.

5. Gastrointestinal Infections: Certain infections can cause inflammation and bleeding in the gastrointestinal tract, although they typically present with other symptoms like diarrhea or abdominal pain.

Solutions and Recommendations
1. Hydration and Diet: As you noted, drinking more water seems to reduce the bleeding. Staying well-hydrated and consuming a high-fiber diet can help soften stools and reduce straining during bowel movements, which may alleviate symptoms associated with hemorrhoids or fissures.

2. Topical Treatments: Using over-the-counter creams or ointments designed for hemorrhoids can provide relief and may help reduce bleeding. However, if symptoms persist, it’s essential to consult a healthcare provider.

3. Avoid Straining: When using the bathroom, try to avoid straining, as this can exacerbate hemorrhoids and fissures. Consider using a footstool to elevate your feet while sitting on the toilet, which can help facilitate easier bowel movements.

4. Medical Evaluation: Given that you have been experiencing this symptom consistently for a month, it is crucial to seek medical attention. A healthcare provider can perform a thorough evaluation, which may include a physical examination, and possibly a colonoscopy, to determine the exact cause of the bleeding.

5. Monitoring Symptoms: Keep track of any changes in your symptoms, such as the frequency and amount of blood, any new symptoms like pain or changes in bowel habits, and report these to your healthcare provider.

Conclusion
While bright red blood in stool can often be attributed to benign conditions like hemorrhoids or anal fissures, it is essential to rule out more serious conditions. A healthcare professional can provide a proper diagnosis and treatment plan tailored to your specific situation. Do not hesitate to seek medical advice, especially since the bleeding has been persistent. Early intervention can lead to better outcomes and peace of mind.

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