Red Stool, Blood in Stool or Bloody Stool

Digestive System

Red Stool or Blood with Stool can technically be referred to as Hematochezia. Blood with  stool can be bright red or dark, black, and/or “tarry” appearing and it requires your doctor’s attention. Blood with Stool can be a indicator of the disease, so you should make it a main concern and shall schedule an appointment with a doctor.

Causes of Red Stool or Blood with Stool

Bleeding in the stool means bleeding somewhere in the large intestine. The color of the blood can be an indication of where the bleeding is occurring. If the blood is bright red and “fresh” looking, the bleeding is likely occurring toward the end of the colon or in the rectum. If bleeding is occurring higher up in the colon, the blood will be dark brownish to black, referred to as tarry stools. Most of the reasons of such rectal bleeding are not life-threatening; frequent reasons include

There are many other causes of rectal bleeding, including

  • Colon Cancer
  • Colon Polyps
  • Colitis
  • Crohns Disease
  • Diverticulosis
  • Angiodysplasia. A condition in which fragile, abnormal blood vessels lead to bleeding.

    Algorithm for the management of lower GI bleeding.
    Management of Bleeding in Stool
  • Peptic ulcers. An open sore in the lining of the stomach or duodenum – the upper end of the small intestine.  Many peptic ulcers are caused by infection with a bacterium called Helicobacter pylori (H. pylori).
  • Gastroenteritis. A viral or bacterial infection of the stomach and bowel. It can cause diarrhea that contains traces of blood and mucous, as well as other symptoms such as vomiting and stomach cramps.
  • Esophageal problems. Varicose veins (varices) of the oesophagus or tears in the esophagus can lead to severe blood loss.

Bleeding occurring from a higher place in the digestive tract, such as the stomach, can produce black, tarry bowel movements, because stomach acid turns blood black. Passing blood from the rectum that is dark red or includes clots usually indicates bleeding from higher in the colon than anal fissures or hemorrhoids would produce.

Diagnosis of Red Stool or Blood with  Stool

Helicobacter pylori bacteria
Helicobacter pylori bacteria (Photo credit: Wikipedia)

Color suggests a huge suspicion as to what might be wrong; it does not necessarily give the whole picture as there are things not related to illness that can affect the color of stool.

  • Black stool usually means that the blood is coming from the upper part of the gastrointestinal (GI) tract. This includes the esophagus, stomach, and the first part of the small intestine.
  • Maroon-colored stools or bright red blood usually suggests that the blood is coming from the lower part of the GI tract (large bowel, rectum, or anus).
  • Shiny black- or plum-colored stool is often not recognized by the patient as blood (melaena). This indicates bleeding from higher up the GI tract – these patients need admission for investigation

The majority of the doctors will take a thorough history and do a physical examination, which may include a rectal exam. Following may also be considered:-

  • Anoscopy. Anoscopy allows to inspect the anus and lower rectum. It can be done in the office and does not require sedation.
  • Sigmoidoscopy.  During a sigmoidoscopy, the rectum and most of the lower large intestine can be examined. Sigmoidoscopy can be done without sedation.
  • Colonoscopy.  A colonoscopy is a procedure in which a physician examines the entire colon, usually while the patient is sedated.

Treatment of Red Stool or Blood with Stool

Treatment will depend on diagnosis. The doctor will initially recommend soft and light food and give medication to control constipation so that blood is not lost due to hard and difficult stool.

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