Blood in the stool: what to do?

There are several causes behind blood in the stool (hematochezia): while bright red blood usually indicates hemorrhoids or anal fissures, occult blood can be a sign of colon cancer. Occult blood is hidden blood that can only be detected in a bowel movement by a stool test. We explain what causes your condition and what treatments are available for blood in the stool.

Causes of blood in the stool

Although many sufferers of blood in the stool think directly about colon cancer, this is only one of many possible causes. Often the bleeding has a completely different, more harmless reason. Below is a list of common causes:

  • Causes in the anal area: hemorrhoids, anal fissure, anal venous thrombosis, anal fistula, anal cancer
  • Causes in the small intestine, large intestine and rectum: diverticula, polyps, colon cancer, rectal cancer, rectum ulcer, inflammation of the colon or small intestine, vascular problems of the intestine

If a black-colored tarry stool occurs, bleeding in the upper digestive tract is usually the cause. It is often triggered by a gastric ulcer or varicose veins in the esophagus, but may also be due to inflammation in the upper digestive tract. The blood turns black through contact with the stomach acid.

Bright red blood indicates hemorrhoids

Scarlet blood, which is deposited on the stool, usually indicates bleeding in the anal area. Cause of such bleeding are often hemorrhoids. Hemorrhoids are nodular extensions located above the sphincter. Together with the sphincter, they ensure that the anus is sealed.

In addition to hemorrhoids, bright red blood in the stool also occurs in anal fissures. These tears in the mucous membrane of the anus are often noticeable in constipation, if those affected must press hard during bowel movements. In addition, patients with inflammatory bowel diseases such as Crohn's disease or ulcerative colitis often suffer from anal fissures.

Colon cancer: occult blood in the stool

Scarlet blood in the stool does not necessarily have to be a sign of colorectal cancer. In colon cancer, the blood in the stool is often only discovered by a stool blood test. This can detect blood residues in the stool, which are not visible to the naked eye. These residues are called occult blood, which is why the test is also called Okkultbluttest.

Colon cancer does not make itself felt for a long time or at most by unspecific symptoms. In addition to blood and mucus in the stool, these may include persistent constipation or diarrhea as well as severe flatulence. For safety reasons, such symptoms should always be clarified by a doctor.

Blood in diarrhea

If diarrhea causes blood to accumulate in the stool, various causes can also be considered. However, an acute or chronic inflammation of the intestine is particularly often behind the complaints. For example, bloody diarrhea is more common in ulcerative colitis patients. Likewise, however, bacterial or viral infections of the intestine can trigger the diarrhea.

Blood in the stool in babies and children

For babies and children, blood in the stool usually causes the same causes as in adults. Anal fissures are especially responsible for the bleeding. In babies who suffer from constipation, the tears caused by the strong pressing during bowel movements.

In addition to anal fissures, blood in the stool in babies may also indicate a cow's milk allergy. This form of allergy occurs in about two to seven percent of all children. If your baby suffers from bloody diarrhea, a bacterial infection can be the trigger. For more severe or prolonged symptoms you should always consult a doctor and clarify the cause.

Medical examination gives certainty

If you notice blood in your stool, you should always see a doctor. To find the cause of the bleeding, a palpation examination is often sufficient, but sometimes a stomach or colonoscopy is necessary. You do not have to be afraid of these examinations nowadays. You will hardly get anything from the examination with appropriate medications.

The aim of the investigations is to find the source of bleeding and stop the bleeding. This is especially important if it is a heavy bleeding such as a stomach ulcer. But even with minor bleeding can be due to the constant blood loss over time develop an anemia.

Treatment depends on cause

The treatment needed depends on the cause behind the blood in the stool:

  • Hemorrhoids: Depending on the size of the hemorrhoids, they can first be treated with ointments or suppositories. Larger hemorrhoids must be obliterated or completely removed.
  • Anal fissures: Many fissures can be treated with ointments or suppositories. In some cases, however, surgery is inevitable.
  • Bacterial infections: Such infections can be treated by appropriate medication, often antibiotics.
  • Chronic bowel disease: Here is a treatment with specific drugs.
  • Colon polyps or intestinal diverticula: These are removed surgically - usually by endoscopy.
  • Colorectal cancer: In colon cancer, the treatment depends on the stage of the tumor. The treatment may be chemotherapy, radiotherapy or surgery.
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