Discovering blood in your stool can be alarming. While it can be a symptom of a relatively benign issue like hemorrhoids, it can also indicate more serious underlying conditions. There are many potential causes of blood in stool. How do you know if it is a serious issue that requires medical attention?
Rectal bleeding refers to any blood that passes from your anus. It can manifest in various ways:
-Bright red blood: Often associated with bleeding in the lower rectum or anus, such as from hemorrhoids or anal fissures.
-Dark red or maroon blood: May suggest bleeding higher up in the colon.
-Black, tarry stools (melena): Typically indicates bleeding in the upper digestive tract (stomach or small intestine).
Hemorrhoids are swollen veins in the anus and rectum. They are often caused by straining during bowel movements, pregnancy, or chronic constipation. Bleeding from hemorrhoids is usually bright red and occurs during or after a bowel movement. Other hemorrhoid symptoms include:
-Itching or irritation around the anus
-Pain or discomfort
-Swelling around the anus
-A lump near the anus
Most prolapsed internal hemorrhoids resolve without treatment. However, severely prolapsed or bleeding internal hemorrhoids may require medical intervention. Doctors treat hemorrhoids with various procedures:
Office-based treatments:
-Rubber Band Ligation: A rubber band is placed around the base of the hemorrhoid to cut off blood supply.
-Sclerotherapy: A solution is injected to shrink the hemorrhoid.
-Infrared Photocoagulation: Infrared light creates scar tissue to cut off blood supply.
-Electrocoagulation: Electric current is used to create scar tissue.
Outpatient or hospital procedures:
-Hemorrhoidectomy: Surgical removal of hemorrhoids.
-Hemorrhoid Stapling: Stapling to remove hemorrhoid tissue and reposition prolapsed hemorrhoids. These procedures usually require anesthesia.
“The main benefit of office-based procedures is that they typically do not cause significant discomfort,” says Joseph E. Bornstein, MD, colon and rectal surgeon at Mather Medical Group. “Many patients either have no discomfort at all following the procedure or experience a minor sense of urgency to move their bowels, which dissipates in a few hours to a couple days. Rubber band ligation is the most commonly performed office-based procedure. For outpatient or hospital-based procedures, hemorrhoidectomy remains a gold standard for treatment given that it involves the removal of all abnormal hemorrhoid tissue, especially for those with both internal and external hemorrhoids. The post-operative recovery, however, is more challenging. Another option in that setting is a newer minimally invasive procedure, called Transanal Hemorrhoidal Dearterialization (THD). This involves tying off the blood vessels that serve the hemorrhoids which can substantially reduce swelling and bleeding.”
While hemorrhoids are a frequent cause of rectal bleeding, several other conditions can cause this symptom. Some of these include:
-Anal fissures: These small tears in the anal lining can be caused by straining during bowel movements, difficult or large stools and even sexual activity.
-Inflammatory Bowel Disease (IBD): Conditions like Crohn’s disease and ulcerative colitis are autoimmune disorders that cause inflammation in the digestive tract, often leading to diarrhea, abdominal pain and bleeding.
-Diarrhea: Frequent, loose stools, whether due to illness, foodborne pathogens, or dietary indiscretion, can irritate and inflame the anus, sometimes causing streaks of blood on toilet paper.
-Food poisoning: Consuming contaminated food can lead to infections that cause significant gastrointestinal distress, including inflammation and bleeding.
-Diverticulitis: Small pouches (diverticula) that can form in the colon can become inflamed or infected, a condition known as diverticulitis. This can cause bleeding, pain and changes in bowel habits.
-Hemorrhoids: These swollen veins in the rectum and anus can develop due to straining from constipation or prolonged sitting. They commonly cause bleeding, particularly during bowel movements.
-Ulcers: Open sores in the stomach or intestinal lining, often caused by bacterial infection can bleed, leading to blood in the stool.
It’s essential to consult a doctor if you experience any rectal bleeding, even if you suspect it’s due to hemorrhoids. Your doctor will likely perform a physical exam and may recommend further testing, to determine the cause of the bleeding. Treatment will depend on the underlying condition.
While blood in your stool can be frightening, it’s not always a sign of a serious problem. However, it’s crucial to seek medical advice to rule out any underlying conditions. Early diagnosis and treatment can significantly improve outcomes for more serious conditions. Don’t hesitate to talk to your doctor if you have any concerns about rectal bleeding.
Resources:
https://www.cancercenter.com/community/blog/2022/03/blood-in-stool
https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/treatment
