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What Causes Constant Blood In Stool When Tested Negative For Hemorrhoids?

Posted on Thu, 27 Jul 2023

Question: Hi, I went to the doctor about some blood in my poo. They said to wait a few weeks to see if it went away. I didn't see any blood in the poo. I also got a rectal examination around 2 months ago. He said he felt nothing, but it only felt as though he was feeling for 2 seconds. Since then I've been noticing that I feel the need to go to the toilet a little more often. I see no blood on the poo as I did before, although the poo can sometimes be half darker than the other on the bottom half, but there is blood on the tissue from wiping, which I made sure was coming from inside rather than outside the anus. it mostly looks like watered down blood mixed with poo. I don't know what to make of it, thanks...

Answered by Dr. Ramesh Kumar (47 minutes later)

Brief Answer:
Can be hemorrhoids or anal fissures.

Detailed Answer:

Hello,

There are a few things to consider when a person says he has blood in the stool.

The first thing is if it is really blood. There are some food and industrial products that might be in stool and give the impression it is blood and in fact, it is not. Unless it's bright red blood (which is clear that it is blood). Another way to know if you are bleeding or not is having a stool occult blood test or stool microscopy that will confirm the presence of blood with the stools.

Generally, blood coming from higher levels (stomach and small bowel) converts into a dark coal black color due to the changes the blood has in the bowel. It is the bleeding from lower parts (colon) that will show as bright red blood.

A CBC would be a good test to be done if you suspect bleeding to see if you are developing anemia as a complication of bleeding and need treatment for it or not.

So to conclude:
1. we need to be sure you are bleeding or not- a stool test for the fecal occult blood test and or stool microscopy for blood will help in this.

If you have bright red blood while defecating (passing stools) this might also be due to hemorrhoids which are mostly due to constipation. So in the meantime please make sure you take extra fiber with diet and drink plenty of water

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Ramesh Kumar, Gastroenterologist

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Ramesh Kumar (18 minutes later)

Thank you for the detailed response, I was just wondering however. In your opinion, do you think this is anything malicious? Should I get another rectal examination done? I've already done a few occult tests that I've bought online which have shown negative for blood. This is another reason for me thinking that the bleeding starts after I poo rather than before.

Answered by Dr. Ramesh Kumar (10 minutes later)

Brief Answer:
Follow up.

Detailed Answer:

Hello,

Definitely yes, a rectal examination should be done by using a machine called proctoscope. By proctoscope, the surgeon could see the walls on the inner side of the rectum or anal canal.

It's not painful and should be done if bleeding continues. Even after that colonoscopy has to be done as per protocol.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Ramesh Kumar, Gastroenterologist

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Ramesh Kumar (1 hour later)

Thanks again, I'll be sure to book an appointment. Based on what I've told you, in your opinion, what do you think is the most likely cause?

Answered by Dr. Ramesh Kumar (2 hours later)

Brief Answer:
Hemorrhoid.

Detailed Answer:

Hi,

As per me, it could be due to hemorrhoid.

Hope I have answered your query.

Regards,
Dr. Ramesh Kumar, Gastroenterologist

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Above answer was peer-reviewed by : Dr. Arnab Banerjee