What is the possible cause of diarrhea with blood in stool?

Q. Do anal fissure present with diarrhea and blood in stool?

Answered by
Dr. Ambalathu Veettil Hussain Shihaz
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jan 10, 2020 and last reviewed on: Aug 07, 2023

Hello doctor,

I am a 22-year-old female. I have been having some symptoms for two years. It started with noticing some blood on the toilet paper, went to my GP and he said probably hemorrhoids nothing to worry about and then, I started having diarrhea with blood on the toilet paper again. Then I had constipation with blood in stool. I went to see a specialist that said I had a fissure. Then four months ago, I started having too much diarrhea (at least once a week) and gas and borborygmi after every single meal, no matter what I ate. I went to the specialist, I did celiac test negative and my blood tests all look fine. All my doctors said that I have nothing that it is probably stress but I am too worried. How can I convince them to give me a colonoscopy?



Welcome to icliniq.com.

I have gone through your query in detail. A few details which could be helpful are, have you lost weight? Do you have anemia or any abdominal pain? Have you had a fecal calprotectin done?

Apparently, your symptoms have been going on for close two years and specifically since you have had diarrhea with blood on toilet paper, it is unlikely to be due to anal fissures. Anal fissures usually are precipitated by constipation and quite unlikely with diarrhea. Persisting diarrhea and bloating is more in keeping with symptoms of inflammatory bowel disease (IBD) especially since the celiac markets are negative (anyways celiac disease is unlikely to cause blood with diarrhea). On these grounds, you can certainly insist on a colonoscopy.

Thank you doctor,

I have lost weight but I do not eat much because of the stress that all this is causing me. No anemia or abdominal pain but sometimes when I wake up in the morning right before diarrhea I have some abdominal pain. When I went to the doctor right after I had diarrhea with blood and then after constipation with blood I insisted on the fact that it cannot be an anal fissure with it and the doctor said that it might be false diarrhea that comes with constipation.

I have not done the fecal test. I am really worried that it might be colon cancer especially since my blood work does not show any inflammation and all markers for IBD. I do not know if this is a symptom, but I also have been experiencing mouth sores a lot.



Welcome to icliniq.com.

At your age (22) and the symptom duration you have mentioned of two years I would not be considering cancer anywhere on the top possibilities, but Inflammatory bowel disease as the first possibility. Usual inflammatory markers may be low or negative except for fecal calprotectin. Mouth sores would again add weightage to the probability of IBD. I think it is advisable to have a discussion with your GP regarding your concern and insist on a colonoscopy.

Hi doctor,

Thank you so much for your help.



Welcome back to icliniq.com.

You are welcome. Keep in touch for further doubts.

Was this answer helpful?


Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Related Questions:
Will fasting help with irritable bowel syndrome?

Hello doctor, Will fasting help with irritable bowel syndrome ... Fasting is not better for IBS (irritable bowe   Read full

Vomiting and Diarrhea

.. the most common symptoms of stomach flu (viral gastroenteritis), but there are many other causes. It is not always serious and gets better in a couple of days .. ...   Read full

Can constipation be related to high sugar levels?

I have constipation problem ... Constipation could be due to diabetes as it affects the nerves ...   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read

PCOS and Liver Problems
The hormonal imbalances in polycystic ovary syndrome could cause liver diseases. Read the article to know the relationship between these medical conditions.  Read more»
Inferior Alveolar Nerve Lateralization Technique
The inferior alveolar nerve lateralization technique is a surgical lateralization technique to reposition the nerve. Read the article to know more about this.  Read more»
COVID-19 and Ebola: Similarities and Differences
This article gives a comparison and broader overview of the outbreak of the two deadliest diseases that showed a greater incidence over the last two decades.  Read more»

Ask your health query to a doctor online?

Ask a Medical Gastroenterologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.