What Is Blood in the Stool?
Blood in the stool (hematochezia) occurs when there is bleeding in the digestive tract. The bleeding often comes from the lower intestine (colon) or rectum and may be noticed when you see blood in the toilet or on toilet paper after wiping following a bowel movement.
Most of the time, blood in the stool is not caused by a serious medical condition but the only way to be certain is to see a doctor to determine the cause.
What Are Symptoms of Blood in the Stool?
Symptoms of blood in the stool include:
- Visible blood in the toilet after a bowel movement
- Visible blood on toilet paper after wiping following a bowel movement
- Red- or maroon-colored stool
Depending on the cause, symptoms that may accompany blood in the stool include:
- Rectal pain
- Rectal itching
- Tissue bulging around the anus
- Sensation of tearing, ripping, or burning pain during or after a bowel movement
- Leakage of stool or difficulty cleaning after a bowel movement
See a doctor for blood in the stool if you also experience:
What Causes Blood in the Stool?
Common causes of blood in the stool that are not serious include:
- Hemorrhoids: swollen blood vessels in the rectum or anus that can cause pain, itching, and sometimes bleeding
- Anal fissure: a tear in the lining of the anus that can cause a sensation of tearing, ripping, or burning pain during or after a bowel movement
Serious causes of blood in the stool are less common and may include:
- Precancerous polyps near the end of the large intestine (colon)
- Colorectal cancer
- Other causes
How Is Blood in the Stool Diagnosed?
The cause of blood in the stool is diagnosed with a patient history and physical exam, which usually involves a rectal examination.
Other tests used diagnose the cause of blood in the stool include:
- Anoscopy to inspect the anal canal and lower rectum
- This is usually an office procedure that does not require sedation
- Sigmoidoscopy to examine the rectum and most of the lower large intestine
- Colonoscopy to examine the entire colon
- Esophagogastroduodenoscopy (EGD)
- Wireless capsule endoscopy
- Push enteroscopy
- Double-balloon enteroscopy
- Radionuclide scans
- Barium X-ray
- Nasogastric lavage to help determine if the bleeding is in the upper or lower digestive tract
- Blood tests
What Is the Treatment for Blood in the Stool?
Treatment for blood in the stool depends on the cause.
- Anal fissure
- Precancerous polyps
- Surgical removal of polyps (polypectomy)
- Colorectal cancer
- Diet changes
- Avoiding medications that worsen symptoms including nonsteroidal anti-inflammatory drugs (NSAIDS)
- Topical medications applied directly to the rectum
- 5-ASA (aminosalicylic acid or mesalamine)
- Topical or oral steroid medications
- Oral 5-ASA
- Biologics: adalimumab (Humira), infliximab (Remicade, Inflectra, Renflexis), and vedolizumab (Entyvio)
- Intravenous steroids for severe cases
- Other medications: tofacitinib or cyclosporine
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