Summary about Disease
Blood in stool, also known as hematochezia (if the blood is bright red) or melena (if the blood is dark and tarry), is the presence of blood in the feces. It is a symptom, not a disease itself, and it indicates bleeding somewhere in the digestive tract. The location and amount of bleeding determine the color and consistency of the blood. It can range from a minor and self-limiting issue to a sign of a serious underlying condition.
Symptoms
Symptoms associated with blood in stool vary depending on the cause and location of the bleeding.
Bright red blood in stool: Usually indicates bleeding in the lower digestive tract, such as the rectum or anus.
Dark red or maroon-colored stool: May indicate bleeding higher up in the colon or small intestine.
Black, tarry stool (melena): Suggests bleeding in the upper digestive tract, such as the stomach or duodenum. The blood has been digested, giving it the dark color and tarry consistency.
Other associated symptoms: Abdominal pain, cramping, diarrhea, constipation, weakness, fatigue, lightheadedness, shortness of breath (if significant blood loss occurs). Blood clots may also be present.
Causes
Blood in stool can be caused by a wide range of conditions, including:
Hemorrhoids: Swollen veins in the anus and rectum.
Anal fissures: Small tears in the lining of the anus.
Diverticulosis/Diverticulitis: Small pouches in the colon that can become inflamed or bleed.
Colon polyps: Growths in the colon that can sometimes bleed.
Inflammatory bowel disease (IBD): Conditions like Crohn's disease and ulcerative colitis that cause inflammation in the digestive tract.
Infections: Bacterial infections like E. coli or parasitic infections.
Ulcers: Sores in the lining of the stomach or duodenum.
Esophageal varices: Enlarged veins in the esophagus, often due to liver disease.
Angiodysplasia: Abnormal blood vessels in the digestive tract.
Cancer: Colon cancer, rectal cancer, or stomach cancer.
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) and blood thinners can increase the risk of bleeding.
Swallowed blood: Blood from a nosebleed or injury in the mouth can be swallowed and passed in the stool.
Medicine Used
The medications used to treat blood in stool depend entirely on the underlying cause. Some examples include:
Hemorrhoids/Anal Fissures: Topical creams or suppositories containing corticosteroids or local anesthetics, stool softeners.
Infections: Antibiotics or antiparasitic medications.
Inflammatory Bowel Disease (IBD): Anti-inflammatory medications (corticosteroids, aminosalicylates), immunosuppressants, biologics.
Ulcers: Proton pump inhibitors (PPIs), H2 blockers, antibiotics (if H. pylori infection is present).
Iron supplements: May be recommended if blood loss has led to iron deficiency anemia.
Blood transfusions: May be necessary in cases of severe blood loss.
Other: Medications to treat specific underlying causes, such as liver disease.
Is Communicable
Blood in stool itself is not communicable. However, if the blood in stool is caused by an infectious agent (e.g., bacterial or parasitic infection), then the underlying infection could be communicable depending on the specific pathogen.
Precautions
Precautions depend on the underlying cause and are aimed at preventing further bleeding or complications.
Seek medical attention: It is crucial to see a doctor to determine the cause of blood in stool.
Maintain good hygiene: Wash hands thoroughly after using the toilet.
Avoid straining during bowel movements: This can worsen hemorrhoids and anal fissures.
Stay hydrated: Drink plenty of fluids to prevent constipation.
Follow your doctor's instructions: Adhere to any dietary recommendations or medication regimens prescribed by your healthcare provider.
Avoid NSAIDs: If possible, avoid NSAIDs as they can increase the risk of gastrointestinal bleeding.
Manage underlying conditions: If you have a condition like IBD or diverticulitis, follow your treatment plan closely.
How long does an outbreak last?
The duration of bleeding depends on the cause and severity. Minor bleeding from hemorrhoids or anal fissures may resolve within a few days or weeks with conservative treatment. Bleeding from more serious conditions like IBD or ulcers may persist for longer periods and require ongoing medical management. If the cause is an infection, the bleeding may stop once the infection is treated. It's important to consult a doctor for accurate diagnosis and treatment.
How is it diagnosed?
Diagnosis involves:
Medical history and physical examination: The doctor will ask about your symptoms, medical history, and medications.
Stool tests: To detect the presence of blood (fecal occult blood test) or infection.
Blood tests: To check for anemia and assess overall health.
Colonoscopy: A procedure where a flexible tube with a camera is inserted into the colon to visualize the lining.
Sigmoidoscopy: Similar to a colonoscopy, but only examines the lower part of the colon.
Upper endoscopy (EGD): A procedure where a flexible tube with a camera is inserted into the esophagus, stomach, and duodenum.
Capsule endoscopy: A small wireless camera is swallowed to take pictures of the small intestine.
Barium enema: X-ray of the colon after it is filled with barium.
Angiography: X-ray of blood vessels to identify bleeding sources.
Timeline of Symptoms
The timeline of symptoms varies greatly depending on the cause.
Sudden onset: May occur with anal fissures, hemorrhoids, or acute infections.
Gradual onset: May occur with colon polyps, IBD, or cancer.
Intermittent: Bleeding may come and go, especially with conditions like hemorrhoids or diverticulosis.
Constant: Bleeding may be continuous, especially with severe ulcers or inflammatory conditions. The presence of associated symptoms, such as abdominal pain or changes in bowel habits, can also provide clues about the underlying cause.
Important Considerations
Don't self-diagnose: Blood in stool should always be evaluated by a doctor.
Severity: Even small amounts of blood can be a sign of a serious condition.
Medications: Inform your doctor about all medications you are taking, including over-the-counter drugs and supplements.
Underlying conditions: Be sure to mention any pre-existing medical conditions to your doctor.
Follow-up: It is important to follow up with your doctor as recommended to monitor your condition and ensure that treatment is effective.
Dietary changes: Changes in diet are sometimes recommended and should be followed as directed by your healthcare provider.