Blood in the Stool (Rectal Bleeding)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
- Definition of blood in the stool (rectal bleeding)
- What symptoms are associated with rectal bleeding?
- What are some of the causes of blood in the stool (rectal bleeding)?
- Anal fissures
- Diverticulitis, IBD, AVM, ischemic colitis, cancer, intussusception
- Bacterial or viral infections
- Ulcers or gastritis
- Esophageal bleeding
- Other causes
- When should I call a doctor for blood in the stool (rectal bleeding)?
- How is the cause of blood in the stool (rectal bleeding) diagnosed?
- What are the treatments for blood in the stool (rectal bleeding)?
- Can blood in the stool (rectal bleeding) be prevented?
- What is the prognosis of blood in the stool (rectal bleeding)?
- Patient Comments: Blood in the Stool - Experience
- Patient Comments: Blood in the Stool - Associated Symptoms
- Find a local Gastroenterologist in your town
Definition of blood in the stool (rectal bleeding)
Rectal bleeding (hematochezia, the medical term) is used to describe the presence of blood with a bowel movement. That blood, whether it fills the commode, or is a streak on the toilet paper when wiping, or just a few drops in the toilet bowl, is not a normal finding and should not be ignored. The source of bleeding can be anywhere in the digestive tract, from the nose and mouth to the rectum and anus. The color can range from bright red to maroon to black or any shade in between, depending on how much the blood has been exposed to the digestive juices.
Anytime there is blood within the gastrointestinal system, it will eventually be excreted in stool (feces, bowel movement, BM). The color of stool will depend upon the amount of blood, the source of the bleeding and how quickly the stool moves through the digestive tract.
Sometimes, the bleeding is too little to be seen by the naked eye but can be tested for by the health care professional.
What symptoms are associated with rectal bleeding?
Depending upon where and why the bleeding has taken place in the digestive tract, the stool consistency and color may vary greatly:
- The stool color may be bright red, maroon, dark red or black.
- The bleeding might be hidden, unseen to the naked eye, but able to be detected by a fecal occult blood test.
- There may be just in the bowel movement or there may be associated feces.
- If the feces are formed, the blood may be mixed in with the stool or it may just coat the surface.
- The stool may be well formed or it may loose and diarrhea like. It may be normal in shape in size or it may become pencil thin.
- There may be associated abdominal pain or the bleeding may be painless.
Depending upon the amount of blood loss, the person may complain of lightheadedness, weakness, shortness of breath, and chest pain. The extent of these symptoms will depend upon the amount and duration of bleeding. If the blood loss occurs slowly over a prolonged period of time, the body may be able to adapt and these symptoms may develop gradually. If the bleeding occurs quickly, the person might become suddenly ill.
Blood in stool is never normal and should not be assumed to be due to a benign cause. Even when the blood is found to be due to hemorrhoids (a common cause of bright red blood in the stool), the amount of bleeding may still be significant and may need a surgical procedure to control it.
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