When blood is discovered in stool, whether by the patient when wiping or by a test from a health professional, it can be quite scary. In some instances, blood in stool can be a symptom of a serious condition. However, this is not always the case. Therefore, it is important to understand the possible causes of blood in stool and what you need to do when it happens to you.

What does blood in stool mean?

Blood in stool, which is also known as bloody stool, rectal bleeding and hematochezia, is the passing of blood through the anus that is mixed with stool. While the bleeding may be present in the rectum, it could also be present in other areas of the gastrointestinal tract, such as the small intestines, stomach or oesophagus.

Causes of blood in stool include:

• Abnormal blood vessels
• Anal fissures
• Bleeding stomach ulcers
• Cancer or polyps in the small intestine or colon
• Diverticulosis
• Haemorrhoids
• Presence of a foreign body
• Inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease
• Intestinal infection
• Stomach lining inflammation, known as gastritis
• Lack of blood in the intestines, known as bowel ischemia
• Overgrown or widened veins in the stomach or oesophagus, known as varices
• Tear in the oesophagus due to violent vomiting, known as Mallory-Weiss tear
• Trauma

The severity of the bleeding, or the amount of passed blood, can vary greatly. Some patients will only pass a few drops, which will turn the water in the toilet bowl pink or cause a few spots on the toilet tissue during wiping following a bowel movement. For other patients, the passage of blood can be as much as a couple of spoonfuls.  In most cases, the bleeding is mild and will eventually stop without any medical attention required.

Mild bleeding can usually be treated without a need or hospitalisation or urgent treatment.

Moderate to severe bleeding from one or more bowel movements that contain a large amount of blood can lead to a number of other symptoms, such as:

• Dizziness
• Drop in blood pressure when standing from a lying or sitting position, known as orthostatic or postural hypotension
• Fainting or near fainting
• Low blood pressure
• Shock, in cases with severe blood loss
• Weakness

Severe blood in stool that causes a reduced blood volume level will usually require emergency medical attention, which will usually include a blood transfusion.

What Should I Do if I notice blood in stool?

The treatment for blood in stool will vary depending on the cause. Therefore, it is important to know what you need to do when you experience this condition, such as:

• Determine the amount of blood that is being passed
• Avoid using anything in the rectum, such as enemas, suppositories or thermometers
• Consume plenty of fibre and fluids
• Use stool softeners under the advice of a health professional
• Carefully clean the anal area with warm, soapy water, rinse thoroughly and pat dry
• Sitz bath or hip bath: A bath in which a person sits in water up to the hips.

In close to a quarter of blood in stool cases, a cause is never found, even following a medical examination. This occurs often in cases where the symptoms resolve suddenly. However, it is critical to rule out any cancerous or other serious conditions when you discover blood in stool.

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