Blood in Stool

Finding blood in stool, a condition also known as Rectal Bleeding, can cause alarm when seen in the toilet bowl or covering the stool itself. Bleeding from the intestine shows that there may be lesions on the inner lining of the gut manly because of inflammatory conditions like colitis or inflammatory bowel disease (IBD), benign or malignant tumors, peptic ulcers, traumatic tearing of the anus (fissures), esophagitis etc. the source of bleeding cannot be confirmed without further tests. Being a relatively common problem, it affects 1 in every 10 people in the UK.

What are the causes and symptoms of blood in stool?

Either a very small streak of blood, negligible to the eye, or an obvious amount of dark red tar, if seen with stool often raises alarm, as it refers to internal bleeding from the gut. The occult blood can be detected through physical examination of fresh stool called the fecal occult test. Fresh stains of blood indicate bleeding from the rectum or pre-rectal colon. The tarry appearance of blood generally points at bleeding occurring higher up in the gut. The following causes can be listed:

Diverticulosis:

• The walls of the intestine may develop tiny pouches known as diverticuli, projecting outwards.
• They can mainly be seen in the colon.
• Divertculosis is a condition where multiple diverticuli are present in the colon.
• Most frequently occurring in adults, painless bleeding may be experienced.
• In case, the condition leads to lower gastrointestinal bleeding, mild cramps along with urgent bowel movement can be felt.
• The bleeding might stop on its own, but diagnosis and confirmation of the condition should take place.
• In severe cases, blood transfusion might be required if the rectal bleeding is heavy.

Hemorrhoids:

• Ampulated, enlargements of blood vessels in the alimentary canal are called Hemorrhoids.
• It mostly occurs between the ages 45-65 in case of beng persistant. But, temporary condition  can be seen in adults of any age.
• It is commonly seen as a post-parturation syndrome.
• The bleeding in the lower gastrointestinal track happens mainly because of internal hemorrhoids.
• Amount of blood in stool may range from few clots to dripping amount of blood after the bowel movement.
• Recurrent hemorrhoids can be treated by ablation therapy, destroying the tissue where the hemorrhoid is present.
• Non-alarming bleeding can be taken care of, by changing lifestyle, eating habits and increasing fluid and fiber intake.

Colonal Ischemia (CI):

• This condition of tissue damage results from reduced blood flow and lack of oxygen.
• This is a temporary condition where tissue damage only occurs in a small segment of the colon.
• Mainly affecting people above 50 years of age, many medications lead to the Ischemia like pain killers, antibiotics, decongestants, diuretics, appetite suppressants and chemotherapy drugs and medical ailments such as artherosclerosis, heart disease, diabetes,chronic obstructive pulmonary disease etc.
• Symptoms may vary from abdominal cramps during strong bowel movement to bloody diarrhea.
• Colonal Ischemia can be treated with proper medication f diagnosed well in time. Severe cases may require surgical processes for removal of the Ischemic segment.

Colonal Angiodysplacia:

• This abnormality in the blood vessels is a degenerative disease wherein healthy blood vessels of the colon become weak and thin as the age grows.
• The capillary-like thin walls of the vessels may show rupturing, leading to mixture of fresh occult blood in stool.
• The condition mainly occurs in elderly patients already suffering from conditions like diverticulosis.
• The condition is usually asymptomatic and painless.
• Continuous bleeding may call for treatments such as ablation of the bleeding vessel.
• Medication or complex surgical processes may also be suggested.

Inflammatory Bowel Disease:

• This condition arises as a conjoint of other two medical ailments, that is, Crohn Disease as well as Ulcerative Colitis.
• Crohn disease may result in inflammation anywhere in the alimentary tract, whereas, in ulcerative colitis, inflammation is only restricted to the colon and rectum.
• Bloody diarrhea is a common symptom along with mucus and pus, abdominal cramps, weight loss, fever, persistent urge of bowel movement.
• If the condition is severe, blood transfusion may be required.
• Generally manageable through medication, surgical processes can be suggested.

Colorectal Polyps and Cancer:

• Polyps are outgrowths arising as a result of abnormal proliferation of the cells lining the colon or rectum.
• These outgrowths may become carcinogenic over time.
• The polyps may vary in shape and size.
• Small amount of occult blood may be observed in physical fecal tests.
• Bleeding is of painless type.
• Colonoscopic screening may be required from time to time for checking enlargement of the polyps.
• Chemotherapy, surgery, radiotherapy and combinational therapy can be suggested.

Some other minor causes

• Anal fissures: these are small lesions or tears of the anus, an opening for passage of stool. These may heal on their own, but deep fissures may require surgical or medicated processes.
• Infectious Proctitis: generally a sexually transmitted infection, which may lead to rectal bleeding, mostly caused by bacterial infections such as gonorrhea and chlamydia.
• Infectious Colitis: it is a type of food poisoning, which causes inflammation in the colon. Common pathogens include, Salmonella, Shigella, Vibrio and E. coli.
• Meckel diverticulum: In this condition, small or large pouches may appear near junctioning of small and large intestines, which is a remaining portion of the umbilical cord, shows bleeding.
• Rectal Varices: These are fragile and enlarged blood vessels in the rectum, mostly found in people suffering from liver cirrhosis, which may show rupturing and bleeding.
• Peptic ulcers, inflammed stomach and rupturing of varies in esophagus may cause brisk bleeding from the upper alimentary canal, appearing as maroon tar in the diarrhoic stools.

Blood in Stool FAQs

What can trigger or worsen blood in stool?

Rectal bleeding can be triggered or worsened by drinking too much alcohol or coffee, eating certain bowel-irritating food stuffs and straining too much during bowel movements or manual maneuvering of the stool.

What other symptoms accompany blood in stool?

Abdominal pain or cramps, narrow stools, nausea and vomiting, changes in stool color, anal irritation,constipation, rectal pain, diarrhea, sudden weight loss, painful bowels, fever, fatigue and weakness are several symptoms that accompany blood in stools.

Which doctor to consult?

Gastroenterologist

Medical References

http://www.webmd.com/digestive-disorders/blood-in-stool#1

https://www.iffgd.org/symptoms-causes/alarm-symptoms.html

http://www.webmd.boots.com/digestive-disorders/blood-in-stool-causes-and-diagnosis

http://www.livestrong.com/article/16100-causes-fresh-blood-stool/