Blood in Stool

Suppose you are in your toilet and see blood in stool; this will be an alarming situation for you. Bleeding in stool leads to serious health problems in the human body, such as hemorrhoids, ulcers, fissures, colorectal cancer, or inflammatory bowel disease (IBD). Contact your doctor immediately if you see any bleeding in stool, on toilet paper, or in the toilet bowl’s water. 

Types of Blood in stool:

The color of blood in stool indicates the places that from where this bleeding is happening:

• Bright red: If you see bright red color in your stool, it means that bleeding is happening in your colon or rectum.
• Dard red: If you feel dark red color in your stool, it usually indicates bleeding in the colon or the small bowel.
• Melena: If the blood is of dark color and tar-like stool, it indicates bleeding in the stomach and shows apparent symptoms of ulcer in the body.

Causes of Blood in Stool

There are many reasons for experiencing blood in stool; its causes vary from condition to condition. Some of the common reasons behind experiencing blood in stool are the following:

• Hemorrhoids: Hemorrhoids are swollen veins problems in the anus or rectum of the body caused by chronic constipation, pregnancy, straining during bowel movement, heavy weightlifting, obesity, and anal intercourse. Hemorrhoids aren’t a severe medical emergency, but you must discuss them with your doctor if you are experiencing this problem most often.
• Anal fissure: An anal fissure occurs when a person has split or torn skin around his anus, usually due to hard stool. If you are suffering from a hard stool problem, it is difficult for stool to pass out from the anus, and due to excessive pressure, the skin of the anus tears or slips out, which is the reason behind experiencing blood in the stool.

• Large polyps: Polyps seem like a mushroom growing on the outer side of your bowel. If large polyps cause bleeding, you may also experience stool bleeding; this is another reason behind stool bleeding. It turns into colorectal cancer in case it is not treated at the proper time. 

• Ulcers: Ulcer is caused by damage to the digestive tract lining. When the amount of the fluids that help in digestion turns out of control in the intestine, it leads to an ulcer. The ulcer is the problem behind a person experiencing black or tar-like stools.

• Anal abscess or fistula: Inside the anus, small glands are present that help pass stool downward. If these glands become infected, filled with puss, and cause blockage, it is known as an abscess, and the anal fistula is the tiny tunnel that usually connects the anus skin with an abscess. The infection in the glands of the anus causes bleeding in the stool.

• Angiodysplasia: Angiodysplasia is a blood vessel abnormality in the gastrointestinal tract (GI), which leads to lesions and bleeding in the colon and stomach. Due to this problem, a person may experience stool bleeding.

• Inflammatory bowel disease (IBD): Inflammatory bowel disease is caused by small or large intestine swelling. There are two types of IBD: Crohn’s disease and colitis. Crohn’s disease happens due to the swelling of patches in the digestive tract, while in colitis, a person experiences swelling in the larger bowel. Due to this problem, a person experiences bleeding in stool, cramping, abdominal pain, and intestinal blockage.

• Diverticulosis/Diverticulitis: When the small pouches develop in the weakened section of the intestine and protrude through the bowel wall, it leads to infection and bleeding; these small pouches are known as Diverticuli. Diverticulosis is another condition due to which a person experiences bleeding in stools.  

Symptoms of Blood in Stool

A person experiencing blood in the stool may have no reported symptoms. But some of the symptoms may not be felt or taken seriously before experiencing blood in stool, leading to severe disease. Signs of bleeding usually depend on the cause, but some of the common symptoms of bleeding in stool are given below:

• Abdominal pain
• Weakness
• Diarrhea
• Fainting
• Weight loss
• Vomiting
• Difficulty in breathing
• Fast heart rate
• Difficulty in urination
• Unconsciousness
• Palpitation
• Feeling dizzy or lightheaded
• Rectal pain or pressure
• Mental confusion

Diagnosis

During diagnosis, the doctor will evaluate the cause of bleeding in your stool. The detail you share with your doctor is constructive in locating the place of bleeding in your body. By analyzing your medical history and doing a physical examination, your doctor may know the actual cause behind this issue which is also helpful in treating this problem. Your doctor may also order the following test for diagnosis:

• Esophagogastroduodenoscopy (EGD): During this test, the doctor might insert an endoscope (a flexible tube with a tiny camera) into your mouth to the esophagus to know the source behind a person’s experience of bleeding in the stool. 

• Enteroscopy is a similar procedure to EGD, in which a colonoscopy is used to test the small intestine to know the reason behind a person experiencing blood in stools. This process also involves swallowing a capsule with a tiny camera that records all the images and videos passing through the digestive tract. 

• Colonoscopy: Colonoscopy is a test closely similar to EGD in which the larger bowel (colon and rectum) is examined through a colonoscope to know the actual place of bleeding.

• Nasogastric lavage: The doctor examines the upper and lower digestive tract bleeding in this test. A tube is inserted into the stomach through the nose during the test to know whether the bleeding is in the stomach or the lower digestive tract.

• Barium X-ray: A contrast material named barium is swallowed or inserted into the rectum to show the actual cause behind bleeding in the stool on an X-ray.

• Radionuclide scanning: In radionuclide scanning, the doctor will inject a small amount of radioactive material into your veins that observe the blood flow in the digestive tract to detect the source of bleeding in the stool.

• Laparotomy: In this process, the doctor opens and examines the patient’s abdomen to investigate the cause of the bleeding in the stool.

• Angiography: The doctor will insert a special dye into the veins in angiography, making the blood vessel visible and monitored through X-ray and CT scan. It helps to detect bleeding because the dye leaks out of blood vessels at the bleeding site.

Treatment

The treatment usually depends on the cause behind the bleeding in stool, and the doctor may use several techniques to stop the bleeding. 

• The doctor may inject the chemical into the bleeding site during endoscopy, which stops the bleeding through a laser by applying a band or clip to close the bleeding vessel. 
• If the endoscopy didn’t work out, the doctor might also use the angiography technique to inject medicine into the blood to control bleeding.
• Medication such as antibiotics or anti-inflammatory drugs is also helpful in treating this problem.
• Surgery is also helpful in treating issues such as removing polyps or other damaged colon parts due to cancer, inflammatory bowel disease, and diverticulitis.
• Improving your diet will also help treat this issue by taking a high-fiber diet. It helps relieve constipation, which can cause anal fissures and hemorrhoids.
• Warm baths are also helpful in relieving fissures and hemorrhoids, which are the ultimate cause of bleeding in the stool.

Reference:

• https://www.webmd.com/digestive-disorders/blood-in-stool retrieved on April 16, 2022. 
• https://my.clevelandclinic.org/health/symptoms/14612-rectal-bleeding#:~:text=Rectal%20bleeding%20is%20a%20symptom,bowl%20or%20in%20your%20stool retrieved on April 16, 2022. 
• https://www.webmd.com/digestive-disorders/ss/slideshow-why-blood-in-stool retrieved on April 16, 2022. 
• https://www.uptodate.com/contents/blood-in-the-stool-rectal-bleeding-in-adults-beyond-the-basics/print retrieved on April 16, 2022. 
• https://patient.info/digestive-health/rectal-bleeding-blood-in-faeces retrieved on April 16, 2022.