Blood in stool

The presence of blood in stool, medically referred to as hematochezia or melena, is a symptom that may indicate a variety of underlying conditions. Hematochezia typically refers to bright red blood, often mixed with stool or present on toilet paper, indicating bleeding from the lower gastrointestinal tract. In contrast, melena is characterized by black, tarry stools, often associated with upper gastrointestinal bleeding.

Fecal Occult Blood Test

Causes of Blood in Stool

The causes of blood in stool can be broadly divided into two categories: gastrointestinal (GI) causes and anorectal causes.

Gastrointestinal Causes

• These include:
• Peptic ulcers: These are sores that develop on the lining of your stomach, upper small intestine or esophagus.
• Gastrointestinal bleeding: This can occur in any part of your gastrointestinal tract from the esophagus to the rectum.
• Gastritis: Inflammation of the stomach lining.
• Diverticulosis: Small, bulging pouches that develop in the digestive tract.

Anorectal Causes

• These include:
• Hemorrhoids: Swollen blood vessels in the lowest part of your rectum and anus.
• Anal fissures: Small tears in the lining of the anus.

Diagnosis

• The diagnosis typically begins with a medical history and physical examination. Additional diagnostic tests may include:
• Fecal occult blood test (FOBT): This is a lab test used to check stool for hidden (occult) blood.
• Endoscopy: A procedure that allows your doctor to view the inside of your gastrointestinal tract.
• Colonoscopy: An examination used to detect changes or abnormalities in the large intestine (colon) and rectum.

Digestive system diagram en

Treatment

Treatment for blood in the stool depends on the underlying cause. For instance, if hemorrhoids are the cause, treatment might include over-the-counter creams or suppositories, or even surgery for severe cases. If a peptic ulcer is the cause, treatment could involve medications to decrease stomach acid or antibiotics to treat a Helicobacter pylori infection.

See Also

• Gastrointestinal bleeding
• Hemorrhoid
• Peptic ulcer disease
• Colonoscopy

References

• Peery AF, Crockett SD, Murphy CC, Lund JL, Dellon ES, Williams JL, Jensen ET, Shaheen NJ, Barritt AS, Lieber SR, Kochar B. (2019). Burden and Cost of Gastrointestinal, Liver, and *Pancreatic Diseases in the United States: Update 2018. Gastroenterology.
• Strate LL, Gralnek IM. (2016). ACG Clinical Guideline: Management of Patients With Acute Lower Gastrointestinal Bleeding. The American Journal of Gastroenterology.

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