Blood in Stool
If you experience bleeding anywhere along your digestive tract, from the mouth to the anus, then it is very likely that you have other gastrointestinal (GI) problems, such as an ulcer, polyps or other digestive complications. The GI tract includes the esophagus, the stomach, the small and large intestines, the rectum and the anus. Bleeding can occur at one point or several points, depending on the case. Problems are not always serious, but it is crucial to detect the area that is causing the bleeding so that further examination of that area can be performed and a proper diagnosis can be made as early as possible.
Because almost all of the digestive tract is concealed inside the body, it is not always easy to detect gastrointestinal bleeding. Many patients who experience the symptom actually don’t know it until more serious indicators come up. When the location of the bleeding is higher up in the GI tract, blood often shows up in the stool as a very dark, blackish color that mixes with fecal matter and mucous, so it may be difficult to detect. Note that foods with high iron content can also produce black stool, so dark fecal matter does not necessarily mean that a patient is bleeding.
By scheduling regular screenings every year with your doctor, you can keep track of changes that occur in your body and catch health problems before they get worse. Some tests that doctors use in order to detect blood in the stool include a fecal blood occult blood test (FOBT) and a fecal immunochemical test (FIT). Gastrointestinal bleeding caused by ulcers or other health problems are also detected by medical professionals during colorectal examinations such as colonoscopy, sigmoidoscopy and routine digital rectal exams. Many X-ray tests can also detect gastrointestinal bleeding.
Possible Causes of Colorectal Bleeding
• Hemorrhoids—hemorrhoids are swollen veins found around the anal and rectal area. They tend to tear and break during movements, which can cause discomfort, pain and concern in any individual affected. Hemorrhoids are the most common causes of blood in the lower gastrointestinal tract. The blood usually appears to be a bright red color and is often visible in the stool. In older patients, general blood vessel problems in the large intestine can also cause bleeding.
• Colon Polyps—colorectal polyps are growths along the colon wall, rectum and anus. They are strong indicators that a patient might have or might develop colorectal cancer. While many are benign, colon polyps are usually removed upon detection as a precaution against the polyp turning cancerous, or adenomatous.
• Colon Pouches—colon pouches, also known in medical circles as diverticula, are growths in the bowel that can cause bleeding in the lower GI tract much like colon polyps.
• Colon Cancer—colon cancer produces many symptoms as cancerous tumors change the makeup of colon tissue. Growths that emerge as a result of colon cancer can often start to bleed, which may or may not be visible in the stool without a stool test. Bleeding may be subtle, and lack of bleeding should not stop you from obtaining routine screening colonoscopy.
• Infections—blood detected in the stool during bouts of diarrhea can indicate inflammation in the bowels or infections anywhere along the lower GI tract. It is important to seek out medical help right away if you have an infection, before the bacteria can spread to other parts of the colon.
• Inflammatory Bowel Disease (IBD)—IBD is a condition that causes inflammation in the lining of the colon or large intestine, also called mucosa, and deep in the tissues of the bowel wall. It can lead to painful bleeding that shows up in the stool, most often while a patient experiences diarrhea, it is important to diagnose and treat this disease early, as it carries an increased risk of developing colon cancer and other serious medical problems throughout the patient’s life.
• Anal Fissures—anal fissures describe any tear or rip in the lining of the anus. They can be caused by unhealthy bowel movements, such as hardened stool, or external causes during sexual activity. Bleeding caused from anal fissures is painful but rarely indicate more threatening health issues.
Reviewed 12/12/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014