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Blood In Stool (Rectal Bleeding): Causes And Treatment


  • Blood In Stool (Rectal Bleeding): Causes And Treatment

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    Blood in the stool is a symptom of a large number of fairly serious diseases. Sometimes this is the only sign of trouble, but more often the appearance of bloody inclusions is accompanied by other manifestations that are not typical for the body normally. By comparing all the symptoms, the doctor will be able to determine the main cause of the alarm sign.

    Bleeding in the gastrointestinal tract is the most common cause of blood in the stool. The length of the digestive tract is about 32 feet, its mucous membrane is saturated with bacteria that can modify the usual type of blood.

    For these reasons, it will rarely end up in the feces unchanged. Fresh blood in them can be detected only when the source of bleeding is close to the anus. Most often, the localization of bleeding is the rectum or lower parts of the large intestine. When bleeding from the upper digestive tract, the color of blood in the feces changes, it becomes dark brown or black (melena).

    With hemorrhoids, a malignant tumor of the lower intestine, a crack in the anal opening, traces of blood appear not only in the feces but also on toilet paper, on underwear.

    If the blood inclusions have the form of dark red clots or streaks – this is a symptom of chronic intestinal disease: non-specific ulcerative colitis, dysbacteriosis, Crohn's disease. If diarrhea with bloody inclusions in the patient has significant hyperthermia, abdominal pain – there is an intestinal infection (dysentery, salmonellosis).

    Hidden blood in the stool, a sign of serious gastrointestinal diseases, can not be seen. If there is a suspicion of hidden blood, a special analysis is prescribed. The use of beets, blueberries, currants, and tomatoes can give rise to a false alarm. The products of processing, similar to the inclusion of blood in the stool.

    When blood appears in the feces, products that change the color of feces should be excluded from the diet for 2-3 days. If an alarming symptom remains, you should immediately consult a doctor. Pharmaceutical preparations-activated carbon, iron preparations-can radically change the color of the chair.

    Bright red, not curled blood The patient detects blood not only in the feces but also on the underwear, on toilet paper after defecation, the cause - bleeding due to a crack edit of the anus, a tumor of the rectum, internal hemorrhoids
    Diarrhea with bloody inclusions, hyperthermia Intestinal infections - dysentery, salmonella
    Clumps or blood veins of dark red color Inflammation of the upper intestine - ulcerative colitis, Crohn's disease, dysbacteriosis
    Analysis for hidden blood is positive Polyps or colon cancer, complications of worm infestation, malignant tumors of the stomach, esophagus, rectum

    If blood is visible in the stool - reasons
    • Cracks in the anus
    Bright scarlet blood, not mixed with fecal matter-a symptom of a cracked anal opening. It is formed in chronic constipation when the patient exerts excessive muscular effort during defecation.

    After the stool has left the ampoule of the rectum, there is a slight discomfort in the area of the anal fissure. Blood in the feces with this pathology is observed for several days, its volume is quite small.

    The diagnosis can be made with a visual examination by a surgeon or proctologist, as well as with a finger examination of the anal area. Correction – the restoration of the regular chair through diet and use of laxatives.
    • Hemorrhoids
    Dark blood in the feces, regularly appearing on its surface, pain, and itching in the rectum, accompanied by a feeling of bursting - symptoms indicating hemorrhoids (varicose veins of the rectum).

    The causes of hemorrhoids are quite a lot, all of them are associated with an overstrain of intra-abdominal pressure, stretching. Damage to the vascular walls causes bleeding.

    With external hemorrhoids, varicose nodes are visible on visual inspection, with internal hemorrhoids, they are detected during rectoromanoscopy of the rectum. Treatment of hemorrhoids involves conservative therapy and surgery.

    Drug therapy is used in the early stages of the disease. These are venotonics in the form of tablets, drops and dragees, ointments and gels, venosclerosing agents. Additionally, anticoagulants and laxatives are used.

    Surgery to remove hemorrhoids is performed in advanced cases, at a late stage of the disease, or in emergency cases – with heavy bleeding from the venous hemorrhoid node.
    • Ulcerative colitis
    This disease is the result of inflammation of the immune nature. In ulcerative colitis, destructive processes are observed in the mucosa and submucosa of the rectum and colon.

    Blood in the feces is not the only evidence of the disease, against the background of intestinal inflammation, pus and mucus appear in the feces, abdominal pain, diarrhea, hyperthermia, and symptoms of intoxication. Complications of pathology – peritonitis, intestinal perforation with bleeding, intestinal obstruction.

    The diagnosis is made after esophagogastroduodenoscopy (EGD) and examination of intestinal tissues for histology. Emergency surgery is indicated for complicated colitis.
    • Crohn disease
    The disease is inherited or occurs as a result of inflammation of the immune nature. It develops in all parts of the digestive system as a complication of measles, food allergies, smoking, or stress. It occurs more often in the colon and small intestine.

    Symptoms of Crohn's disease are frequent diarrhea, pus, mucus, and blood in the feces, abdominal pain and joint pain, skin rashes, fever, ulcers on the oral mucosa, decreased visual acuity. Diagnostics – esophagogastroduodenoscopy and histological examination of tissues.
    • Intestinal infection
    Blood in the feces may appear when pathogens of acute intestinal infections enter the body caused by:
    Viruses (enterovirus, rotavirus);

    Bacteria (staphylococcus, salmonella, klebsiella, paratyphoid and dysenteric sticks, campylobacter);

    Parasites (amoebiasis, schistosomiasis).

    The consequence of these infections is the defeat of the small intestine (enteritis), and the large intestine (colitis).

    Symptoms of infection – liquid stool containing pus, mucus, and blood in the feces, fever. In viral hemorrhagic fevers, small vessels are affected. This leads to the appearance of a hemorrhagic rash on the skin and intestinal bleeding.

    When the large intestine is affected by cytomegalovirus, there is diarrhea with blood, fever, and pain in the projection of the intestine.

    Diagnosis of infections – bacteriological fecal culture, microscopic, and serological blood tests to detect antigens to pathogens.
    • Tumors of different parts of the intestine
    Symptoms of cancer - intestinal obstruction, blood in the feces when the intestinal wall or vessels are destroyed, perforation with fecal peritonitis. Diagnosis – total x-ray examinations of the abdomen (a symptom of gas bubbles, Kloiber bowls).
    • Dysbacteriosis
    An alternative name is excessive bacterial colonization of the intestine. Dysbacteriosis provokes the use of antibiotics. Blood in the feces with this pathology appears when the intestinal mucosa is damaged by clostridia.
    • STIs
    This abbreviation stands for sexually transmitted infections-rectal gonorrhea, anorectal syphilis, herpes, and venereal granuloma. Symptoms – blood in the stool, or on its surface due to violation of the integrity of the intestinal mucosa.

    If infections are complicated by atherosclerotic damage to the arteries, ischemic colitis develops (oxygen starvation of one of the sections of the large intestine). Symptoms of ischemic colitis – acute pain in the bowel area, bleeding due to erosion of the intestinal wall.

    Causes of hidden blood in the stool

    Blood in the feces, coming from the upper gastrointestinal tract, usually has a slightly different appearance. The reason for this is the breakdown of hemoglobin, its conversion to iron sulfate. As a result of this biochemical reaction, the blood turns black, and this stool is called "melena".
    • Bleeding from esophageal varicose veins

    It is part of the portal hypertension syndrome that occurs in cirrhosis of the liver. Additional symptoms – tar-colored stools, chest pains after eating, vomiting with blood, hypotension, rapid heartbeat, cold sweat, bitterness in the mouth, vascular stars on the stomach.

    The first emergency aid for the rupture of varicose veins of the esophagus is the introduction of a balloon probe into it to stop bleeding, squeezing the veins.
    • Mallory-Weiss Syndrome
    Manifestations of the syndrome – a deep bleeding defect of the esophageal mucosa or the cardiac part of the stomach, reaching the submucosa.

    Most likely to occur during repeated vomiting in patients with perforated ulcers of the stomach or persons suffering from alcoholism. The main symptoms are tar-black blood in the feces and severe pain.
    • Bleeding from a stomach ulcer or duodenal ulcer
    Symptoms - tar-black blood in the feces, which acquires a liquid consistency, nausea, and vomiting with blood ("coffee grounds"), fainting, chills.

    Perforation of duodenal ulcer. Complication-symmetrical ulcers on the opposite side of the intestine. Symptoms – acute dagger pain on the right, loss of consciousness, cold sweat, chills, weakness, tachycardia.
    • Stomach cancer
    Symptoms – aversion to food, especially meat, rapid satiation, anemia, weakness, rapid weight loss, bleeding as a result of tissue breakdown.
    • Bowel cancer

    Symptoms-alternating diarrhea and constipation, rumbling in the intestines, false urges to empty, defecation, which does not bring relief. There is a ribbon-shaped feces with blood admixture in the latter stages of the disease, intestinal obstruction.
    • Tumors of the esophagus
    The symptoms are similar, tissue breakdown causes bleeding and the appearance of melena.
    • Tuberculosis of the intestine
    • Stomatitis, periodontal disease
    • Nosebleed

    Blood in the stool can appear as a result of poisoning with rat poison or poisonous plants (melilot, spindle tree). Possible bleeding is the result of reduced blood clotting function of a hereditary nature or a side effect of medications. The appearance of blood during defecation against the background of medication is a reason to cancel the drug and consult a doctor.

    Diagnosis of hidden blood in the feces

    With minimal blood loss during tooth extraction, wounds, and ulcers in the mouth, small bleeding in the digestive system, the blood in the feces may not be visible visually. To make sure that it is present, a laboratory test called the "Gregersen reaction" is performed.

    For maximum reliability of the analysis, the patient should not eat meat, fish, brush his teeth, or use iron preparations 3 days before it is performed. Collected after preparation, feces are treated with a solution of reagents in acetic acid, and the change in color of the drug is analyzed.

    If it has acquired a blue or green color, the test for hidden blood is considered positive.

    Reasons for the presence of blood in the stool of a child

    In childhood, almost all the above-described pathologies of the digestive system are diagnosed, so the blood in the feces of children may appear for the same reasons as in adults. However, in pediatric practice, there are specific reasons that are unique to childhood.

    Violations of the diet of infants, unjustified treatment with antibiotics, weak immune protection can lead to the following symptoms: bloating, mucus, and blood in the feces, diarrhea, diathesis, reduced appetite. The reason for this is enterocolitis caused by staphylococcus or klebsiella.

    Differential diagnostics is performed for helminthiasis and acute intestinal infections with similar symptoms.

    Intestinal obstruction
    The most dangerous prerequisites for children under two years of age to have blood in the feces are intestinal obstruction or intestinal intussusception. The reason for these conditions is a congenital abnormality in the development of the intestinal tube, overfeeding of the child, too early complementary feeding, changing the usual formula.

    Invagination – blocking the lumen of the intestine with another part of it. The consequence of this is intestinal obstruction.

    It all starts with anxiety and a strong cry of the baby after feeding, gushing vomiting. Then there is frequent liquid stool and blood in the feces.

    This condition quickly worsens, and within a few hours, the child begins to defecate with red mucus. Procrastination with medical care leads to shock or collapse, which ends in death.

    Diagnostics – overview x-ray or ultrasound of the abdominal cavity.

    Food allergy

    Types of food allergies:

    For cow's milk protein,

    For citrus fruits,

    For gluten,

    For food additives, food colorings, and flavorings.

    Allergy symptoms – diarrhea, foamy stools, blood in the feces in the form of streaks, bloody spots, tearfulness, restless behavior, insufficient weight gain. If you experience these symptoms, you should contact your pediatrician.

    Emergency medical assistance is required if children are diagnosed with the following symptoms:


    Vomiting, regurgitation in the form of a fountain,

    Frequent stool of liquid consistency,

    Excessive excitement or inhibited behavior.

    With such manifestations, treatment is required in a children's infectious hospital.

    Blood in the stool of men

    A specific reason for the appearance of blood in the feces of men, associated with gender differences, is the late stages of prostate cancer. In the advanced stage, the prostate tumor grows through the wall of the large intestine and is injured during defecation.

    Blood during defecation in women

    Specific reasons for the appearance of blood in the stool of women are related to the physiology of the female body:
    • Perineal varicose veins on the background of the last trimester of pregnancy
    • Intestinal endometriosis
    • Side effects of radiation therapy for cancer of the reproductive organs

    At the end of pregnancy, the growing uterus has a mechanical effect on the pelvic organs and peritoneum. The lower parts of the intestine and genitals are more intensively supplied with blood, its clotting slightly decreases within the physiological norm of pregnancy development. Therefore, when defecation is accompanied by constipation, blood in the feces is occasionally possible.

    If it increases, you should seek medical help to differentiate from vaginal bleeding. Prevention of the appearance of blood during defecation – the introduction of foods with vegetable fiber in the diet, the use of soft toilet paper.

    In women with endometriosis, cells that function similarly to the cells of the endometrial mucosa of the uterus spread in various organs. They are introduced with a current of lymph or blood.

    During menstruation, foci of endometriosis bleed. If a woman is diagnosed with intestinal endometriosis, the cells will produce blood with mucus. Most often, its amount is minimal, the pathology is detected only when testing for hidden blood, and only during menstruation.

    Possible complications – with significant foci, intestinal obstruction, stenosis is possible.

    Complications of radiation therapy can be radiation colitis. Its symptoms are alternating diarrhea and constipation, the appearance of mucus and blood in the feces. Treatment is symptomatic, with the passage of time, the regeneration of the mucous membrane occurs.

    What should I do if I find blood in my stool?

    If such a symptom appears, first of all, you need to consult a proctologist and do it as soon as possible. The doctor will find out the details of the pathology, study the history and prescribe diagnostic measures.

    If blood is detected in the feces-basic laboratory and instrumental diagnostics:
    • Fecal analysis for worm eggs, hidden blood, coprogram;
    • Visual examination of the state of the anus by a proctologist;
    • Rectal examination of the lower rectum (condition of tissues, sphincters, mucosa);
    • Rectoromanoscopy-instrumental examination of the large intestine, its tissues, and peristalsis

    When the diagnosis is clarified, additional diagnostics are performed:
    • X-ray examination of the gastrointestinal tract;
    • Ultrasound of the colon;
    • Colonoscopy.

    To examine the upper parts of the digestive system, you need to consult a gastroenterologist. The doctor will analyze the patient's complaints, perform palpation of the abdomen in the projection of the stomach, and small intestine.

    Possible studies:
    • Ultrasound of the stomach and small intestine;
    • EGD gastroscopy (an auxiliary method of examination).
    In most cases, if there is blood in the feces, it turns out that a few studies are enough to clarify the diagnosis. It should be remembered that early access to a specialist and timely diagnostic research will help to preserve health and life, reduce the period of recovery after treatment.
    Last edited by Dr. Mary Basco; 06-15-2020, 09:29 AM.

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