Blood in stool (med .: hematocheia, melena) is seen by most patients as something terrible. Noticing the blood in stool, do not be afraid of the worst, but you should immediately go to the doctor. Possible causes of blood in the stool may be gastrointestinal infections, polyps of the large intestine or hemorrhoids, as well as gastric ulcer or chronic inflammatory disease of the large intestine. To exclude the diagnosis of malignant diseases – such as bowel cancer - it is necessary to immediately carry out relevant studies in the clinic. Below you will learn all the important information about the symptom “blood in stool”.
Blood in stool: Description
Blood in the stool indicates that the body somewhere in the gastrointestinal tract loses blood, which is then found mixed with a stool. The color and consistency of the mixed blood can serve as an almost reliable indication of the source of the bleeding.
Blood in the stool does not necessarily occur as a bright red or dark red plaque or impurity, in fact it can stain the stool black. The corresponding manifestations in this case depend on the height of the bleeding in the digestive tract, as the blood state changes upon contact with gastric juice and as a result of processing by microorganisms.
Red blood in stool (hematochezia)
If the blood in the stool is in the form of bright red or dark red, in the form of an impurity or strips, then the blood is relatively fresh. This type of blood in the stool is called hematochezia. The source of bleeding is most likely in the middle or lower parts of the gastrointestinal tract (GIT), because the blood could not be destroyed in large quantities by hydrochloric acid of the stomach, or bacteria.
If stool is evenly colored in a dark red color, this can indicate, for example, large bleeding in the large intestine. With small bleeding in the stool, jelly-like traces of blood are observed.
In turn, the light red bands may indicate a fresh bleeding in the rectum, for example, with hemorrhoids.
Black blood in the stool (melena, tarry stool)
If stool is black and shiny, then we are talking about the so-called tarry stool (melena). In cases of bleeding in the upper gastrointestinal tract, that is, from the esophagus to the duodenum, hemoglobin in the blood, upon contact with gastric juice, decomposes to hematin. This hematin is the reason for the black color of the stool, and in the case of vomiting, the vomiting mass may resemble coffee grounds.
Black stool often indicates that the source of bleeding is above the small intestine and is caused by either a stomach ulcer or bleeding in the esophagus.
Since intestinal bacteria with prolonged exposure to blood also cause the breakdown of hemoglobin into the pigment of hematin, the black color of the stool may not necessarily be a consequence of bleeding in the upper gastrointestinal tract. With delayed passage of chyme (contents of the intestine), melena may cause bleeding, located deeper.
Under certain circumstances, high-located bleeding in the gastrointestinal tract, on the contrary, can lead to hematochezia, both with a decrease in the secretion of gastric juice due to medication, and with severe bleeding, when the chyme quickly passes through the intestine.
Hidden blood in stool
It may also be that, despite the fact that the blood in the stool is present, it is not visible. Then it's about hidden blood. In most cases, it is detected accidentally in a routine examination or in a targeted study with a known damage to the digestive tract.
Since blood cannot be detected with the naked eye, a guaiacol test for detecting blood in the stool (hemoccult test) is used, with which it can be detected even in small amounts.
Cases that are confused with the presence of blood in stool
After eating certain foods, the feces may look as if there is blood in it. This leads to the use of red beets, staining the stools in a dark red color, which occurs during hematochezia. Bilberry stains a chair in black, similar to licorice, so that when viewed it is perceived as melena.
In addition, some medications may give a black color to the stool (for example, activated charcoal or iron preparations).
Blood in stool: causes and possible diseases:
Various possible causes of the appearance of blood in the stool are considered, which cause bleeding in the gastrointestinal tract. These include bleeding from the oropharynx, esophagus, stomach, small and large intestine and anus. In principle, bleeding can occur in each department, and the frequency and significance of various causes vary.
Blood in stool with bleeding in the upper parts of the gastrointestinal tract
Blood in stool with bleeding in the middle and lower parts of the gastrointestinal tract
Blood in stool: When should you see a doctor?
If you have found blood in your stool, you should see a doctor in any case. Despite the fact that most bleeding stops without medical assistance on their own and that often does not pose a threat. Still, it is necessary to find out where the source of bleeding is and whether there is a more serious disease behind it. Especially when there are other symptoms – for example, when:
Do not postpone the visit to the doctor
With severe bleeding in the gastrointestinal tract after a certain period due to blood loss, anemia may occur, which in any case requires treatment.
Blood in stool: What does the doctor do?
If blood in stool is caused by acute bleeding in the gastrointestinal tract, which caused severe blood loss, first of all it is necessary to compensate for the missing volume of blood. In the absence of treatment, this in the worst case can lead to hypovolemic shock – a life-threatening condition.
The patient is placed in the supine position, receives oxygen through the nasal probe and as soon as possible – a blood substitute, to replenish lost blood volumes. With large blood loss, blood transfusion is also performed.
In addition, with chronic bleeding in the gastrointestinal tract for a long time, anemia may develop, the treatment of which is similar [to the treatment of acute blood loss].
Anamnesis and examination
If the patient seeks a doctor with complaints of blood in stool, in most cases the place of bleeding is unknown and should be established.
Data from the medical history can give valuable guidance. For example, it may be important whether blood was previously in stool. It should be clarified whether there were previously hemorrhoids, peptic ulcer disease, chronic inflammatory bowel disease, alcohol abuse or diverticula, that is, whether there are risk factors for gastrointestinal bleeding. Further investigations are carried out to find the source of bleeding.
Since gastroduodenoscopy may not always show a source of bleeding and, besides, it is not always possible to obtain sufficient data, then in such cases additional methods of examination are used.
Treatment depends on the cause of bleeding. First, you should, of course, stop the active bleeding, then you must prevent repeated bleeding, fighting the cause.
In order to stop the active bleeding in the alimentary canal, various endoscopic techniques are used in the first place. It is advisable that if a source of bleeding is found during gastrointestinal or colonoscopy, the cause of bleeding can also be eliminated by one of the following methods:
When the bleeding is stopped, treatment begins, aimed at eliminating the cause of the disease: