What is Blood in Stool?
Blood in stool indicates there is bleeding somewhere in the digestive tract. You might find the blood is bright red or dark and the stool may also appear tar like.
Seeing blood in your stool, on toilet tissue or in the toilet bowl can be quite alarming. The causes may not be serious but it is certainly something that you need to see your doctor about.
The color of the blood can indicate where in the digestive tract the bleeding originates. If bright red it’s likely to be in the lower digestive tract, whereas dark red points to the upper section.
The medical term for this symptom is hematochezia, however there is also another type of blood called occult bleeding. This means you have blood present but not visible in the stool and it can be detected by special tests. (1)
Causes
There are many reasons why you can find blood in the stool. We will detail some of the minor and more serious ones.
Hemorrhoids
Even though you might not realize it we all have hemorrhoids. They are small cushions of tissue filled with blood vessels situated at the end of the rectum, just inside the anus.
Their function is to help control bowel movements along with a muscle called the anal sphincter. Sometimes they can become enlarged and cause what are commonly known as piles.
When this happens we can experience symptoms such as itching, mucus discharge or bleeding without pain.
The blood from hemorrhoids is bright red and seen on toilet paper, in the actual toilet bowl or in the stool. (2)
Anal Fissure
An anal fissure is a small break or tear in the skin of the anal passage way which causes pain and bleeding.
The blood from this condition will be bright red and usually seen on toilet paper, in the toilet bowl or in the stool. (3)
Crohn’s Disease
This is an inflammatory disease causing irritation in the gastrointestinal tract. It normally affects the small intestine or colon, although it can appear anywhere in the digestive system.
It causes rectal bleeding which is red and appears in the stool, on toilet paper or in the toilet bowl. Bleeding can be serious and persistent which requires immediate medical care. (4)
Ulcerative Colitis
Ulcerative colitis is a chronic disease causing inflammation and ulcers in the lining of the of the large intestine.
Ulcerative colitis damages the lining of the colon which causes it to bleed. Pus, diarrhea, and abdominal discomfort can also accompany the bleeding.
The blood can be found in the stool, on toilet paper or in the toilet bowl and is red in color. (5)
Colon Polyps
Colon polyps are abnormal tissue growths which look like small, flat bumps or tiny mushrooms. They can measure from 5mm to more than 1cm in size.
Generally most polyps are non cancerous or benign, however they do form as a result of abnormal cell growth. Consequently there are times when they can become more serious and sinister.
They cause bleeding which is bright or dark red in color. It can be seen in the stool or on toilet paper and can also drip from the anus.
Bleeding is usually accompanied by diarrhea or constipation and you can also have abdominal pain or mucus in your stool. (6)
Colon Cancer
The colon is the longest part of the large intestine. It measures about 6 feet long and joins the small intestine to the rectum and anus.
Cancer cells can form in the tissues of the colon. In fact one of the signs for this type of cancer is bright red or dark blood in the stool.
Others symptoms include diarrhea or constipation and your stool may be narrower than what is considered normal for you. Stomach pain, excess gas and bloating are also signs of this disease. Rapid weight loss for no apparent reason is another cause for concern. (7)
Diverticulitis
Pouches which form in weak spots along your digestive tract are called diverticula and this happens mostly in the colon. These pouches balloon outwards from the intestinal wall and become inflamed or infected.
When this happens you have diverticulitis. This can cause blood in your stool or on toilet paper. (8)
Peptic Ulcer
Sores which form as a result of acid attacking the lining of your stomach are known as peptic ulcers. These sores can open and bleed into the stomach.
Blood in stool from this ulcer will be dark red or maroon and the stool will be sticky and dark. (9)
Gastritis
Gastritis is the name given to inflammation of the stomach lining. It can cause the stomach lining to bleed and leave it vulnerable to the formation of peptic ulcers.
The blood in stool from this condition will be dark red or maroon and stools may be dark and sticky. (10)
Proctitis
The rectum is classed as the last few inches of the intestine and has a mucous lining. Proctitis is the condition caused by inflammation of this lowest part of the digestive system. The inflammation can cause bleeding accompanied by a mucous discharge.
The blood in stool from this condition will be bright red and can be seen in the stool or on toilet paper. (11)
Symptoms
As we have already seen the main reason for blood in stool is bleeding within the gastrointestinal system. Blood in stool is itself a symptom which can be accompanied by others. (12)
These include abdominal pain, gas and bloating and you may also find your bowel movements will change from what you consider normal. Constipation or diarrhea are other factors to take into account.
There are other symptoms which affect the lower intestinal tract like for example: pain and itching in the rectum or anus.
Anemia caused by iron deficiency may indicate occult bleeding.
However, fever, fatigue or weakness and unexplained weight loss are warning signs which can indicate a more serious medical condition.
Diagnosis
As with any complaint related to the gastrointestinal system your doctor will ask many questions. They will want to know about your diet, any medication you may be taking and your family medical history.
The severity, duration and presentation of the blood in stool will also be investigated.
A physical examination of your abdomen and anus is typical, as are blood and stool tests. (13)
If your doctor is unable to determine the cause referral to a specialist or further tests is the next step. These tests include:
Endoscopy
This procedure examines the inside of your body using an endoscope. This medical instrument has a flexible tube with a light and camera attached. It also has a central channel which can accommodate things like forceps or brushes for taking tissue and cell samples.
Dependent on the which part of the gastrointestinal tract needs to examined, the endoscopy may be called something different.
A colonoscopy, sigmoidoscopy or proctoscopy will entail the endoscope being inserted via the anus. These tests will examine the lower digestive system.
A gastroscopy or esophagoscopy will involve the endoscope being inserted through the mouth. This will examine the upper gastrointestinal tract.
It is likely that you will be sedated in some way for any of these tests to be carried out. You will also be given full details of what is involved prior to having the test. (14)
CT Scan
This is not an invasive test but involves use of scanner that emits x-rays. This can give a detailed picture of the inside of your body. (15)
Capsule Endoscopy
A virtual endoscopy involves swallowing a small capsule containing a camera. As the capsule passes through the digestive tract, images are collated by a sensor worn for 8 hours. (16)
Regarding diagnosis, it’s important to remember to see your doctor immediately if your stool is dark red and smelly or you have bloody diarrhea for no reason. Severe bleeding or blood in the stool accompanied by fever, vomiting and/or chest pain is a medical emergency.
FAQ
What is blood in stool? Blood in stool is an indication that something is causing bleeding in the digestive tract. Dependent on the source the blood can be bright red or dark.
What causes blood in stool? There are many different reasons why you might see blood in stool. They can vary from minor to severe medical conditions. Minor conditions include hemorrhoids, polyps and anal fissures, whereas more severe conditions include cancer, crohn’s disease and peptic ulcers.
How do doctors test for blood in stool? Your doctor may request tests to determine the cause of bleeding. These include various types of endoscopy procedures and CT scans.
When should you go to the doctors with blood in stool? You should see your doctor if you have noticed blood in stool for more than 3 weeks. Other reasons you should seek medical advice include: pain in your rectum or anus, pain or a lump in your stomach, unexplained tiredness or loss of weight for no reason. However, urgency is required if you have dark red or black stools and if you have bloody diarrhea. Should you experience constant or profuse bleeding it is a medical emergency. (17)
Can you prevent blood in stool? Most causes of blood in stool cannot be avoided. Fortunately, there are things you can do to keep your digestive system healthy and prevent constipation. A high fiber diet accompanied by plenty of fluids and exercise can help colon health and prevent hemorrhoids. (18)
What can relieve blood in stool? Again a high fiber diet, plenty of fluids and exercise can help relieve symptoms of some conditions associated with blood in stool. In particular inflammatory conditions associated with the digestive tract like crohn’s disease, diverticulitis and gastritis. There are also over the counter medications that can help hemorrhoids. (19,20)
Are there foods that can make it look like there is blood in stool? Certain foods can make your stools appear as though they have blood in them. Black licorice and blueberries can make your stool black, while beetroot can make it red. (21)
Can blood in stool be treated? Whilst the causes of blood in stool are varied there are treatments available for majority of them. After diagnosis your doctor will be able to advise you of treatment and prognosis.
Summary
Blood in stool is an indication of bleeding somewhere in the gastrointestinal system, both the color and persistency can vary depending on the cause.
Conditions associated with blood in stool are mixed and affect all parts of the digestive tract. It is likely that tests will be needed to ascertain the exact cause.
There are treatments available for many of these conditions which can alleviate blood in stool. There are also measures you can take like following a healthy high fiber diet, staying hydrated and exercising.
It’s clear that whilst alarming, the cause may not always be serious. However, consultation with your doctor is of paramount importance to ensure a timely diagnosis.