The presence of blood in stool can be an alarming symptom. While some instances stem from minor conditions, others signal a serious underlying health issue requiring prompt medical evaluation. Understanding the different presentations and associated symptoms helps determine the appropriate course of action. This article identifies circumstances necessitating an immediate emergency room visit for blood in stool.
Appearance of Blood in Stool
The visual characteristics of blood in stool offer clues about the potential source of bleeding within the digestive tract.
Bright red blood, often seen on toilet paper or in the toilet bowl, is typically called hematochezia. This usually indicates bleeding from the lower gastrointestinal tract, such as the colon or rectum. Conditions like hemorrhoids or anal fissures are common causes, as the blood is fresh and has not traveled far.
Dark red or maroon-colored blood can also appear in the stool, sometimes mixed with clots. This suggests bleeding from higher up in the colon or small intestine. The darker color results from the blood being partially digested as it moves through the digestive system. This type of bleeding can be significant and may arise from conditions like diverticulitis or inflammatory bowel disease.
Black, tarry, and foul-smelling stools, known as melena, signify bleeding from the upper gastrointestinal tract, such as the stomach or duodenum. The black color and tarry consistency occur because hemoglobin reacts with digestive enzymes and stomach acid. Gastric ulcers or esophageal varices are common causes, indicating the blood has been present in the digestive system for a longer duration.
Understanding Potential Causes
Blood in the stool can arise from various conditions, from benign issues to more significant health concerns.
Common, less serious causes include hemorrhoids, which are swollen blood vessels in the rectum or anus, and anal fissures, small tears in the lining of the anus. These often result in bright red blood, particularly after bowel movements, and are associated with constipation or straining. Minor infections or temporary inflammation can also lead to small amounts of blood.
More significant underlying issues can also manifest as blood in the stool. Inflammatory bowel diseases (IBD) like Crohn’s disease and ulcerative colitis cause chronic inflammation of the digestive tract, leading to bloody diarrhea. Diverticulitis, an inflammation of small pouches in the colon, can also cause bleeding. Peptic ulcers in the stomach or duodenum are another common source, often presenting as dark or tarry stools.
Other serious causes include polyps, growths on the colon lining that can sometimes bleed and have the potential to become cancerous. Colorectal cancer is a significant cause of blood in stool, which may not always be visible. Certain infections, such as E. coli or Salmonella, can also lead to bloody diarrhea. Determining the precise cause requires a thorough medical evaluation.
Urgent Signs for an ER Visit
While any instance of blood in stool warrants medical attention, certain signs indicate a severe situation requiring an immediate emergency room visit.
Large amounts of blood in the stool, especially if continuous or forming significant blood clots, is a clear indicator. This suggests rapid and substantial blood loss that could quickly become life-threatening. The volume of blood is a primary indicator of urgency.
Accompanying symptoms signaling a medical emergency are those indicative of shock, which occurs when the body does not receive enough blood flow. These include severe dizziness or lightheadedness, particularly when standing, which can lead to fainting. A rapid heartbeat (tachycardia) and low blood pressure also indicate the body is struggling to compensate for blood loss. Confusion, disorientation, or a sudden change in mental status also suggest inadequate blood flow to the brain.
Other indicators for immediate ER care include severe, sudden abdominal pain that may be sharp or cramping. Cold, clammy, and pale skin, along with a significant decrease in urination, are further signs of severe blood loss and shock. Persistent vomiting, especially if it contains blood or resembles coffee grounds, also points to an urgent internal bleeding issue. Any combination of these symptoms with blood in the stool necessitates immediate emergency medical attention.
What Happens After Seeking Care
Upon arriving at the emergency room for blood in stool, medical professionals will first assess your overall condition and vital signs. They will perform a physical examination, including an abdominal and potentially a rectal exam, to look for immediate sources of bleeding or tenderness. Provide a complete medical history, including details about the amount and appearance of blood, associated symptoms, and any existing medical conditions or medications. This information will help guide the diagnostic process.
Diagnostic steps often include blood tests to check for anemia, assess blood clotting, and evaluate kidney function. A stool sample may be collected to test for hidden blood or infections. Depending on the suspected source, imaging studies such as a CT scan or an angiogram might be performed to visualize the digestive tract. In many cases, an endoscopy procedure, such as a colonoscopy or an upper endoscopy, will be recommended to directly visualize the lining and identify the source of bleeding.
While awaiting medical help, staying hydrated by sipping small amounts of water can be helpful, unless instructed otherwise. Avoid taking any over-the-counter pain relievers that can thin the blood, such as aspirin or ibuprofen, as these could worsen bleeding. Seek professional medical evaluation without delay, as timely diagnosis and intervention are important for managing the underlying cause.