Finding blood in the stool is always alarming, as it typically suggests bleeding somewhere in the digestive tract. While blood in the stool is a common, painless symptom of hemorrhoids at what point does it indicate another problem?
Anal Fissures
An anal fissure is a common condition that is generally nothing to worry about since they typically resolve on their own. They are usually caused by:
- Passing a large stool
- Childbirth
- Trying to pass a hard stool while constipated
- Diarrhea
- Rectal exam
- Foreign object in the anus
If an anal fissure does not heal in 8 to 12 weeks, it is considered chronic and may require medical intervention. Blood in the stool from an anal fissure is typically on the surface of the stool.
Ulcerative Colitis
Blood in stool is a common symptom of ulcerative colitis which may or may not accompany severe diarrhea as well as other symptoms such as:
- Pus in the stool
- Abdominal cramps
- Painful bowel movements
Gastritis
Gastritis can also be another cause of blood in the stool. This inflammation of the stomach lining can cause bleeding in the stomach, which makes its way down the digestive tract, resulting in blood in the stool.
Peptic Ulcers
Peptic ulcers can cause blood to appear in the stool if they are large enough, as smaller ulcers may be asymptomatic. These are open sores in the lining of the stomach or upper part of the small intestine and caused by a bacterial infection or long term use of NSAIDs like aspirin.
Other symptoms include:
- Bloating
- A burning feeling under the breastbone that mimics heartburn
- Lowered appetite
Colon Cancer
The presence of blood in the stool can also be an early sign of colon cancer. However, one should not automatically assume that blood in the stool is predictive of a cancer diagnosis alone. There are other symptoms present such as:
- Unexplained weight loss
- Unexplained anemia
- Abdominal pain
- Vomiting
Tests should be run to check for the presence of tumors or polyps through a colonoscopy and a biopsy of the tissue for examination and testing. A blood test can also be ordered to get a complete blood count (CBC) to determine the severity of the bleeding.
Making A Diagnosis
To determine what is causing blood in stool, it is vital to get as much information from the patient as possible. For example, what does the blood in the stool look like? If it is bright red, that could indicate a problem in the lower digestive tract. A black, tarry stool points to bleeding in the upper digestive tract.
Asking patients about their over-the-counter drug use, including painkillers, as well as any smoking or drinking habits as they can trigger conditions like gastritis.
