Q. What causes blood in stool?

Answered by
Dr. Ishwar Chandra Rai
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on May 27, 2019 and last reviewed on: Sep 16, 2020

Hello doctor,

From the last few days and sometimes, not regular, I noticed blood in middle of stool. Reasons I do not know. I am a vegetarian, do not drink coffee or any tea. Since a long time, I am suffering from joints problem. One doctor says it is gout but always my uric acid level is low. But average I feel my joint problem is also normal. This blood is due to summer heat or not? Please guide me.



Welcome to

I have read your complaints carefully and got your issues. You have two major complaints, bleeding per rectum and joints pain. I would like to explain it. In case of bleeding per rectum when it comes before defecation indicates hemorrhoids, however, after defecation indicates fissure in ano. Mostly, it happens in those persons who have chronic constipated bowel.

In hemorrhoids, there is bleeding without pain however in fissure in ano with pain and burning. And regarding your second issue there are several causes to joints pain. Raised uric acid is one of them. Other causes may be due to rheumatoid arthritis or osteoarthritis or others. So you should go for proper investigations to evaluate its right diagnosis.

The Probable causes:

Acidity, indigestion, constipation, rheumatoid arthritis or osteoarthritis.

Investigations to be done:

Per rectum examination to rule out fissure in ano or hemorrhoids.
Uric acid, RA factor, X-ray of affected joints.

Differential diagnosis:

Fissure in ano, hemorrhoids, gout, rheumatoid arthritis, osteoarthritis.

Treatment plan:

To provide proper medications, need your complete disease history with latest investigation reports.

Preventive measures:

Avoid spicy and fried junk foods. Drink plenty of lukewarm water in morning before defecation. Quit smoking and drinking, if you have these habits. Eat seasonal leafy vegetables and seasonal fruits. Do regular kapalbhati and pranayana like anuloma vilom nadi sodhan and bhramari.

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