What are the causes of constipation and blood in stools?

Patient's Query

Hello doctor,

I had diarrhea two years back, and since then I had gastrointestinal problems. But, I never had mucous or blood in the stools, so I thought it is because of IBS and did not take any medication. My stool test reports showed no signs of parasites or any other organisms in the stools. Later, I had alternate constipation and diarrhea, and sometimes the stools come hard and later soft. I have been straining to defecate, and I saw bright red blood along with the stool yesterday. I had a little bleeding before also, but yesterday I lost almost 30 ml of blood. I do not have any pain, fever, or any other associated symptoms.

Answer

Dr. Arvind Guru

General Surgery Surgical Gastroenterology Surgical Oncology

Hi,

Welcome to icliniq.com.

Thanks a lot for the detailed description of your problem. I think you have the following issues.

The blood in stools that you are describing appears to originate from some disease in your rectum or sigmoid part of your large intestine.

Few drops of painless blood in stools during constipation is most likely from hemorrhoids. It is not a big issue to manage.

However, repeated 20 to 30 ml of painless, bright red blood in stools is a bit concerning. It would need an examination of the rectum, to look at what is the problem.

Following are the possibilities:

Hemorrhoid.
Polyp inside the rectum.
Ulceration on walls of the rectum, because of repeated straining for constipation.
Some tumors can also have such presentation. But, because of your age, I would advise you not to worry much about this right now.

You need to see a general surgeon or a gastro surgeon in your town. The doctor would examine you and do a proctoscopy examination to look for hemorrhoids or other diseases. If there is nothing found in proctoscopy, then you may need to see a gastroenterologist for a sigmoidoscopy or colonoscopy.