Blood in stool: Common causes & treatment

Blood in stool (rectal bleeding or haematochezia) can refer to any blood that passes from the anus, although blood in the stool is usually assumed to refer to bleeding from the lower colon or rectum. However, not all bleeding passing out from the body comes from the rectum. The blood or blood clot can come from anywhere in the gut. The correct term used in medicine is gastrointestinal tract bleeding.

Haematochezia also causes or is accompanied by the following symptoms:

• Pain in the rectal region
• Diarrhoea
• Change or disruption in bowel habits
• Cramping and abdominal pain
• Weight loss
• Fever
• Fainting or confusion

Normally, blood in stool is a symptom rather than a condition by itself. Thus, bleeding in stools could be an indication of an underlying condition or problem and must be taken seriously.

Possible reasons for blood in stool

Typically, blood in stools indicates bleeding in the digestive tract. However, when you delve deeper into what does blood in stool indicate, the following reasons for blood in stools come to light:

Diverticular Disease

Although the prevalence of diverticulitis in India is 1-3%, it could be the reason behind abdominal pain and bleeding. Diverticula are small pouches that form on the colon wall. The formation and excessive growth of the diverticula up to several centimetres cause diverticulosis. The infection of these overgrown diverticula causes diverticulitis.

Ischemic colitis

Ischemic colitis often affects the elderly and is caused by inadequate blood flow to the colon. In addition to blood in stools, ischemic colitis also exhibits symptoms of diarrhoea, abdominal pain, and vomiting. Thus, if you experience no constipation but blood in stools, you may have ischemic colitis.

False alarm

If you experience blood in stool but no pain, it is possible that the pigments in foods consumed have resulted in red-coloured stools, which may be mistaken for blood.

Inflammatory bowel disease (IBD)

IBD is an autoimmune disease that causes inflammation of the bowels. Crohn’s disease and ulcerative colitis are the most prevalent forms of IBD.

Cancer

Blood in stools could also be an indication of colorectal cancer. Polyps, which are benign tumours that eventually grow and become cancerous, can also cause bleeding in the stools.

Today, we will discuss at-length the commonest blood in stool causes, namely, piles and fissures.

Piles

Piles, also known as haemorrhoids, are characterised by inflamed blood vessels, muscles, support tissue, and elastic fibres in the anus and rectum.

These could be internal or external and are categorised from Grade I to IV.

Fissure

Anal fissures are a tear in the anal lining. The cut in the skin caused by hard stools that come with blood flow and severe pain after every bowel movement.

It may take the body about 4-6 weeks to recover from an anal fissure. On the other hand, severe cases may result in the exposure of the muscle tissues present underneath.

What are the risk factors associated with the blood in stool?

The risk of having blood in your stool could increase if you have:

• A history of haemorrhoids or stomach bleeding
• History of peptic ulcers
• Diagnosed or undiagnosed inflammatory bowel disease
• Genetic, predisposed a risk for colorectal or upper gastrointestinal cancers.

When to See a Doctor?

Unknown bleeding inside the body is always a reason for you to get a diagnosis from your doctor. Seek medical help if the bloody stool persists for more than two days or if you are experiencing diarrhoea that is not becoming better.

You should receive medical treatment at the earliest if you develop additional symptoms, including:

• Vomiting blood
• High fever
• Dizziness or fainting
• Severe or increasing abdominal pain
• Rapid pulse

To confirm the diagnosis, your doctor may order several diagnostic tests, including:

• Stool culture test: In this process, a stool sample is taken and analysed under a microscope for signs of blood, parasites, infections etc. 
• Esophagogastroduodenoscopy (EGD): The endoscope is inserted into the oesophagus and passed down into the patient’s stomach and the upper part of the small intestine. Air is then passed through the endoscope to see the lining of the oesophagus. During the test, the doctor might take a small sample using the endoscope. These samples can later be examined with a microscope to identify any abnormalities in the cells. 
• Nasal irrigation: It helps the doctor to see where the bleeding is occurring; during the procedure, the contents of the stomach will be removed to see if the stomach is bleeding. If there are no signs of gastric bleeding, the most likely cause of the bleeding is in the lower digestive tract.
• Colonoscopy: Colonoscopy is a process to detect changes or abnormalities in the large intestine and rectum. During the colonoscopy process, a long, flexible tube (colonoscope) is inserted into the rectum. A tiny video camera attached at the tip of the tube allows the doctor to view the inside of the entire colon.
• Enteroscopy: Examines the small intestine for abnormalities; your doctor will insert a tube with a camera into your mouth or rectum and route it through your upper or lower digestive tract. As the camera moves through the digestive tract, it takes pictures to diagnose the location of the bleeding.
• Barium X-ray: Barium inserted into the rectum to detect changes or abnormalities in the large intestine, which shows on an X-ray.
• Angiography – Can determine the location of the bleeding in the digestive tract; during the procedure, a dye is injected into a vein so that the vessels appear on an X-ray or CT scan.

What are the treatments for blood in stool?

The initial treatment for blood in the stool is to stop the bleeding. Once the bleeding has stopped, your doctor will suggest a plan to treat the cause of the bleeding.

Depending on the cause, your doctor may recommend:

• Medication – Antibiotics, anti-inflammatory drugs, or drugs used to suppress stomach acid are often prescribed to stop rectal bleeding.
• Surgery: It may be necessary to repair or correct abnormalities in the digestive tract.

Final thoughts

If you spot blood in your stool, it need not always be a cause of concern. But if the bleeding persists for more than two days, consulting a gastroenterologist is a must. If you are concerned about bleeding in your stool or if you have any other stomach problems that you need help with, you can book an appointment with our consultants, or you can reach us at +91 124 4882200

Consult a doctor for blood in stools now!