Summary about Disease
Bloody stool, also known as hematochezia (if the blood is bright red) or melena (if the blood is dark and tarry), indicates bleeding somewhere in the digestive tract. The color and consistency of the blood can offer clues as to the location of the bleed. Bright red blood usually indicates a lower GI bleed (colon, rectum, or anus), while dark, tarry stool suggests bleeding higher up in the GI tract (esophagus, stomach, or small intestine). Bloody stool is a symptom, not a disease itself, and requires medical investigation to determine the underlying cause.
Symptoms
Visible blood in stool (bright red, dark red, or black/tarry)
Abdominal pain or cramping
Weakness or fatigue
Dizziness or lightheadedness
Shortness of breath
Anemia (if bleeding is chronic)
Rectal pain or itching (especially with hemorrhoids or anal fissures)
Changes in bowel habits (diarrhea or constipation)
Causes
Lower GI Bleeding:
Hemorrhoids
Anal fissures
Diverticulitis/Diverticulosis
Inflammatory Bowel Disease (IBD) - Crohn's disease, Ulcerative Colitis
Colon polyps or Colon Cancer
Infections (bacterial, viral, parasitic)
Proctitis
Upper GI Bleeding:
Peptic ulcers (gastric or duodenal)
Esophageal varices
Mallory-Weiss tear (tear in the esophagus from forceful vomiting)
Esophagitis
Gastritis
Stomach cancer
Medicine Used
The medications used to treat bloody stool depend entirely on the underlying cause. Examples include:
Hemorrhoids/Anal Fissures: Topical creams (hydrocortisone, local anesthetics), stool softeners, pain relievers (acetaminophen, ibuprofen).
IBD: Anti-inflammatory drugs (corticosteroids, aminosalicylates), immunomodulators, biologics.
Infections: Antibiotics, antivirals, or antiparasitic medications.
Peptic Ulcers: Proton pump inhibitors (PPIs), H2 receptor antagonists, antibiotics (if H. pylori infection is present).
Esophageal Varices: Beta-blockers, endoscopic banding or sclerotherapy.
Iron Supplements: To treat anemia if blood loss is significant.
Blood Transfusions: In cases of severe blood loss.
Is Communicable
Bloody stool itself is not communicable. However, if the bloody stool is caused by an infection (e.g., bacterial dysentery, parasitic infection), the infection can be communicable depending on the specific pathogen involved.
Precautions
Precautions depend on the underlying cause, but generally include:
Good hygiene: Frequent handwashing, especially after using the toilet.
Safe food handling: Proper cooking and storage of food to prevent foodborne infections.
Avoidance of NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) can increase the risk of GI bleeding.
Limit alcohol and caffeine: These can irritate the GI tract.
Manage stress: Stress can worsen some GI conditions.
Follow your doctor's instructions: Take prescribed medications as directed and attend follow-up appointments.
How long does an outbreak last?
The duration of bloody stool depends on the underlying cause and its treatment.
Hemorrhoids/Anal Fissures: Bleeding may resolve within a few days to weeks with treatment.
Infections: Can last days to weeks, depending on the infection and treatment.
IBD Flare-ups: Can last weeks to months.
Ulcers: Can heal within weeks with medication.
Cancer: Bleeding may be intermittent and persist until the cancer is treated.
How is it diagnosed?
Diagnosis involves:
Medical History and Physical Exam: Including questions about symptoms, medications, and past medical conditions.
Stool Tests: To detect blood (fecal occult blood test), infection (stool culture), or inflammation.
Blood Tests: To check for anemia, infection, and liver function.
Endoscopy:
Colonoscopy: Examines the entire colon.
Sigmoidoscopy: Examines the lower portion of the colon.
Upper Endoscopy (EGD): Examines the esophagus, stomach, and duodenum.
Imaging Studies:
CT scan: Can help identify abnormalities in the abdomen.
Angiography: Can identify the source of bleeding.
Capsule Endoscopy: A wireless camera is swallowed to visualize the small intestine.
Timeline of Symptoms
The timeline of symptoms varies greatly depending on the cause.
Acute bleeding: Sudden onset of bright red blood, often associated with hemorrhoids, anal fissures, or infections.
Chronic bleeding: Intermittent or persistent dark, tarry stools or fatigue/weakness due to anemia, often associated with ulcers, IBD, or cancer. The onset may be gradual and symptoms may worsen over time.
Infectious causes: May have sudden onset of bloody diarrhea with abdominal cramping and fever.
Important Considerations
Bloody stool should always be evaluated by a doctor, regardless of the amount of blood.
Do not self-diagnose or self-treat.
The presence of bloody stool can be a sign of a serious underlying condition, such as cancer. Early diagnosis and treatment are crucial.
If you experience severe abdominal pain, dizziness, lightheadedness, or weakness along with bloody stool, seek immediate medical attention.