Blood in the stool can be a cause for alarm, though the reason for it could be piles or anal fissure and not necessarily cancer. Before you think the worst, consider the type of bleeding from mild to life threatening. Black stool means bleeding from high up in the gut and for this, you need to call a doctor at once.
What is Bloody Stool?
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Rectal bleeding or bloody stool is when blood is passed out in the faeces when you go to the toilet. Also called gastrointestinal tract bleeding or GI bleeding, this can range from mild to severe bleeding or haemorrhage. In case bleeding is mild and irregular, tests need to be conducted. But heavy bleeding is a medical emergency which must be tended to.
Bleeding from Colon
This is when blood is present in stool. Blood is dark red in this case and can result from bowel cancer or colitis, Bleeding is continuous, then you will have bright red blood.
Blood from the Stomach/Small Intestine
This blood travels along the gut before it is passed out and the blood becomes dark and altered during this. Faeces can turn black or plum coloured- this is referred to a melaena. Bleeding stomach or duodenum should be immediately treated by the doctor, as it indicates internal bleeding.
When you have bloody stool, you may be asked about weight loss, family history of bowel disease, itching in the lower regions, diarrhoea or constipation. The doctor will also have toe examine you and diagnosis may require further tests than a mere physical examination or proctoscope.
Causes of Bloody Stool
Piles/Haemorrhoids
This is a swelling in the anus and the lower back passage. A small network of blood vessels is there which becomes wider and more filled with blood. This leads to small swellings called haemorrhoids. Larger swelling also causes mucous, pain, irritation and itching.
Anal Fissure
A small tear in the anal skin can also cause bloody stool. A sensitive and bleeding anus will cause blood to emerge in the faeces and the blood is bright red in colour.
Diverticula
This is a condition where the diverticulum or a small pouch with a narrow neck sticks out from the gut’s wall. While these can occur in any part of the gut, they generally form in the colon. Many of these pouches may develop over time and bleed, leading to bloody stool. Bleeding is the result of burst blood vessel in the walls of the pouch. So you can get heavy bleeding from this condition, along with rectal bleeding.
Crohn’s Disease
This is when the gut becomes inflamed. Depending upon how severe the disease is, symptoms range from bloody stool to stomach pain.
Colitis
Ulcerative and other forms of colitis result when the colon or rectum becomes swollen. Another common resulting symptom is a bloody stool. Blood is from ulcers which develop in the walls of the swollen gut. Inflammation of the rectum is called proctitis and it can also cause rectal bleeding.
Polyps
A polyp is a small growth on the inner lining of the colon or rectum. It generally occurs in older people. Benign ones cannot cause much harm, but cancerous ones can be life threatening and cause GI bleeding.
Colon and Rectum Cancer
This is another cause of bloody stool. Other symptoms like weight loss and anaemia may also be noticed. Cancers of other parts above the colon rarely cause rectal bleeding.
Angiodysplasia
This is when enlarged blood vessels in the colon lining develop and cause bleeding which is painless. It can lead to dark red and bright coloured bleeding depending on the blood flow.
Gut Abnormalities
Numerous abnormalities of the gut may cause rectal bleeding in children. This includes:
- Volvulus
- Intussusception
- Meckel’s Diverticulum
- Hirschprung’s Disease
- Stomach and duodenal ulcers
Symptoms
Persons suffering from bloody stools may be unaware of the bleeding and report no symptoms. On the other hand, they could have the following symptoms:
- Weakness
- Breathing Difficulty
- Diarrhoea
- Palpitations
- Fainting
- Weight Loss
- Abdominal Pain
- Associated Symptoms
The symptoms depend on the cause, location and severity of bleeding.
Treatment
Depending on the cause of bleeding there are various treatment options available. After collecting your medical history, the doctor will perform a physical examination.
Tests for Bloody Stool
Following tests may be suggested:
- Colonoscopy
- Sigmoidoscopy
- CT Colonography/virtual colonoscopy
Colonoscopy is performed when the doctor looks into the colon using a thin, flexible telescope called a colonoscope. It’s the size of a small finger and it can mass into the anus and reach the caecum (the point where small and large intestine meets) of the colon.
A colonoscope allows light to shine through fibre optic channels. So, doctors can look down the tube or even attach it to a TV monitor. From small samples to large scale tests and biopsies, colonoscopy is used to detect the cause of GI bleeding.
Sigmoidoscopy is the part of the bowel attached to the rectum. A sigmoidoscope is a thin, finger-like tube which is very short and is inserted into the rectum to observe its lining and the sigmoid colon. CT colonography is a new test where the tube is passed only into the rectum and not further up and is for those who cannot withstand standard colonoscopy.
Faecel Occult Blood Test
This detects blood in the stool in small amounts which is not clearly visible or the patient may be unaware of. If there is only a small amount of blood in the faeces, it looks normal. FOB test detects the blood, however.
Treatment for Blood in Stool
Doctors will use many techniques to stop bleeding:
- Endoscopy
- Angiography
- Medications
Endoscopy involves injecting chemicals into the area bleeding and use of band/clip. current or laser to treat the bleeding vessels. Medicine may be injected into blood vessels to control bleeding through angiography.
Medications like antibiotics or anti-inflammatory drugs may also be used to treat colitis or H. pylori respectively which are often associated with bloody stool. Surgery may be needed if the bloody stool is due to IBS, cancer or diverticulum swelling.
Conclusion
Good nutrition and high fibre diet to relieve constipation, anal fissures and piles can also work wonders. A warm bath can relieve fissure. Depending on a diagnosis, different forms of treatment are available.
While the doctor will prescribe what to take and how to cure this condition, take some precautions like eating plenty of green vegetables and drinking enough water. These simple prevention tips will protect you against further medical complications.