Blood in Stool: What Does it Mean?

Whether you discover blood after wiping or from a fecal test ordered by your doctor, finding blood in your stool can be scary. While bloody stool can be a symptom associated with several serious medical conditions, this usually isn’t the case. Regardless, if you find blood in your stool you should seek advice from a health care provider to determine the cause and treatment options

What are the Causes of Blood in Stool?

Bloody stool is a sign that there is bleeding somewhere along the digestive tract. The blood can range in color from bright red to maroon, and it can even appear tarry and black if the bleeding is occurring higher up in the digestive tract.

Some of the more common, less-serious causes of bloody stool include:

• Hemorrhoids – Hemorrhoids are swollen blood vessels found in the rectum or anus that can be itchy, painful and sometimes bleed. Those who suffer from hemorrhoids may notice bright red blood either in the toilet or coating the stool after a bowel movement.
• Anal Fissures – An anal fissure is a small tear in the lining of the anus, which can cause bleeding and the sensation of ripping, tearing or burning after a bowel movement.
• Peptic Ulcers – A peptic ulcer is an open sore in the lining of the stomach, upper end of the small intestine or duodenum caused by a bacterial infection.
• Food poisoning – In addition to other issues, several foodborne organisms can cause bloody stool. A stool sample can help identify which bacteria you have been exposed to and how to treat the infection.

Other more serious causes of blood in stool include:

• Crohn’s disease – Crohn’s disease causes inflammation of the digestive tract lining and can lead to severe diarrhea and abdominal pain.
• Colon Polyps – Colon polyps are benign growths, or clumps of cells, that form along the lining of the colon. Although usually harmless, colon polyps can grow, bleed and become cancerous.
• Cancer – Blood in stool can be a symptom of cancer along the digestive tract. Colon cancer and rectal cancer are two types that can cause bleeding; sometimes not noticeable to the naked eye to more severe bleeding.

When to Worry About Blood in Stool

Because bloody stool can be a sign of a serious medical condition, it is suggested that anyone who notices blood in his or her stool speak with a physician to determine if further examination and treatment is needed. In addition, regular screenings, such as fecal occult tests and colonoscopies, are recommended for everyone above the age of 50 to help detect more serious digestive issues.

Treatment for Blood in Stool

Most patients only pass from a few drops to a spoonful of blood in their stool, which is referred to as mild rectal bleeding. Usually, mild rectal bleeding can be evaluated and treated in the doctor’s office and does not require urgent treatment or hospitalization.

In other cases, patients report repeatedly passing larger quantities of blood that may be accompanied by blood clots. This moderate to severe rectal bleeding can deplete blood supply, causing weakness, low blood pressure, dizziness or fainting. Moderate to severe rectal bleeding often requires evaluation and treatment in the hospital.

Forms of additional evaluation include:

• Fecal Occult Blood Test – This is a lab test to check for blood in the stool. If blood is detected, additional tests will be used to help determine the source of the bleeding.
• Digital Rectal Examination (DRE) – If you experience rectal bleeding, your physician may perform a digital rectal examination to find the source of the bleeding. To perform a DRE, your doctor will put on a latex glove and insert a lubricated finger into the rectum to feel for growths and other abnormalities.
• Anoscopy or Proctoscopy – An anoscopy or proctoscopy may be done in conjunction with a DRE to inspect the anus and lower rectum. A lubricated instrument that has a light on the end is inserted into the rectum so the physician can examine the area. A proctoscopy uses a slightly longer instrument than an anoscope, so an enema or laxative will likely be suggested before the procedure is done. 
• Sigmoidoscopy – To examine the colon and remove small growths, a sigmoidoscopy may be suggested. During this procedure, a lighted tube is inserted through the anus. Patients will need to receive an enema or laxative to empty the colon before the test is done.
• Esophagogastroduodenoscopy (EGD) – During this procedure, an endoscope, or flexible tube with a small camera on the end, is inserted through the mouth and down the esophagus to the stomach and duodenum. Your physician can use this to look for the source of the bleeding and may also be used to collect small tissue samples for further testing.
• Colonoscopy– If you doctor needs to examine the entire colon, a colonoscopy will likely be completed. This procedure is similar to an EGD except the scope is inserted through the rectum to view and take samples of the colon. The prep for a colonoscopy requires an empty colon, so your doctor may request an enema, laxative and/or special diet before the exam.

Depending on the results of examination, treatment can include medication, such as antibiotics or anti-inflammatory drugs, to surgery. Other treatment may involve simple things you can do on your own, such as adding more fiber to your diet, sitting in warm baths or avoiding certain foods that trigger your symptoms.

If you do experience moderate to severe rectal bleeding, your physician may refer you to a gastroenterologist. The gastroenterology team of physicians and health care professionals at UnityPoint Clinic work together to provide a coordinated care approach in order to achieve the best outcome for every patient. If you find yourself needing an expert in the diagnosis and treatment of disorders involving the esophagus, stomach, small and large intestine, liver, gallbladder or pancreas, trust the gastroenterologists at UnityPoint Health.