Blood In Stool: Causes, Symptoms, Treatment

Blood is always an alarming sign, even for people who don’t know much about health and medical sciences. 

Coughing up blood, vomiting blood, and blood in the stool are usually worrying symptoms. 

And effectively, it should always be reported because even if a severe disease is not the diagnosis, we should rule them out as soon as possible.

Blood in the poop is a common symptom of many digestive conditions and can indicate potential health problems. 

This symptom is also considered a sign because a doctor can see it clearly and measure how much blood there is in your stool. 

It can appear in different ways depending on the cause, and the two most common variants are hematochezia and melena.

In this article, you will learn the medical terms for different types of blood in the stool, their causes, accompanying symptoms, when to see the doctor, and more.

What does blood in stool look like?

Even if the presence of blood in the stool does not necessarily indicate a life-threatening condition, it should still be evaluated to rule out any potential underlying causes. 

The aspect of the blood gives you and your doctor an idea of where it comes from. Thus, there are two variants of bloody stool, and the medical term for each is melena and hematochezia.

Melena is the presence of dark-colored, tarry, or black stools. It is often described as having a coffee grounds appearance. The dark color is due to the breakdown of hemoglobin from red blood cells. 

Melena is caused by upper gastrointestinal bleeding, such as the stomach or small intestine. Something similar can also be seen after taking certain medications, such as aspirin or iron supplements.

Hematochezia is the presence of bright red blood in the stool, in which you can still see the maroon color of normal feces. 

This one can sometimes be spotted with the naked eye, but in other cases, bloody poo is only visible under the microscope. 

It is typically caused by a lesion or a tear in the lower gastrointestinal tract, such as the rectum or anus. It can also happen in infectious diseases that cause bleeding in your gut. Hematochezia typically occurs after a bowel movement but can also be seen when straining to have a bowel movement.

What causes blood in stool?

There are many possible causes of blood in the stool. Even if they are not all life-threatening, looking for a diagnosis is essential to rule out serious ailments. 

We can highlight the following causes of bloody stool:

Peptic ulcer and peptic ulcer recurrence

This is perhaps the most common cause of gastrointestinal bleeding. You can have an active ulcer in your stomach or bleeding duodenum. The blood turns into melena and ends up in your stool.

Inflammatory bowel disease

Inflammation in your intestines can also trigger bleeding, but it is not always visible in plain sight. 

One entity of inflammatory bowel disease is known as ulcerative colitis and is more likely to cause hematochezia.

Amebiasis

Infections with pathogenic microbes can also trigger microscopic bleeding, and when the infection is severe, bleeding can be seen by the naked eye. 

This is a common symptom in amebiasis, which presents as blood in the stool with mucus. Even when not visible, a lab test can detect blood and mucus in the stool.

Hemorrhoid bleeding

Internal hemorrhoids can also bleed. In these cases, the blood may come out with or without a bowel movement. However, it is more common if you have constipation.

Clotting problems

If you have a blood-related disorder with a low platelet count or prolonged clotting time, you could also experience gastrointestinal bleeding and bloody stools.

Diverticulosis and diverticulitis

These are finger-like projections growing inside your colon. They can sometimes become inflamed or bleed, causing this symptom.

Bowel cancer

In some cases, diverticulitis turns into colon cancer. The tumor grows new blood vessels, and these arteries are fragile and prone to bleeding.

Anal fissure

You can also experience bleeding if you have a wound or fissure in the anus. In these cases, you can experience bleeding with or without bowel movements.

Bleeding esophageal varices

These dilated veins grow in patients with portal hypertension when they have chronic liver problems

When these varices in the esophagus break, they can trigger massive and life-threatening bleeding.

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Accompanying symptoms

As noted, blood in the poo can have different diagnoses. But doctors can guide their diagnosis, order lab tests, or recommend a colon screening depending on the accompanying symptoms, which can be:

Stomach pain

If you feel stomach pain and have blood in the stool in the form of melena, the most likely diagnosis is a stomach or duodenal ulcer.

Mucus

Bloody mucus in the stool is a sign of amebiasis, especially accompanied by diarrhea.

Lower abdominal pain or tenderness

If you experience low abdominal pain and blood in the stool, the problem can be related to your colon. If that’s the case, you will have red stools instead of melena.

Diarrhea

Blood in the stool with diarrhea is a sign of infectious diseases in the gastrointestinal tract. The first guess is usually amebiasis, but there’s also a pathogenic type of Escherichia coli known as enterohemorrhagic Escherichia coli (EHEC), which also causes bloody stools.

Nausea

The gastrointestinal tract is very large, but when nausea and bloody stools are found in the same patient, it is probably because the problem is in the esophagus or because it affects all the gastrointestinal tubes. Thus, even one vomit can help your doctor rule out the diagnosis.

Constipation

In some cases, constipation forces you to strain to produce bowel movements. When that happens, inflamed diverticula and the mucosa can bleed as hard stools pass.

Palpitations

If your blood loss is significant, your heart increases its beating frequency to compensate for the decrease in blood volume. It can also be that you’re nervous after seeing blood in your stool.

When to worry about blood in stool

It is normal to worry if you produce poop with blood, but as you can see above, the causes are not always life-threatening. 

In some cases, you may have minor rectal bleeding or a small bleeding episode in the upper gastrointestinal tract.

It is still important to schedule a consultation with a healthcare professional to diagnose your condition. But coming as soon as possible to the emergency room is important if you have the following symptoms or health conditions:

Significant blood loss

If you consider the blood loss to be massive or very abundant, coming to the doctor is fundamental to perform a blood cell count and diagnose the problem as soon as possible.

Difficulty breathing

When you have blood in your stool and difficulty breathing simultaneously, it is an alarm sign of a more severe health condition.

Weight loss

Unexplained weight loss when you are not changing your diet or exercise pattern should be an alarm sign of a more severe condition, probably related to a systemic alteration.

Lightheadedness

Another sign that something is probably not going the right way is feeling dizzy or fainting. This can be a sign that you have lost a considerable blood volume.

Pregnancy

If you’re pregnant and start experiencing any blood loss, it is essential to seek medical attention immediately. 

When to see a doctor

Even if you don’t have the alarm signs listed above, it is always a good idea to see your doctor if you notice blood in your stool. 

If you experience these accompanying symptoms, schedule your visit as soon as possible:

Sudden changes in your bowel habits

For example, having diarrhea and then constipation without any apparent reason.

Stool mucus with blood

The combination of blood and mucus, especially in patients with diarrhea, is probably due to an infection in your gastrointestinal tract.

Abdominal pain or stomach cramps

This combination counts as a sign that something is wrong in your stomach or intestines. It can be a duodenal ulcer or something that requires immediate attention.

Continuous bleeding episodes

If you’re constantly seeing blood in your stools, it is always important to talk to your doctor about it, even if you initially think it is because of constipation and straining.

A doctor will order blood tests to measure your hemoglobin levels and stool tests to evaluate them under the microscope. They can locate the bleeding site according to your symptoms and the test results and will have a first guess of what it can be.

In some cases, doctors may recommend more advanced diagnostic techniques such as a colonoscopy to explore your colon, a sigmoidoscopy to examine your sigmoid colon, a tomography if they suspect there’s a tumor, or even a barium X-ray if you need to rule out the presence of polyps or inflammatory bowel disease.

In explorative imaging tests such as sigmoidoscopy and colonoscopy, doctors insert a probe guided with a camera and may also take tissue samples of suspicious lesions.

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Treatment

What is the medical treatment when you have blood in your stools? It highly depends on the diagnosis your doctor makes based on your symptoms, the lab tests, and the imaging tests.

For instance:

  • You have your stool with blood and mucus. Your doctor orders stool tests and detects amebiasis. Then you will be prescribed antibiotics to deal with the infection.
  • You have frequent melena with stomach cramps. Treatment procedures start after your doctor finds duodenal ulcers in the endoscopy. You may need further workup to find out if Helicobacter pylori is involved, in which case you also need antibiotics and mucosal protective agents.
  • You have seen blood in your stool for a long time, and the doctor’s recommendation is to perform a colonoscopy. They find many inflamed colon polyps and take a tissue sample to rule out colon cancer. You need anti-inflammatories and lifestyle changes to avoid constipation but may also need to start a more complicated therapy if colon cancer is detected.
  • You have a sensation of heavy weight in your bottom and sometimes bleed after passing stool. Your doctor detects internal hemorrhoids, which often improve with over-the-counter medications or cream products. Other treatments include laser therapy and rubber band ligation.

How to stop blood in stool

As mentioned above, if you have blood in your stool, there are many conditions you should rule out before starting treatment. However, a few things you can do right now include:

  • Increasing your fiber and water intake. This will soften your stool and reduce the risk of bleeding.
  • Reduce your stress levels. They can trigger episodes of gastrointestinal bleeding, especially if you have a history of peptic ulcer disease.
  • Schedule a visit with your doctor to get an accurate diagnosis as soon as possible.

Frequently asked questions

Why do I have blood when I wipe but not in stool?

If you find blood in your toilet paper, but your bowel movement didn’t come with blood in your stool, the problem is more likely located in the anus or near the anal opening. For example, it can be due to hemorrhoids or an anal fissure.

Why do I have blood in my stool with no pain?

Not all bleeding episodes are painful. Blood in the stool with no pain can happen in patients with coagulation problems and, in some instances, colon cancer. Thus, having no pain doesn’t mean you can ignore the symptom.

Is bright red blood in stool serious?

Not always. It is serious if you see lots of blood in the stool. Otherwise, it is only a sign that the bleeding site is close to the anal opening. It can be an anal fissure or internal hemorrhoid bleeding.

What does cancerous blood in stool look like?

There are many alarm signs. Bleeding episodes are recurrent; the feces with blood are usually dark-colored and not fresh red. However, you can also have colon cancer with red stools. 

Pain is not always present, but it can be another sign. As noted, symptoms are not enough to diagnose colon cancer, and the best thing you can do is ask your doctor if you’re a candidate for colon cancer screening.

Conclusion

Bloody poop can be a worrying symptom, and it is essential to find the exact reason for the blood in the stool. However, it is not always a life-threatening condition.

Some alarm signs that it can be severe are that you’re losing weight without changing your diet or exercise habits, when the volume of blood you’re losing is massive or significant, or when it causes lightheadedness, fainting, or difficulty breathing.

It is also important to explore the cause as soon as possible if you experience frequent episodes of bloody stools, abdominal pain, diarrhea, mucus in your stools, or frequent changes in your bowel habits.

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Sources

  1. Wilson, I. D. (1990). Hematemesis, melena, and hematochezia. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition.
  2. Cotter, T. G., Buckley, N. S., & Loftus, C. G. (2017, May). Approach to the patient with hematochezia. In Mayo Clinic Proceedings (Vol. 92, No. 5, pp. 797-804). Elsevier.
  3. Qureshi, W. (2018). Hemorrhoid Disease and the Role of the Gastroenterologist. Gastroenterology & Endoscopy News, 1-4.
  4. Ahlquist, D. A., & Shuber, A. P. (2002). Stool screening for colorectal cancer: evolution from occult blood to molecular markers. Clinica Chimica Acta315(1-2), 157-168.

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