Blood in stool, often called rectal bleeding, indicates bleeding within the gastrointestinal (GI) tract. This can be unsettling, but it stems from various sources, ranging from minor, treatable conditions to more significant health concerns. Understanding its characteristics and potential origins is an important first step. This article clarifies what different appearances of blood might mean, explores common and more serious causes, and guides when to seek medical attention.
Understanding Different Appearances
The color and consistency of blood in stool provide clues about where bleeding might be occurring in the digestive system. Blood changes as it travels through the GI tract, influenced by digestive processes. Recognizing these differences helps individuals better describe their symptoms to a healthcare provider.
Bright red blood typically suggests bleeding from the lower GI tract, such as the colon, rectum, or anus. This fresh blood may appear on toilet paper, in the toilet bowl, or mixed with the stool. Conversely, dark red or maroon blood often indicates bleeding from higher in the colon or small intestine. Here, the blood has been exposed to digestive enzymes, causing it to darken.
Black, tarry stools, medically termed melena, usually point to bleeding from the upper GI tract, including the esophagus, stomach, or duodenum. Their black, sticky, foul-smelling appearance results from the blood being digested as it moves through the digestive system. Sometimes, blood may be present in the stool but not visible to the naked eye; this is occult blood, detected only through specific laboratory tests.
Common Reasons for Blood
Blood in stool often arises from common, less concerning conditions affecting the lower digestive tract. While discomforting, these causes are frequently manageable with appropriate care.
Hemorrhoids are a frequent cause of bright red blood, appearing as swollen veins in the anus or rectum. They can bleed, particularly after straining during bowel movements, and may cause itching or discomfort. Another common cause is anal fissures, which are small tears in the lining of the anus. Fissures can be painful and often result in bright red blood, especially after passing a hard stool.
Diverticulosis involves small, bulging pouches in the colon lining that can sometimes bleed. This bleeding is often painless and can produce dark red or maroon blood. Angiodysplasia refers to fragile, abnormal blood vessels within the GI tract that can rupture and lead to bleeding.
More Serious Conditions
While many causes of blood in stool are minor, some conditions are more serious and require thorough medical investigation. These conditions often involve inflammation, abnormal growths, or structural issues within the digestive system.
Inflammatory Bowel Disease (IBD), encompassing Crohn’s disease and ulcerative colitis, involves chronic inflammation of the digestive tract. This can lead to ulcers and bleeding, often accompanied by abdominal pain, diarrhea, and fatigue. Peptic ulcers are open sores that develop on the lining of the stomach or the first part of the small intestine. These ulcers can bleed, frequently causing black, tarry stools.
Polyps are growths on the inner lining of the colon or rectum. While many are benign, some can bleed and have the potential to become cancerous over time. Colorectal cancer, a significant concern, can also manifest with blood in the stool, which may be visible or occult. Other signs might include changes in bowel habits, unexplained weight loss, or abdominal pain.
Esophageal varices are enlarged veins in the esophagus, typically occurring in individuals with liver disease. These fragile veins can rupture, leading to severe upper GI bleeding, presenting as black, tarry stools or vomiting blood.
When to See a Doctor
Any instance of blood in the stool warrants evaluation by a healthcare professional to determine the cause. While some situations allow for a scheduled appointment, others require immediate medical attention. It is always prudent to err on the side of caution.
Seek immediate medical attention if you experience a large amount of blood in your stool, especially if it is continuous. Accompanying symptoms like dizziness, lightheadedness, or fainting suggest significant blood loss and require urgent care. Severe abdominal pain, a rapid heart rate, shortness of breath, or black, tarry stools are also red-flag symptoms that require immediate medical evaluation. If blood is mixed with diarrhea, this also indicates a need for prompt assessment.
For less severe symptoms, such as small amounts of bright red blood that appear consistently, scheduling an appointment with a healthcare provider is important. Even if the bleeding seems minor, a medical professional can identify the source and rule out more serious conditions. Ignoring persistent bleeding, regardless of quantity, can delay diagnosis and treatment of conditions that may worsen over time.
What to Expect at the Doctor
The diagnostic process typically begins with a thorough medical history and physical examination. The doctor will likely ask detailed questions about the appearance of the blood, its frequency, and any associated symptoms like pain, changes in bowel habits, or weight loss. A physical exam may include an abdominal assessment and a digital rectal exam to check for abnormalities in the lower rectum or anus.
Several diagnostic tests may be recommended to pinpoint the bleeding source. Stool tests, such as the fecal occult blood test, can detect hidden blood or identify infections. Blood tests, including a complete blood count, may be performed to check for anemia, which can result from chronic blood loss.
Endoscopy and colonoscopy are common procedures where a flexible tube with a camera is used to visualize the GI tract. An upper endoscopy examines the esophagus, stomach, and duodenum, while a colonoscopy inspects the large intestine and rectum. These procedures allow for direct visualization, and biopsies can be taken if needed.
In some cases, other imaging tests like CT scans may also be used to help locate the bleeding source. The specific treatment will depend on the underlying cause identified through these diagnostic steps.