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The colon cancer becomes one of common disease which is often found in people; at the same time, the number of patients has been increasing constantly. One of symptoms that cause patient urgently go to see a doctor is bloody defecation. As stated, the consultant at ASIT Advanced Surgical Interventional Technologies Center, Phyathai 3 Hospital, ASS.PROF.DR.Thanyadej Nimmanwudupong and a doctor from gastrointestinal clinic Phyathai 3 Hospital, DR.Sanchai Prasertpetmanee have answers for you.

Severity of Blood Defecation

Dr. Thanyadej explained that blood in stool derives from the defecation sometimes you can even notice it clearly after the defecation is finished. However, for another cause of the blood, it may come from a different reason which could be somewhere inside the body that make your stool color change to abnormal color.

Each type of blood in the stool helps doctors diagnose diseases differently as the symptom could be signs of many serious diseases apart from hemorrhoid. Therefore, as soon as you can detect or notice it, you are highly recommended to promptly see the doctor to receive a proper treatment suiting with your condition. As mentioned, this is for your benefits.

Diseases Associated with “The Blood in Stool”

The severity from this symptom can be accounted by number of defecation time of patients as well as amount of blood. Those who have more blood definitely contain high risks from many diseases. In fact, drop of the blood after the defecation may be happened by rectal vein ulcer. On the other hand, if the blood only comes with the defecating that means this could be a sign of heavy bleeding from the colon some disorder might happen to it. In accordance with that, these are list of disease caused by this abnormality.

  • Hemorrhoids
  • Rectal bleeding is main symptom of hemorrhoids due to diarrhea or constipation pushing. For that reason, the rectal veins start swelling and being unable to go back inside which later causes patients Hemorrhoids. Some of them become inflamed and prolapse out from the anus. However, the patients can feel pain while walking or sitting. In addition, what you need to know is that its severity can start by bleeding every time you do the defecation or you may find the blood when you wipe tissue to clean the anus as mentioned. Although mentioned symptoms happen, what one thing you can obviously notive is the color of stool which will always remains normal. Moreover, the pain may not affect in certain cases while some patients may feel pain around the anus along with feeling itchy including obstructed defecation.


  • Arteriovenous malformation
  • It is caused by small arteries that accidently duplicate themselves with numerous amount. In regard to that, this later causes bleeding to a person during defecation. Moreover, it can come with both forms either blood clot or liquid without abdominal pain.However, this disease is always found in elderly aged over 70 and in some patients the bleeding can stop by itself. More importantly, even symptom disappears, you still have to see the doctor to ensure a condition as the symptom is not distinctive enough to be defined as specific disease.


  • Colorectal polyp
  • This polyp is transferred by heredity, a disease is mostly found in men aged over 50. In fact, this condition can develop to colon cancer as the polyp can locate in any area of the colon. Its shape looks circle with soft pink color and many of them will be grown inside the colon. However, sometimes symptoms are not shown while there is bleeding inside the colon. This is why the stool is covered with the blood. According to that such symptom can happen periodically and mostly doctors will recommend patients aged over 50 to receive colon screening properly so that the polyp can be found in time.


  • Colitis
  • It caused by some infectious diseases such as dysentery. The major symptom happens when you have frequent defecation with fever, anorexia, abdominal pain and blood in stool. However, these symptoms require patient to quickly receive treatment.


  • Colon Cancer
  • This disease is commonly found in many countries around the world including Thailand. Most of patients are older than 50 in regard to that what they usually suffer from the disease are constipation, diarrhea or blood in stool. After having blood loss, some people come to see a doctor due to the loss causes them anemia. Moreover, according to what mentioned, this cancer more detected in the abdominal cavity area close to the colon than the rectum and what we should know that it actually happens due to eating habit of those who love to have food that contain high fat regularly. On the other hand, another reason of its source is genetic, in term of that circumstance, the cancer cannot be cured meaning that patients may require colonoscopy or another treatment alternative in order to detect the disease and remove the cancerous part in time. However, this concept is used to help prevent the disease from its spreading.

Colon cancer and Blood in Defecation

Dr. Sanchai explained that usually the cancer is found after screening or any time when symptoms are shown such as blood in stool, which is primary symptom in most patients. It is a reason why they rush into the doctor. In addition, some people may only have blood alone without being shown in stools. In order to receive an accurate result, patients must have endoscopy.

Hemorrhoids is not Colon Cancer

Patients with hemorrhoids has blood defecation while patients with colon cancer also come with the same symptom. According to that Doctor Sanchai added, after seeing this initial sign, patient need to look after themselves properly by consulting pharmacist and when it still does not improve, please do not leave the symptom until it gets worse due to those who came to meet him always find having the colon cancer with ulcer instead of hemorrhoid. Therefore, keep in mind that after 1- 2 weeks of looking after yourself to treat the hurrmuroid, the symptom cannot be improved, happens and disappears periodically. The patients must see the doctor urgently to make sure it is actually the hemorrhoid or colon cancer.

Signals from Your Stool

The change of your stool size, such as hard to liquid or liquid to hard and it also becomes smaller for example first diameter is about 1-2 cm then changes to half of centimeter like it is compressed by the tumor. In regard to that, it could be the sign of cancer. Nevertheless, if the cancer is in the cecum, patients then will have bowel obstruction instead of blood in the stool. Moreover, this group of the patients will only suffer from severe abdominal pain.

Symptoms That may Lead You to Colon Cancer

Symptoms are shown depend on where the tumor is located. If it is near the end of the colon or anus means that the symptoms can be noticed quickly for instance having blood in stool etc. Fast noticing helps detect the cancer during first stage. Treatment then work well and there is a high chance of cure according to the quick detection. On the other hand, those who find having the cancer in the top of the colon will always come with the symptom of bowel obstruction. It is considered as near of last stage causing difficulty during the treatment. However, as soon as find yourself having some abnormalities during defecation, do not be hesitate to meet the specialized doctor as fast as you can.

What are the causes of this disease?

Most of the causes come from external factors such as eating habits. People who like to have fried food can have more risks as well as those who love drinking alcohol or smoking cigarette regularly. For internal factor could be genetic people whose families have a history of colon cancer also have more risks.

Preventing Colon Cancer

Colon cancer is found to be on top of serious disease in Thailand including breast cancer and cervical cancer regarding the way to protect yourself from the disease are as follows:

  • Having more foods that contain fiber
  • fruits and vegetables like bananas or papaya can help prevent constipation. Avoid foods with high fat or strong taste that irritate to the stomach. Drink at least 8 glasses of water a day also do not forget to avoid alcoholic beverages.


  • Avoid holding defecation
  • according to that it causes the colon taking water back to the body. The stool then become hard due to lack of the water. A person will find obstruction while excreting. Good protection is to make your defecation set on time, for example, in the morning and most importantly do not push while having the excretion as it cause blood obstructing around the anus as well as swelling and ulcer. In addition using your mobile phone or reading books while using toilet are not allowed. You are recommended to leave the toilet after done with your secretion.


  • Exercising regularly and consistently
  • Do not sit or stand in the same posture for too long because this increases pressure in the anal veins which is the risk of hemorrhoids. However, the exercise can make the muscles of that area become strong also prevents you from constipation.


  • Cleaning after done using the toilet
  • You are recommended to clean the bottom with water after done using the toilet instead of using tissue since the latter can create the anal ulcer inflammation as some bacteria from the stool then will transfer infection to the ulcer.

Why Blood in Stool Requires Screening ?

The most important thing which both patients and doctors must collaborate with each other is to find the cause of disorder. Hence when the abnormality occurs, please rush to receive examination in order to detect these following causes of the disease……...

  • To find the real cause of blood defecation
  • If bleeding is caused by the hemorrhoids. The doctor must examine the anus internally to point out where the location of the bleeding is. The doctor has to examine the anus by a finger and endoscopy. As soon as the hemorrhoids are found but there is no evidence of bleeding means that it is not a cause of the bleeding. As stated above, both methods are used to ensure the patients if there is nothing other than the hemorrhoids as the cause such as colorectal tumor or cancer. Moreover if the cause is still unknown, this means additional screening is required as the cause may locate in somewhere deeper causing the fingers or tool being unable to reach.

  • To plan for the treatment accurately and promptly
    • If the bleeding comes from hemorrhoids, the disease will be treated appropriately based on each stage.

    • If the blood comes from the tumor, the doctor then will remove the tumor and analyze what kind of tumor patient is having in order to plan for further treatment.

  • To stop the bleeding; the case of unstoppable bleeding
    • If the blood comes from the hemorrhoids and it does not stop, the doctor then may either have to provide patients injection or surgery.

    • If the bleeding is derived from other causes, the doctor then will give you endoscopy to detect the cause promptly and to find the most suitable method for patients which require both experienced doctor and advanced equipment.

Colonoscopy with Phyathai 3 Hospital

The Colonoscopy is an effective way to evaluate problems with the colon. A process ulterizes a small flexible tube set with camera and light at the end in order to present clear image of organs. The doctor then can be able to see pathology clearly and providing accurate treatment to different areas. As mentioned, today, using camera during operation has been developed and resolution of it is quite high. In addition, it is made of fiber optics which is harmless to the patients meaning that they will not feel pain during procedure.

The examination takes about 30-40 minutes. The doctor then will use a sleeping pill. When that patient falls to sleep, the camera will then be inserted through the anus. If there are polyp or abnormalities, they will be treated all at once.

Preparing for Endoscopy

Before going under the procedure, the doctor then will provide laxatives to patients one day in advance. They need to avoid having fruit 2-3 days before the procedure to prevent the intestine from having things left over. However, recently, medicine that helps adjust the intestinal movement has been developed and does not cause lack of minerals to the body. During examination, there is a way to relax patient as endoscopy is quite detailed for Colon Cancer Screening such as detecting tumors or polyp that can develop to the cancer. As mentioned, this method helps removing the cancerous part in time which also reduce the risk for colon cancer.

How to deal with Blood in Stool

  • Give information to the doctor thoroughly. Do not be embarrassed if you have to receive screening through the anus whereas it is very important.

  • Be recommended to see the doctor to receive the screening on the same day that bleeding is found.

How do doctors and nurses provide the treatment to patients?

  • Ask them about history of illness as well as providing them physical examination.

  • Provide anal screening thoroughly to see where the blood came from.

  • Check condition of bleeding in the stool.

  • Do Blood tests for additional test based on condition

  • Do Blood tests for additional test based on condition

Quick Screening Increase More Chances for Cure

Doctor Sanchai added that we all have to look after ourselves since getting to know the disease and after noticing some disabilities then you need to quickly go see the doctor. Moreover, the possibility for cure can happen especially during 1-2 stage on the other hand, for stage 3 doctors may need to observe its spreading such as where the cancer is located which is possible for the patients to be cured.

When the process is completed, there is follow-up plan set to observe symptoms. During 1 year, 3 years and 5 years, patients need to receive check up regularly to prevent reoccurence or in case when the occurrence happens so that symptoms will always be under control.

No symptoms but you still require the colonoscopy

Dr. Sanchai said that nowadays the colon cancer becomes well known and more people suffer from it. As mentioned, it is very important to raise awareness in those who are still free from the disease. In addition, people who aged over 50 are recommended to receive the colonoscopy. Moreover in case of the place in which the screening is provided is unfavorable, other methods for example stool test will be applied instead. However list of those who require the colonoscopy is as follows:

  • Those who love having read meat, high fat food

  • Alcoholic drinkers and smokers

  • People with irritable bowel syndrome or chronic bowel inflammation

  • People aged over 50

  • People having a family with a history of colon cancer

The colon cancer is not the most dangerous disease. People just need to have good eating habits according to nutrition. Also we have to always observe our excretory system so that when the abnormalities are found, people will know that they must see a doctor to receive treatment promptly. Finally, for those who still have no signs of the disease, we also would like to recommend you to have the screening before it is too late.

 

ASS.PROF.DR.THANYADEJ NIMMANWUDIPONG
General Surgery Clinic

DR.SANCHAI PRASERTPETMANEE
Gastrointestinal Clinic



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