A gastrointestinal disorder can lead to blood in stool. Diagnosis sometimes, confirms bleeding in the large intestines due to presence of ulcers. To know how to diagnose bloody stools, read on...
Blood in stools is an indicative of internal bleeding. Normal bowel movement produces medium brown color stools. However, blood in stool is a cause of worry, and it means something is wrong with the large intestine. In fact, blood in the stool is the symptom of a number of diseases, involving the stomach, intestines or the liver.
Hematochezia is the medical term used to describe blood in stools. To put simply, along with stool, the patients also defecate blood. In most cases, bleeding occurs from the rectum, hence hematochezia is also sometimes referred to as rectal bleeding. Also, in majority of hematochezia cases, only a small amount of blood is defecated. Usually, the toilet paper may show few marks of blood but in moderate to severe cases, one or two spoons of blood is passed down the anus.
There are different ways to identify the presence of stool. It is not necessary to be a doctor to know that there is blood in stool. Following are the options to arrive at a diagnosis, that confirm blood in stool.
Stool Color: How to know whether there is blood in the stool? Simply observe the color of stool and one will get the answer to this question. The color of the stool drastically changes, if there is red blood in stool. The stool appears bright red and the consulting the doctor is important to diagnose the condition. However, blood in stool, doesn't means that stool color will always appear red. Bleeding in the intestines can also cause bowel evacuation that gives rise to black, tarry stools. This unusual stool color that lasts for more than 2 days is certainly not normal and consulting a physician is essential as it may be a symptom of disorder, involving the large intestine or gall bladder.
The color of blood in the stool is a crucial factor in determining the site of bleeding in the large intestine. To be specific, color of the blood will vary depending upon where the bleeding is occurring in the intestine. It is said that farther the location of bleeding from the anus, the darker will be the color of the blood in the stool. For instance, if the bleeding site is deep inside the colon, the blood appears dark red. On the other hand, if bleeding is taking place near the anus such as the rectum, then the blood color changes to bright red.
In case the site of bleeding is anywhere in the small intestine or the stomach, black bowel movement is the likely outcome. When the blood from the small intestine reaches the large intestine, there it combines with the good bacteria. By the time, the blood from the large intestines reaches the anus, the bacteria stimulate breakdown of blood into its basic components that are black in color. Hence, stools that combine with this blood (that is broken down into its black constituents) appear tarry black.
Fecal Occult Blood Test: This is one test that is used when blood in feces is not visible to the naked eye. In such a case, unusual color may not be seen, due to presence of small amount of blood in stool. This test is the most reliable way to confirm blood in stool. Diagnosis for the underlying disorder is the next task for the physician. This is achieved by performing various blood tests. This is a low-cost, non invasive procedure that gives details about the exact quantity of blood in stool sample. An easy way to perform fecal occult blood test is given below:
Guaiac Test: This test involves putting stool sample over a piece of paper that has a thin coating of guaiac. 1-2 drops of hydrogen peroxide are then added to the sample. If discoloration in the stool appears, then one can say that blood is present.
Melena is a term that describes a particular appearance of blood in stools. This term describes stools that are black, tarry and often foul-smelling because of the presence of blood from the upper gastrointestinal tract. Melena is associated with gastrointestinal hemorrhage, peptic ulcers, gastritis and other upper gastrointestinal tract disorders.
The blood associated with melena gives stools a black, tarry appearance because blood is rich in a molecule called hemoglobin. This molecule is responsible for transporting oxygen through the bloodstream, and each molecule of hemoglobin contains an iron atom. As hemoglobin passes through the stomach and gastrointestinal tract, the iron goes through a chemical reaction called oxidation, which changes the color and appearance of the blood and stool.
Blood generally passes through the intestines quickly. When blood originates in the lower gastrointestinal tract, it typically is bright red, because the iron has not yet had time to oxidize. This means the source of oxidized blood usually is the upper gastrointestinal tract. Bright red or maroon-colored blood in stools is called hematochezia and usually originates from the large bowel, rectum or anus. This type of bleeding is most often caused by hemorrhoids. In rare cases, massive, rapid-onset bleeding in the stomach also can lead to bright-red blood in stools.
The appearance of blood in stools is often no cause for alarm, but even so, a doctor should be consulted as soon as possible. The doctor will first ask for a medical history, which might include questions relating to medications being used, diet, gastrointestinal health and the presence of other symptoms in addition to blood in stools. The doctor might also perform a physical examination of the abdomen and rectum to determine whether any physical signs are present that might provide diagnostic clues.
Hematochezia is the technical term for passing stool with blood in it. It is distinguished from melena, passing dark, tarry stool which contains digested blood, and from bleeding around the anus, which causes bright red blood. In patients with hematochezia, the blood indicates that there is bleeding somewhere in the lower part of the intestinal tract. It can be indicative of a number of medical problems, and can be a cause of concern.
One of the most worrying causes of hematochezia is colon cancer, which can cause blood to appear in the stool as the cancer spreads, since many cancerous tumors bleed. Irritable bowel disease can also cause hematochezia, which can be a concern when it is causing bleeding ulcerations in the lower intestine. Extremely large upper gastrointestinal tract bleeds can also result in bloody stool.
Hemorrhoids are another common reason for people to have bloody stool, as is diverticulosis. Polyps in the bowel, whether or not they are benign, can also lead to the development of hematochezia. Likewise, foreign objects in the bowel can cause bleeding because they may cut the bowel walls. This is a definite cause for concern, as a ruptured bowel is something which requires surgical attention.
Bowel ischemia, in which the supply of blood to part of the bowel is cut off, may cause bloody stools as well. Ischemia is worrying because the tissue which has been cut off can die from lack of blood, which can lead to an abdominal infection. Likewise, trauma may cause bleeding, in which case it is very important to find out where the bleed is located, so that it can be addressed. This may require surgery to explore the bowel and check for signs of damage, in addition to checking for other internal bleeding which could have been caused by the trauma.
Blood in the stool means there is bleeding somewhere in your digestive tract. Sometimes the amount of blood is so small that it can only be detected by a fecal occult test (a test to check for hidden blood in the stool). At other times it may visible on toilet tissue or in the toilet after a bowel movement as bright red blood. Bleeding that occurs higher up in the digestive tract may make stool appear black and tarry.
Possible causes of blood in stool include:
Diverticular disease. Diverticula are small pouches that project from the colon wall. Usually diverticula don't cause problems, but sometimes they can bleed or become infected.
Anal fissure. A small cut or tear in the tissue lining the anus similar to the cracks that occur in chapped lips or a paper cut. Fissures are often caused by passing a large, hard stool and can be painful.
Colitis. Inflammation of the colon. Among the more common causes are infections or inflammatory bowel disease.
Angiodysplasia. A condition in which fragile, abnormal blood vessels lead to bleeding.
Peptic ulcers. An open sore in the lining of the stomach or duodenum, the upper end of the small intestine. Many peptic ulcers are caused by infection with a bacterium called Helicobacter pylori (H. pylori). Long-term use or high doses of anti-inflammatory drugs such as aspirin, ibuprofen, and naproxen can also cause ulcers.
Polyps or cancer. Polyps are benign growths that can grow, bleed, and become cancerous. Colorectal cancer is the third most common cancer in the U.S. It often causes bleeding that is not noticeable with the naked eye.
Esophageal problems. Varicose veins of the esophagus or tears in the esophagus can lead to severe blood loss.