Talking about poop might be something we giggle about as kids, but as adults, it’s often avoided in conversation. Finding blood in your stool can be alarming and understandably embarrassing. However, this symptom is your body’s way of signaling that something requires attention, making it a crucial topic to discuss with your doctor.
While cancer is a top concern when noticing blood in stool, it’s important to know that numerous other conditions can be responsible. As Dr. David Richards, a gastroenterologist, explains, “The thing that everyone worries the most about is cancer, but blood in your stool can be caused by a whole variety of things.”
Understanding Blood in Stool: Not Always a Cause for Panic, But Always Worth Checking
Discovering blood in your stool can trigger immediate anxiety, and while it’s essential to take it seriously, it’s not always indicative of a life-threatening condition. Blood in stool, clinically known as hematochezia or melena depending on its appearance, can stem from a range of causes, some minor and easily treatable, others more serious requiring prompt medical intervention. The key takeaway is that any occurrence of blood in your stool warrants investigation to identify the underlying cause and ensure your health.
Various Shades of Red (and Black): What Blood in Stool Can Look Like
When you notice blood in your stool, the appearance can offer clues about its potential origin within your digestive tract. It’s crucial to observe and describe what the blood looks like to your doctor, as this information aids in diagnosis.
Bright Red Blood: Often from the Lower Digestive Tract
Bright red blood in stool is often referred to as hematochezia. This type of bleeding is typically a sign of issues in the lower part of your digestive system, such as the rectum and anus. Common causes for bright red blood include:
- Hemorrhoids: Swollen veins in the rectum and anus are a frequent cause, and the blood is usually seen on the toilet paper or in the toilet bowl after a bowel movement.
- Anal Fissures: Small tears in the lining of the anus, often caused by straining during bowel movements, can also lead to bright red bleeding.
- Diverticular Bleeding: Diverticula are small pouches that can form in the lining of the colon. Sometimes these pouches can bleed.
- Rectal Polyps: Polyps in the rectum, while often benign, can sometimes bleed.
- Lower Rectal or Colon Issues: Inflammation or other conditions in the lower sections of the colon can also present with bright red blood.
Dark Red Blood: Potentially from Higher in the Colon
If the blood appears darker red, it might originate from higher up in the colon. While still concerning, the darker color suggests the blood has traveled further through your digestive system. This type of bleeding can be associated with conditions affecting the colon.
Black, Tarry Stool (Melena): Indicating Upper GI Bleeding
Black, tarry stool, known as melena, is a more alarming presentation of blood in stool. This typically indicates bleeding from the upper gastrointestinal (GI) tract, which includes the stomach, esophagus, and small intestine. The dark, tarry appearance is due to the blood being digested as it moves through the GI tract. Melena requires prompt medical attention as it can signify conditions such as:
- Stomach Ulcers: Open sores in the lining of the stomach.
- Duodenal Ulcers: Ulcers in the first part of the small intestine.
- Gastritis or Esophagitis: Inflammation of the stomach or esophagus lining.
- Less commonly, bleeding from the small intestine.
Blood Only on Toilet Paper: Often Hemorrhoids or Anal Fissures
Sometimes, you might only notice blood on the toilet paper after wiping and not visibly in the stool itself. This is frequently linked to hemorrhoids or anal fissures. While these conditions are often less serious, it’s still important to have them confirmed by a doctor to rule out other potential causes.
Common Causes of Blood in Stool: From Minor Irritations to Serious Conditions
The reasons for blood in stool are varied, and pinpointing the exact cause often requires medical evaluation. Here are some of the common conditions that can lead to blood in your stool:
- Hemorrhoids: As mentioned, these swollen veins are a very common cause, often linked to straining during bowel movements.
- Anal Fissures: Small tears in the anal lining, also frequently related to constipation and straining.
- Rectal Polyps: Growths in the rectum that can bleed. Some types of polyps have the potential to become cancerous over time.
- Diverticular Disease: Small pouches (diverticula) in the colon wall can sometimes bleed or become inflamed (diverticulitis).
- Inflammatory Bowel Diseases (IBD): Conditions like ulcerative colitis and Crohn’s disease cause inflammation in the digestive tract, which can lead to bleeding.
- Colorectal Cancer: Cancer of the colon or rectum can cause bleeding, sometimes visible and sometimes microscopic.
- Rectal Prolapse: When part of the rectum protrudes out of the anus, it can become irritated and bleed.
- Ulcers in the Rectum: Sores in the rectal lining.
- Injury to the Mucosa: Damage to the lining of the colorectal system.
“Some of these things, like hemorrhoids, fissures or prolapse, can be related to constipation and straining, or on the other side of the spectrum, they can be related to having a lot of loose stools,” explains Dr. Richards.
Why a Colonoscopy is Often Necessary: Getting a Clear Picture
While describing the appearance of blood in your stool is helpful, the most definitive way to determine the cause of blood in stool is through a direct visual examination, often via a colonoscopy.
“The investigative part is straightforward: we take a look inside and out,” says Dr. Richards. A colonoscopy involves inserting a thin, flexible tube with a camera into the rectum and colon, allowing the doctor to visualize the entire large intestine. This procedure helps identify the source of bleeding, whether it’s polyps, hemorrhoids, inflammation, or other abnormalities.
Many people feel apprehensive about colonoscopies, but they are generally well-tolerated. The procedure is typically performed under sedation, and while bowel preparation is required beforehand, it’s a crucial step for ensuring a clear view of the colon. Routine colonoscopies are recommended starting at age 45 for colorectal cancer screening, and earlier if you experience symptoms like blood in stool.
Dr. Richards emphasizes the importance of not delaying investigation: “With data telling us that more younger people are getting colorectal cancer, most doctors will say, ‘Let’s just do a colonoscopy.’ I know people don’t want to hear that, but my priority is to make sure I don’t miss anything.”
When Blood in Stool Might Be More Concerning: Additional Symptoms to Watch For
Blood in your stool, regardless of the amount or appearance, should be evaluated by a doctor. However, certain accompanying symptoms can make it more concerning and warrant more urgent medical attention. Be sure to inform your doctor if you experience blood in your stool along with any of the following:
- Anemia and/or feeling light-headed or dizzy: Significant blood loss can lead to anemia, causing fatigue, weakness, and lightheadedness.
- Chest pain and shortness of breath: These can be signs of severe anemia or other serious underlying conditions.
- Pain in your abdomen, pelvis, or rectum: Persistent pain can indicate inflammation, infection, or other gastrointestinal issues.
- Fevers: Fever can suggest infection or inflammatory processes.
- Nausea and vomiting: Especially if persistent or severe, can be associated with various GI problems.
- Pain or difficulty swallowing: This might indicate issues in the upper digestive tract, potentially related to upper GI bleeding if stool is black.
- Jaundice (yellowing of the skin and eyes): Can indicate liver or gallbladder issues, which, while less directly related to blood in stool, are serious medical concerns.
- Significant unexplained weight loss: Unintentional weight loss is a red flag symptom that should always be investigated.
Listen to Your Body: Don’t Ignore the Signal
Your body sends signals when something isn’t right, and blood in your stool is a significant signal that should not be ignored. Even if the bleeding is intermittent or seems minor, it’s essential to consult with your doctor to determine the cause.
“We know there are people out there who have colorectal cancer and don’t have any symptoms at all,” states Dr. Richards. “If you see blood in your stool, your body is telling you something. Don’t ignore it.”
If you notice blood in your stool, make an appointment with your doctor. Early detection and diagnosis are crucial for effective treatment and maintaining your long-term health.
