Rectal bleeding and flat stools

Author: OncoLink Team
Last Reviewed: August 12, 2019

Question:

Dear OncoLink "Ask The Experts,"
Sometimes after a bowel movement, I notice blood on the tissue paper and a streak of blood along one side of the flat stool. I do plan on returning to see my doctor, but I still do not know the significance of this finding. Could someone please let me know?

Answer:

Carolyn Vachani, RN, MSN, OncoLink's Nurse Educator, responds:

Blood visible in the stool can be caused by a number of non-cancerous (benign) problems such as hemorrhoids, diverticulitis, colitis, or tears in the skin due to forcing a bowel movement when constipated. However, it can also be a sign of colon or rectal cancer.

The fact that you can see the red blood means that the bleeding is happening close to or in the rectum. When bleeding happens further up the GI tract, it does not appear as red blood, but may turn stools a darker color (black or tar-like).

Bleeding in the bowel can be detected by a fecal occult blood test, which can be performed by your provider. The test is performed by placing a small amount of stool on a special card and applying a solution (called developer) to the card. The card turns blue if blood is present in the stool.

Although your bleeding may seem harmless, it is worth investigating with your provider. You also mentioned that your stools have a flat appearance. Changes in the shape of stool can be another sign of colon or rectal cancer. As a tumor grows in the colon or rectum, it can change the shape of the bowel that the stool passes through. This may cause stools to become thinner, pencil-like, or flat in shape. You should report these problems to your provider for further investigation.

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