Is Blood in Stool Serious?

Reviewed on 2/2/2021

What Is Blood in the Stool?

Blood in the stool may be an indication of a serious health problem, like bowel cancer. But it's more likely the result of a minor condition, like hemorrhoids. Only your doctor can say for sure, however.
Blood in the stool may be an indication of a serious health problem, like bowel cancer. But it’s more likely the result of a minor condition, like hemorrhoids. Only your doctor can say for sure, however.

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:

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: 

SLIDESHOW

Super Tips to Boost Digestive Health: Bloating, Constipation, and More See Slideshow

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
  • Angiography
  • Nasogastric lavage to help determine if the bleeding is in the upper or lower digestive tract
  • Blood tests
    • Complete blood cell (CBC) count
    • Serum electrolyte levels
    • Coagulation profile, including activated partial thromboplastin time (aPTT), prothrombin time (PT), manual platelet count, and bleeding time
    • To check for H. pylori infection

What Is the Treatment for Blood in the Stool?

Treatment for blood in the stool depends on the cause. 

  • Hemorrhoids
    • Fiber supplements
    • Laxatives 
    • Warm sitz baths 
    • Topical treatments: pain-relieving creams and hydrocortisone rectal suppositories to help temporarily relieve pain, itching, and inflammation
    • Surgery for severe cases
      • Laser, infrared, or bipolar coagulation
      • Rubber band ligation 
      • Sclerotherapy 
  • Anal fissure 
    • Fiber therapy
    • Laxatives 
    • Topical nifedipine and topical nitroglycerin 
    • Botulinum toxin 
    • Surgery for cases that persist despite other treatments
      • Lateral internal sphincterotomy
  • Precancerous polyps 
    • Surgical removal of polyps (polypectomy)
  • Colorectal cancer 
  • Colitis 
    • Diet changes
    • Avoiding medications that worsen symptoms including nonsteroidal anti-inflammatory drugs (NSAIDS)
    • Topical medications applied directly to the rectum
    • 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

Health Solutions From Our Sponsors

Reviewed on 2/2/2021
References
https://www.uptodate.com/contents/blood-in-the-stool-rectal-bleeding-in-adults-beyond-the-basics

https://emedicine.medscape.com/article/188478-overview

https://www.uptodate.com/contents/hemorrhoids-beyond-the-basics

https://www.uptodate.com/contents/anal-fissure-beyond-the-basics

https://www.uptodate.com/contents/colon-polyps-beyond-the-basics

https://www.uptodate.com/contents/colon-and-rectal-cancer-the-basics

https://www.uptodate.com/contents/ulcerative-colitis-beyond-the-basics