Ask the Doctor
July 23, 2013

Why is my stool flat and bloody?

Dear Doc,

When I pass stool it is comes out flat. My wife has made it a talking point, joking about it to our friends. Now there is some blood on it. Can this just be haemorrhoids?{{more}}


Dear Kenneth,

Maybe yes. Maybe no!!

The old Royal Readers had a caption with every new chapter that states: “Looking Back”. You too have been looking back, and everyone should, when we use the toilet. What you have seen is most likely the effect of a mass narrowing the anus, thus compressing the stool into a flat shape. The presence of blood on the stool could be from haemorroids or fissures, but we must never underestimate the presence of a tumour.

The anus is a point where cancers are known to develop and though it can be obvious, sometimes it takes a suspicious or knowledgeable person to bring it to the attention of their doctor. Cancers can develop at any point of the gastrointestinal tract. When the mass grows into the passage it can block the flow of the faeces or food, but before that, it has the effect of compressing the stool, making it flat. Many will feel the sensation as if there is always stool left in the rectum and that they are constipated.

Your doctor can examine the anus easily by doing rectal examination with the finger to feel for unusual masses. A more proper examination can be done with a rigid scope to examine the rectum and anus. This does not require sedation and can be done on a regular office visit.

Persons with a family history of intestinal (colon, rectal, duodenal) cancer must have regular examinations for early diagnosis and treatment. Waiting for symptoms or signs is inefficient, as at that time there could have been significant spread of the cancer.


SVG Cancer Society, P.O. Box 709, Kingstown.
Phone: 526-7036