Brief Answer:
Any blood in stools for more than 1-2 weeks needs to be investigated

Detailed Answer:
Hello and welcome to "Ask a Doctor" service,

Blood with stools that is lasting for more than 1-2 weeks needs to be evaluated with a doctor. This is for two main reasons.
One is for the cause of the bleeding to be identified and also you need to have some blood tests to make sure you have not developed anemia due to prolonged bleeding (the test to rule out anemia is called CBC).

If you notice bright red blood (and not black stools) then the bleeding is very likely due to the large bowel.

During the visit:
Firstly, the doctor will need to confirm that what you are seeing is blood so some stool tests to identify the presence of blood in stools may be done.
Sometimes, common conditions such as hemorrhoids may cause rectal bleeding and are easily identified with a rectal exam.
If no rectal changes are seen, your doctor may have to repeat the colonoscopy. Some blood tests may be done (CRP and ERS) as well as a calprotectin stool test to make sure if inflammatory bowel disease is the cause of your symptoms (Crohn's disease or Ulcerative Colitis).

The colonoscopic examination will give more information on the bowel structure such as the presence of polyps, vascular malformations, diverticula, etc. Rarely, the doctor may need other examinations such as angiography, etc.

To conclude:
- Because the bleeding in your case has lasted for more than 1-2 weeks and due to the previous history of blood with stools, it is important to see a doctor and possibly have some tests done to rule out inflammatory bowel disease and also other possible causes of hematochezia (blood with stools).
- A complication with anemia needs to be ruled as well.


I hope this answers your query.
I remain at your disposal for further medical assistance.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

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