Blood in the stool

Blood in the stool can be red, reddish-brown, dark and black (tarry stool) or occult, meaning it cannot be seen with the naked eye.
The causes of blood in the stool range from harmless disorders in the gastrointestinal tract such as hemorrhoids, to serious diseases such as colon cancer.


Types of bleeding

There are two possible sources of bleeding: the upper digestive tract (stomach and small intestine) and the lower digestive tract (large intestine with colon, rectum and anus).
Bleeding in the upper gastrointestinal section usually results in black stools (tarry stools).
With bleeding in deeper intestinal regions, the stool is covered or mixed with bright red blood.
Certain foods and medicines can cause blood in the stool.
However, it is not always possible to determine the origin and nature of rectal bleeding based on the appearance of the stool.
Sometimes the amount of blood is so small that it is only visible on the toilet paper.
In most cases, a medical clarification is necessary.

It may happen that bleeding in the digestive tract is too slow to cause rectal bleeding.
Then there is an occult hemorrhage that cannot be seen with the naked eye; in this case, the blood can only be detected by laboratory analysis (test for hidden blood in the stool).
Occult blood has similar causes to rectal bleeding and can cause the same symptoms. It can occur along with anemia caused by iron deficiency caused by blood loss.

Causes of blood in the stool

Blood in the stool can be caused by:

Diverticulitis. Intestinal diverticula are protrusions in the intestinal wall that are usually unproblematic but can bleed and become inflamed.

fissures. Small tears in the skin or mucous membrane of the anus, similar to the cracks that occur with chapped lips. fissures are often caused by large and hard stools, which may cause pain when excreting and traces of blood that show up when wiped.

Colitis or inflammation of the colon. The most common causes of the occasional appearance of blood in the stool include infection or inflammatory bowel disease.

Angiodysplasia. In this condition, the abnormal and weak blood vessels cause bleeding.

Gastric and duodenal ulcer. Open wound in the inner wall of the stomach or duodenum (upper section of the small intestine).
Many ulcers are caused by infection with the bacterium Helicobacter pylori. Permanent use of anti-inflammatories, such as aspirin, ibuprofen and naproxen, can provoke gastritis and stomach and duodenal ulcers.

Gastroenteritis or intestinal flu. Gastroenteritis is a viral or bacterial infection of the stomach and intestines, which is usually combated by the immune system in a few days. It can cause diarrhea with traces of blood and mucus, as well as symptoms such as stomach cramps and vomiting.

Polyps or cancer. Polyps are benign neoplasms that can grow, bleed and change cancerously.
Often they cause bleeding that is not visible to the naked eye.
Stomach cancer can provoke blood in the stool.

Problems of the esophagus. Varicose veins (esophageal varices) or cracks in the esophagus can cause significant blood loss.

Trauma or foreign body

Vascular malformation (structural malformation of blood vessels, called arteriovenous malformation). This disease can, among other things, provoke liquid stool with blood.

Blood in the stool during pregnancy

Most often, rectal bleeding in pregnancy is caused by hemorrhoids, which are blood vessels in the rectum that enlarge and become inflamed.
Hemorrhoids are quite common in pregnancy, especially in the last three months and in the weeks after birth.
Anxiety and stress favor the appearance of constipation and, therefore, the inflammation of the hemorrhoids.
If cracks appear in the veins due to hard bowel movements or vigorous cleaning with toilet paper, these swollen veins may bleed.
fissures are another cause of rectal bleeding, for example, when sufferers have to press hard during bowel movements due to constipation, which is common in pregnancy.

Blood in the child’s stool

fissures — fissures can occur at any age, in babies as well as in schoolchildren or the elderly.
The symptoms of fissures are pain and bright red blood in the stool or on the toilet paper.

Intolerance to milk and soy proteins, also known as cow’s milk allergy, milk-induced enterocolitis or proctocolitis, is an infant disease.
It can also occur in breastfed children if the mother consumes cow’s milk or soy products.
Protein intolerance usually passes within the first year of life.
Typical symptoms of intolerance to milk or soy proteins are vomiting and diarrhoea, as well as blood deposited in the stool or stool.
The treatment provides for the renunciation of cow’s milk.

Rarer causes
Inflammatory bowel diseases, such as Crohn’s disease or ulcerative colitis, lead to inflammation of the intestinal mucosa. The inflammation causes symptoms such as blood in the stool, diarrhea, loss of appetite and weight loss.

Infectious diarrhea Infectious diarrhea
is caused by viruses, bacteria or parasites and can cause blood in the stool in children of preschool and school age.
Infectious diarrhoea can be caused by the consumption of contaminated food and drinks or as a result of antibiotic treatment.
Typical symptoms are abdominal pain, fever and bloody diarrhoea.

Juvenile polyps are tumors that can develop between the ages of 2 and 8. Symptoms are usually painless rectal bleeding.
Juvenile polyps are usually not precancerous or cancerous, but require medical evaluation and usually need to be removed.

Various serious conditions, such as intestinal intussusception (a type of intestinal obstruction) or Hirschsprung’s disease, also known as congenital or aganglionotic megacolon (occlusion of the colon that develops before birth because some nerves are missing), can cause blood in the stool.
Occlusion is the medical term for an intestinal obstruction.
Most of these diseases cause a sudden malaise of the baby.

When is cause for concern? Diagnosis of blood in the stool

In any case, a doctor’s visit is recommended to clarify the exact causes of the blood in the stool.
For example, black stools (tarry stools) can be provoked by a stomach or duodenal ulcer or other disorder in the upper digestive tract and can occur along with stomach pain.
Bright red blood in the brown stool usually indicates a disorder in the lower digestive system, such as hemorrhoids or diverticulitis.
After the doctor has inquired about the patient’s medical history (medical history) in a conversation and examined him physically, he can perform supplementary examinations to determine the cause of the bleeding.

Who is the right contact person?

The first point of contact is the family doctor, who can refer the patient to a gastrointestinal specialist (gastroenterologist) if necessary.

What examinations are carried out?

In this mirror examination, an endoscope is inserted through the mouth into the digestive system to examine the mucous membrane of the esophagus, stomach and duodenum.
The endoscope is a flexible, tube-like instrument with a camera at one end.
The endoscope can also be used to take tissue samples, which are then examined microscopically in the laboratory (biopsy).Colonoscopy In this method of examination, the endoscope or colonoscope is inserted into the rectum to control the colon. As with endoscopy, tissue samples can also be taken for analysis during colonoscopy.

This method of examination is similar to endoscopy and colonoscopy and is performed to examine the small intestine.
In some cases, a camera-equipped capsule must be swallowed, which then transmits images to a screen as it passes through the digestive system.

Colon contrast enema
In this procedure, barium is used as a contrast agent to make the digestive tract visible on an X-ray. The barium is swallowed or introduced into the large intestine.

Here, a special dye is injected into the vein. With this substance, the blood vessels are visualized on the X-ray or a computed tomography.
In this way, bleeding can be detected, because the dye emerges from the blood vessels and accumulates at the point where the hemorrhage exists.

Laparotomy In this surgical method, the doctor makes a few small incisions in the abdomen to examine the abdomen. This may be necessary if the cause of the bleeding could not be determined on the basis of the other examinations.

Laboratory tests are also carried out on blood in the stool, because the samples can be used to detect problems of blood clotting, anemia and infection with Helicobacter pylori.

Therapy for blood in the stool

The treatment depends entirely on the cause, the following therapeutic measures are possible:

  • Antibiotics for the treatment of Helicobacter pylori.
  • Anti-inflammatory drugs for the treatment of colitis.
  • Surgical intervention to remove the polyps or parts of the stomach damaged by cancer, diverticulitis or inflammatory bowel disease.

For hemorrhoids, creams and suppositories can be used.
In many cases, simple self-treatment with natural remedies is possible.

Home remedies include:
High-fiber diet to relieve constipation, which may cause or worsen hemorrhoids or fissures.
Eat plenty of fruits (especially prunes) and vegetables (e.g. zucchini, green vegetables, pumpkin) and avoid fried foods, meat, dairy products and sugar.
Sedentary baths in warm or salty water to relieve the symptoms of fissures and to promote scarring.
Also, bathing in the sea is an excellent remedy, because the salt water has a therapeutic effect.
There are people with low platelets who take months for a cut or abrasion to be completely scarred; a bath in seawater accelerates the closing of the wound and promotes the formation of normal skin.

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