Causes and Treatment: Blood in your stool can be for many reasons: How to recognize cancer and other diseases
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Blood in the stool can look very different and also have different causes – this is why you should always inform your doctor. All information about the examinations, possible origins of the blood and how tarry stools are formed.
There are many different causes of blood in your stool. Depending on where it originates in the gastrointestinal tract, the blood looks different when there is anal bleeding. You can already see the rough origin of the blood in the stool by looking at it.
- Does the Blood stool a very dark color – one also speaks of tarry stool or melena – this is an indication that the blood comes from the upper areas of the gastrointestinal tract. The dark blood in the stool comes from things like the esophagus or the stomach. The appearance of the tarry stool comes from the fact that the blood comes into contact with stomach acid and bacteria. The iron in the red blood pigment oxidizes and turns black – black stools occur.
- Fresh blood on toilet paper after a bowel movement with a bright red color on the other hand, most likely comes from the back of the intestine. Doctors call this type of rectal bleeding hematochezia.
- Another variant of blood in stool is this Blood that cannot be seen with the naked eye. It mixes with the stool, which is not necessarily noticeable by its appearance. This form of blood in the stool is called hidden blood, and doctors call it occult blood.
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Blood in the stool: the causes
Anyone who observes blood in the stool immediately wonders what that means. However, bloody stools need not be directly stressful. Blood in the stool can be the result of an operation, for example if a doctor removes polyps during a colonoscopy. Bleeding and blood in your stool may also occur more easily during chemotherapy because blood clotting is reduced.
More often, however, blood in the stool is the result of impairment of the gastrointestinal tract. There are a number of possible causes that can be differentiated according to whether they occur in the upper digestive tract or in the lower and middle digestive tract.
Blood in the stool: causes in the upper digestive tract
- Esophageal varices: These are varicose veins in the esophagus. They can develop as a result of cirrhosis of the liver. Cirrhosis of the liver can also lead to varicose veins in the stomach.
- Esophageal cancer: Tumors in the esophagus can also lead to bloody stools. The blood is colored black, one speaks of tarry stools. Tumors in the esophagus also cause pain or discomfort when swallowing, loss of appetite and weight loss, and vomiting.
- Mallory-Weiss lesion: Describes tears in the mucous membrane in the lower part of the esophagus. The mucous membrane is usually already damaged or severely irritated and tears due to frequent vomiting – triggered by excessive alcohol consumption, for example. In addition to blood in the stool, there is also blood in the vomit and those affected have severe abdominal pain in the upper abdomen.
- Refluxerkrankung: The stomach contents flow back into the esophagus and irritate it. The esophagus can become inflamed. One sign of this is stool that is dark in color. In addition, reflux disease causes heartburn, pain when swallowing and those affected have to burp.
Blood in the stool: causes in the middle and lower digestive tract
- Hemorrhoids: They are the most common cause of blood in stool when it is bright red blood. The bleeding often takes place without pain. Sometimes there is also itching, oozing or burning. Some hemorrhoids can be surgically removed, and minor bleeding may also occur after the operation.
- Gastric ulcer or duodenal ulcer: Describes an injury to the gastric mucosa. In addition to bloody stools, there may be abdominal pain in the upper abdomen, nausea and vomiting.
- Inflammation of the gastric mucosa: Even if the lining of the stomach is just inflamed, it can lead to blood in the stool. Other symptoms of acute gastritis are stomach or back pain, nausea and vomiting, loss of appetite, a feeling of fullness or gas.
- Stomach cancer: Tumors in the stomach can also lead to blood in the stool. The stool is also dark in color (tarry stool). In addition, there is prolonged pain in the upper abdomen, pain when eating, nausea and vomiting, loss of appetite and weight loss or reduced performance.
- Medication: some drugs alone or in combination with other drugs may cause gastric bleeding as a side effect. This can happen if certain anti-inflammatory pain relievers with active ingredients such as ibuprofen, diclofenac, naproxen or acetylsalicylic acid are taken for a long time. Antibiotics can also lead to blood in the stool – for example when it leads to pseudomembranous colitis, an inflammation of the colon.
- Divertikel: These are small protrusions in the lining of the intestine. In addition to minor bleeding, they can lead to pain in the lower abdomen (usually on the left side), flatulence, constipation or diarrhea. The symptoms are usually worse after eating.
- Colon cancer: Tumors in the bowel can also lead to blood in the stool, which is dark. In addition to blood, there can also be mucus in the stool, and a tumor in the intestine can lead to pain, constipation or diarrhea.
- Crohn’s disease: This is a chronic inflammatory bowel disease in which the mucous membrane becomes inflamed. The main symptoms are abdominal pain and diarrhea and the symptoms come on in flares.
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In addition to the digestive tract causes, endometriosis can also be the cause of blood in the stool in women. Endometriosis describes a benign, but often painful, growth in the lining of the woman’s uterus. Concomitant symptoms are abdominal pain, back pain or pain during sexual intercourse. The symptoms usually occur in line with the woman’s cycle.
Irritable bowel syndrome, on the other hand, is not one of them: Even if one might suspect it, blood in the stool is not a common symptom of irritable bowel syndrome.
Blood in the stool: the examination
If someone sees blood in their stool, the question arises when they should see a doctor about it. You should always contact your family doctor because Blood does not belong in a bowel movement. If the amount of blood in the stool is particularly large or if there are other strong symptoms in addition to the blood in the stool, a trip to the hospital is recommended.
To make the correct diagnosis, doctors need to find the cause of the blood in the stool. First, the doctor will examine the patient in general. With a stool sample, he can also discover hidden blood in the stool that cannot be seen with the naked eye (occult blood). Similar analyzes are also carried out for colorectal cancer screening; exceeded limit values serve as an indication of otherwise undetectable blood in the stool.
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Doctors usually do a gastroscopy or colonoscopy for further examination. Depending on the results, symptoms, and patient history, the doctor may also perform a capsule endoscopy or an ultrasound scan.
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Blood in the stool: which doctor?
If you have blood in your stool, your family doctor can be the first point of contact. He can do one give an initial assessment of the severity of the problem and already carry out one or the other test. If necessary, he will then refer the person concerned to a specialist. This is usually one Gastroenterologist or a proctologist.
The gastroenterologist is a specialist in the gastrointestinal tract; he also performs gastroscopy for colorectal cancer screening, for example. The proctologist, on the other hand, is an expert on the rectum.
What to do if there is blood in the stool
Blood does not belong in a healthy stool. There is blood in the stool because of it always a warning sign and should be clarified by a doctor. Those affected should contact their doctor and discuss how to proceed. If there is a lot of blood in the stool or if other acute symptoms occur in addition to the bleeding, those affected can also contact the nearest clinic directly.
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Blood in the stool in the child and baby
The most common reason children, babies, or infants have blood in their stools is small tears at the anus. Doctors also call the tears anal fissures. But intestinal polyps, hemorrhoids or another underlying disease can also be the cause.
Particular caution is required if there is not just a little but a lot of blood in the stool. Or the blood leaks even without a stool. Black or tar-colored stools are also a warning sign. Then parents should contact the pediatrician in any case and discuss the next steps with him. Even if the baby is less than twelve weeks old or if blood is found in the stool more often, parents and their child should see a doctor.
Blood in stool during pregnancy
When a woman has blood in her stool, the most common haemorrhoids during pregnancy. The tissue becomes softer due to the changed hormonal balance. This makes hemorrhoid formation easier. Especially in the last trimester of pregnancy, there is a greater risk of hemorrhoids forming.
Affected women can address the blood in the stool at the next gynecologist appointment or contact their family doctor.
Swell:
- Online information The gastroenterology portal: http://dasgastroenterologieportal.de; Access: 04.06.2020
- Online information from the Professional Association of Established Gastroenterologists in Germany (bng): www.magen-darm-aerzte.de; Access: 04.06.2020
- Online information Professional Association of Paediatricians e. V .: www.kinderaerzte-im-netz.de; Access: 04.06.2020
- Online information Pschyrembel Online: www.pschyrembel.de; Access: 04.06.2020
This article was written by Jan Schwenkenbecher, psychologist M.Sc., science journalist
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