Online Medical Advice by Dzi, MD

 

Blood in the stool

I often times am asked whether or not a small amount of blood in your stool is normal or whether it’s concerning when the blood is bright red and/or it was only a couple of drops noted on the toilet paper (a long time ago) or in the commode or on the stool.

My answer to questions relating to blood in the stool is that it is not normal. A drop of blood in the stool indicates a need to be evaluated by a health care professional immediately. While it is very possible that the blood in your stool is due to hemorrhoids or a small tear, it is also possible that the blood in the stool may be indicative of a bigger problem than needs to be formally diagnosed. Even if an individual is considered to be healthy and fit, there still may be a risk that the blood in found in the stool is due to colorectal cancer. I’ve diagnosed colorectal cancer in marathon runners, vegetarians, people born in Asia and Africa, along with those who may be considered as unhealthy. Based on growing evidence and my personal practice, more younger persons without a family history of colon cancer are being diagnosed with polyps and/or colorectal cancer.

While there are those who are at a higher risk of colon cancer, being a person of younger age does not mean you cannot be diagnosed with colorectal cancer. The youngest patient that I diagnosed with colon cancer was age 19. Remember, it is quite possible for you to have both hemorrhoids and something more serious like colon cancer or other diseases within the colon. Because these things are not mutually exclusive, I recommend that every person who has blood in the stool be evaluated by a physician as soon as they can and be referred for colonoscopy.

Some evidence-based guidelines and recent data for you to look up for yourself:

1.  American Cancer Society recommends colorectal cancer screening at age 45 https://www.cancer.org/health-care-professionals/american-cancer-society-prevention-early-detection-guidelines/colorectal-cancer-screening-guidelines.html

2. American College of Gastroenterology recommends that African-Americans be screening for colorectal cancer starting at age 45 https://gi.org/guideline/colorectal-cancer-screening/

3. ASGE position on Latino-Americans less likely to be screened and second-most diagnosed with colorectal cancerhttps://www.asge.org/docs/default-source/importfiles/ed-yourself-hispanic-americans—final—1-20-08.pdf

4. In Asian-Americans, cancer alone is the #1 cause of death. Asian-Americans have lowest colorectal cancer screening rates https://www.ncbi.nlm.nih.gov/pubmed/23991947

Some general articles below for your perusal:

Read Sarah’s story… https://www.nytimes.com/2017/03/16/well/live/what-young-people-need-to-know-about-colon-cancer.html

https://utswmed.org/medblog/colon-cancer-young-adults/

https://www.oncnursingnews.com/oncnurse-tv/young-people-with-gi-complaints-should-be-screened-for-colon-cancer

https://www.yalemedicine.org/stories/colorectal-cancer-in-young-people/

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Dzi, MD

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