Bloody Stool
If you notice blood in your stool, it could be a sign of a worrying condition. Bloody stools are a symptom of a variety of conditions.
Some causes of bloody stools, such as hemorrhoids, may not require treatment. However, other conditions, such as colorectal cancer, require immediate treatment.
Meanwhile, other causes of bloody stools are possible ulcers, anal fissures, and inflammatory bowel disease. A doctor can help diagnose the cause of bloody stools, which has the medical name hematochezia.
Symptoms of Bloody Stools
When you have bloody stools, it can usually show up in a few different ways. You might notice bright red streaks in your stool, or you might see blood clots or blood and mucus mixed in with your stool.
Stools usually look dark, black, and tarry. The color of the blood you see may be a sign of where it’s coming from:
- Bright red blood in the stool usually means the bleeding is in the colon, rectum, or anus.
- Dark red or maroon blood means you are bleeding in your large intestine or small intestine.
- Melena (black stool) often indicates bleeding in the stomach, such as a bleeding stomach ulcer. Regarding black stool, also read this article further: Need to Know These 8 Things If Your Stool is Black.
Sometimes, rectal bleeding is not visible to the naked eye and can only be seen under a microscope.
You may find this type of blood in your stool if you have a lab test on a stool sample called a fecal occult blood test. This test is a screening test for colorectal cancer.
Causes of Bloody Stools
There are various causes of bloody stools or hematochezia. The causes can vary, from common and mild conditions to more severe and rare conditions, which require immediate medical attention.
Sometimes other symptoms can provide clues as to the possible cause. Common causes of bloody stools include:
- Hemorrhoids
Hemorrhoids or piles are a condition in which there is swelling of the blood vessels in the rectum or anus. This condition is very common and is the most common cause of bloody stools.
This condition is generally not serious. Hemorrhoids are usually associated with straining or pressure, such as due to pregnancy, lifting heavy objects, or straining to have a bowel movement.
- Anal fissure
This condition occurs when there is a tear in the lining of the anal canal. Like hemorrhoids, anal fissures often occur after straining to have a bowel movement.
Although it can heal on its own, sometimes anal fissures require treatment to heal.
- Inflammatory bowel disease
This condition causes chronic (ongoing) inflammation in the lining of the intestines, both the small intestine and the large intestine.
Meanwhile, Crohn’s disease usually affects the small intestine, while ulcerative colitis usually affects the large intestine. Inflammatory bowel disease, meanwhile, can cause chronic abdominal pain and diarrhea, and if severe, can cause bleeding.
- Diverticulitis
This condition occurs in the large intestine, usually at the lower end near the rectum. Diverticulitis occurs when small pouches in the inner lining of the large intestine (diverticula) become infected and inflamed.
Inflammation in the diverticula pouches can make the blood vessels inside them more fragile and more likely to rupture. If that happens, it can cause acute rectal bleeding.
- Infectious colitis
Some bacterial infections, such as E. coli and C. diff, can cause hemorrhagic colitis, or bleeding from the colon. This condition usually presents as bloody diarrhea.
You will know if it is due to an infection, and often it will go away on its own.
- Sexually transmitted infections (STIs)
Certain common STIs can cause inflammation and bleeding in the lining of the anus. Examples include gonorrhea, chlamydia, and syphilis.
Herpes causes sores that can bleed, while human papillomavirus (HPV) causes anal warts that may bleed a little.
Most STIs require specific treatment to cure, so it’s important to get a diagnosis promptly.
- Gastric ulcer disease
This condition occurs when stomach acid erodes the protective lining, or creates an open wound.
Ulcers can cause burning or gnawing stomach pain and may bleed causing bloody stools.
- Colon polyps and colorectal cancer
Polyps are a common condition, and if they are larger they can bleed. Sometimes they turn into cancer, and cancerous polyps are more likely to bleed than others.
Risk Factors for Bloody Stools
Constipation and straining too hard to have a bowel movement can cause rectal bleeding.
Straining can cause conditions such as hemorrhoids or anal fissures, which may bleed. Also, very hard stools can tear the skin inside the anus, causing bleeding.
Bloody Stool Diagnosis
Here are some tests to diagnose bloody stools:
- Digital rectal examination, to physically examine the rectum and anus.
- Anoscopy. Examination of the anal canal using a small telescope with a magnifying glass.
- Proctoscopy. Examination of the rectum and anus using a short, rigid scope.
- Flexible sigmoidoscopy. An examination using a longer scope to look into the lower colon.
- Rectal culture swab, to identify infection.
- Stool test. Your doctor can check a stool sample for evidence of active bleeding, occult blood, or inflammation. This can also identify certain infections.
- Colonoscopy. An examination of the entire colon using a colonoscope, a lighted camera on the end of a long tube. This type of exam is also commonly used to screen for colon cancer.
- Upper endoscopy. Your doctor may recommend an upper endoscopy if they suspect bleeding in the upper gastrointestinal (GI) tract. This is because the endoscope can pass through the throat into the stomach and duodenum.
Treatment for Bloody Stools
The best treatment depends on the cause and source of bleeding in the gastrointestinal tract. If bloody stools are caused by an ulcer, infection, or inflammation, your doctor may prescribe medication.
Meanwhile, if there is cancer, the doctor will recommend appropriate treatment, depending on the stage and other factors. In some cases, the doctor needs surgical procedures to prevent further bleeding.
Doctors may use an endoscopy or colonoscopy to treat bloody stools. The procedure may involve:
- Injecting medication to stop bleeding.
- Burning the source of bleeding using a heat probe, electric current, or laser.
- Closing the affected blood vessel using a clip.
Prevention of Bloody Stools
The best way to prevent bloody stools is to prevent the underlying cause. For example, to prevent hemorrhoids, it is important to keep your stool soft so that it is easy to pass.
To keep your stool soft, drink plenty of fluids and eat foods high in fiber. Go to the toilet as soon as you feel the urge to have a bowel movement and avoid straining during bowel movements. Also, limit the amount of time you sit on the toilet.
Meanwhile, you can prevent anal fissures by avoiding rectal irritation and wiping the area with soft tissue, a damp cloth, or cotton. Do not use rough or scented toilet paper.
People at high risk for colorectal cancer should have regular screenings, especially colonoscopies. Colorectal cancer screening can detect precancerous polyps in the colon or rectum, so they can be removed before they turn into cancer.
Screening procedures can also identify colorectal cancer early when treatment is more likely to be successful.
Complications of Bloody Stools
Bloody stools in people under 40 years of age rarely require medical attention.
However, if the bleeding continues or is severe, it can lead to shock, a life-threatening condition where the body does not receive enough blood flow.
If left untreated, bloody stools can potentially cause organ damage. You should seek medical attention if you experience rectal bleeding and any of the following signs of shock:
- Faint.
- Nauseous.
- Breathing feels rapid and shallow.
- Blurred vision.
- Dizzy.
- Confusion.
- Skin looks pale.
- Small amount of urine.
Untreated polyps in the colon or rectum that cause bleeding can lead to colorectal cancer.