Blood in the stool : Causes, Types, Treatment Symptoms

What is Blood in the stool (Hematochezia)?

Blood in stool, sometimes referred to as rectal bleeding or hematochezia, is the presence of blood in the gastrointestinal tract during bowel movements.
Depending on the bleeding source, it may appear as brilliant red streaks, clots, dark red mixed with blood, or black tarry stools (melena), with bright red coming from the lower GI tract and deeper hues coming from the upper GI tract.

Here are some of the most common accompanying blood in Stool symptoms:

• Abdominal pain
• Diarrhoea
• Fatigue
• Dizziness
• Mucus in stool
• Pain around the anus
• Weight loss
• Bright red colored stool indicates lower rectum or anal issues like hemorrhoids.
• Stools colored in maroon or dark red indicate colon bleeding
• Black, tarry, foul-smelling stools indicate upper GI infection
• Large blood clots
• Rapid heartbeat
• Short of breath
• Extreme fatigue

Common, Uncommon, or Underlying Causes of Blood in Stool

Rectal bleeding can indicate a variety of gastrointestinal conditions, ranging from mild disorders to severe diseases, and the color of the blood can indicate whether it originates from the upper or lower digestive system. While common causes, such as hemorrhoids, are usually harmless and related to straining, persistent symptoms require an in-depth exam by a gastroenterologist to rule out more significant underlying causes.

Here are some reasons for blood in the stool:

• Hemorrhoids: Involve enlarged veins that, either during or after bowel movements, usually generate bright red blood
• Anal fissures: Hard stools produce small rips in the anus lining, resulting in intense pain and bright red blood
• Diverticulitis: Diverticula are small colon pouches that can become inflamed or bleed, resulting in maroon or bright red blood in the stool
• Infectious Colitis: Infections that induce inflammation and bloody diarrhea might be bacterial (e.g., E. coli, Salmonella, C. diff), viral, or parasitic
• Inflammatory Bowel Disease (IBD): It includes ulcerative colitis and Crohn’s disease, both of which cause chronic inflammation of the digestive system
• Angiodysplasia: Fragile, abnormal blood vessels in the gut lining may burst, particularly in older persons
• Colorectal polyps: Noncancerous growths on the gut lining that can cause bleeding and, in some cases, malignancy
• Ischemic Colitis: This condition is characterized by reduced colon blood flow, resulting in acute stomach discomfort and bloody stools
• Esophageal Varices/Mallory-Weiss Tears: Esophageal tears or swollen veins, which frequently occur through vomiting or liver illness, might result in black, tarry stools
• Radiation Proctitis: Usually, bleeding is seen in the case of pelvic cancers after radiation therapy
• Meckel’s Diverticulum: It is a congenital small intestinal pouch that produces painless rectal bleeding, especially in youngsters
• Colorectal Cancer: A slow-growing, malignant tumor can produce painless, prolonged rectal bleeding
• Peptic Ulcer Disease: Sores in the stomach or duodenum, commonly caused by an H. pylori infection or the use of nonsteroidal anti-inflammatory drugs (NSAIDs), which frequently result in black, tarry stools
• Anal/Rectal Cancer: Tumors of the anus and rectum
  Mesentric Artery Embolism/Mesentric Thrombosis
• Food Protein-Induced Allergic Proctocolitis: Infants react to milk protein that results in blood-streaked stools.
• Intussusception: It happens when the colon collapses on itself, resulting in discomfort and “currant jelly” feces

When to Seek a Specialist for Your Blood in Stool?

Rectal bleeding must be evaluated as soon as possible to rule out reasons ranging from benign hemorrhoids to severe disorders such as colorectal cancer, which should begin with a consultation with a primary care physician or gastroenterologist.

Visit your specialist if these blood in stool symptoms are present:

• Urgent Situations: If you experience substantial bleeding, black tarry stools, dizziness, or severe stomach discomfort, get emergency medical attention right away, since these symptoms may indicate a life-threatening GI incident.
• Routine Specialist Referrals: A professional recommendation for a colonoscopy is required for persistent symptoms lasting more than three weeks, especially when they are accompanied by weight loss or changes in bowel habits, to rule out cancer.
• Types of Specialists: Providing your doctor with specific information about the color and frequency of the bleeding will assist experts such as colorectal surgeons or gastroenterologists in deciding the most appropriate treatment strategy.

Don’t wait for signs to grow severe. Consult our Gastroenterologist today.

Diagnostic Approach for Blood in Stool

The diagnosis of blood in stool, also known as rectal bleeding, is performed by gastroenterologists in an orderly manner, beginning with non-invasive testing and moving to endoscopy based on risk factors, symptoms, and first results. The choice depends on the features of the bleeding (whether it is bright red or black), the age of the patient, and any related symptoms such as weight loss or anemia.

Here are the specialist-approved diagnostic steps:

• Initial Non-invasive Test: Fecal immunochemical testing (FIT) identifies concealed blood in stool samples and is a first-line screening method, particularly for colorectal cancer risk. Multipurpose stool DNA assays, such as Cologuard Plus, detect DNA markers and blood, increasing sensitivity for precancerous lesions. These at-home tests determine whether a colonoscopy is required, preventing unnecessary operations.
• Endoscopic Evaluation: Colonoscopy remains the gold standard, as it allows for viewing of the whole colon, abnormal biopsy, and polyp removal all in one session. Flexible sigmoidoscopy may be sufficient for lower rectal bleeding, while upper endoscopy (EGD) checks for dark or upper GI causes. If an endoscopy fails to finish, imaging such as CT colonography is performed.
• Additional Assessments: Blood tests look for anemia, infection, or coagulation problems; labs look at hemoglobin levels and fecal calprotectin for inflammation. High-risk individuals (over 45 or with a family history) skip directly to colonoscopy according to screening standards.

Types of Blood in Stool

Blood in stool, also known as rectal bleeding, comes in several varieties based on color, consistency, and site of origin inside the gastrointestinal tract, allowing physicians to identify possible reasons. These categories assist diagnostic urgency; bright red blood often indicates lower GI disorders, but darker colors indicate upper GI origins. Accurate monitoring of the amount, frequency, and concomitant symptoms assists professionals in triage.

Commonly classified types of blood in stool include:

Based on color:

• Bright red blood: Seen in the cases of hemorrhoids, anal fissures, and inflammatory bowel disease, indicating blood in the lower gastrointestinal tract.
• Black or tarry stool: Blood that has been digested or oxidized, usually from the upper gastrointestinal system.
• Dark red or maroon blood: Suggests bleeding in the higher regions of the colon or in the small intestines.
• Occult blood: Blood not visible to the naked eye and seen through lab tests

Based on consistency:

• Streaks on stools/toilet paper: Caused by hemorrhoids or anal fissures
• Mixed with stools: Indicates inflammation or infection higher in the intestines
• Blood and mucus: seen in conditions like colitis or other infections

How to Treat Blood in Stool Symptoms?

Treatment for blood in stool focuses on addressing the root cause following a specialist diagnosis, encompassing conservative approaches for benign conditions and surgical procedures for more severe cases. Rehabilitation prioritizes relief of symptoms, recurrence prevention, and lifestyle modifications to promote healing. Always seek advice from a gastroenterologist for customized management, as self-treatment might miss dangerous malignancies.

For underlying causes, treatments & rehabilitative strategies include:

• Conservative options: Treatment for hemorrhoids and fissures includes a high-fiber diet, stool softeners, hydration, and sitting baths; topical treatments containing hydrocortisone or nitroglycerin enhance recovery.
• Medications: Proton pump inhibitors (PPIs) or antibiotics are normally prescribed to treat ulcers/infections, while iron supplements help with anemia.
  Procedures include hemorrhoid ligation, sclerotherapy, or coagulation; polypectomy or ablation during a colonoscopy; and surgery for severe diverticulitis or malignancy.
• Advanced options: For uncontrolled bleeding, advanced treatment options include embolization or resection.
• Rehabilitative Strategies: Prevent recurrence by committing to a high-fiber diet, maintaining adequate hydration, and adopting healthy living practices, complemented by periodic colonoscopies and nutritional advice.

What if Blood in the stool is Left Untreated?

The presence of blood in stool when left untreated might result in major difficulties, as it frequently indicates the presence of a deeper issue that becomes worse over time if it is not addressed. Chronic cases can advance from benign causes to life-threatening diseases, which highlights the importance of obtaining an expert review as soon as possible.

Some possible complications of an untreated Blood in Stool include:

• Heavy or persistent bleeding risks severe blood loss
• Causes anemia, dizziness, shock, or even death if untreated
• Infections from diverticulitis or inflammatory bowel disease can cause sepsis
• Systemic organ damage
• Slow, ongoing bleeding leads to iron-deficiency anemia
• Benign issues like hemorrhoids or fissures may recur painfully, forming strictures or ulcers
• Polyps left unchecked can evolve into colorectal cancer
• Raises the risk of spread to the liver or lungs. Early colonoscopy prevents this in high-risk groups.

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