Blood In Your Stool
When you wipe after a bowel movement, it can be alarming to see blood on the toilet paper. It means that there is bleeding somewhere along your digestive tract. Although bloody stools are scary, they don’t always mean a life-threatening disorder. Here’s what you need to know about the causes of bloody stools and how these conditions are treated.
Color of the Blood
The color of the blood in the stool can show where it came from:
- If the blood is bright red, you may be bleeding from your lower colon or rectum.
- If the blood is dark red, it may come from the upper colon or small bowel.
- If you have dark, tarry stools, your stomach may be bleeding.
Remember too that if your stool looks red, it may be from something you’ve eaten. Cranberries, cranberry juice, tomatoes, tomato juice, beets, and red food coloring can make your bowel movement look red.
Many conditions can cause rectal bleeding. These include:
Hemorrhoids
Hemorrhoids (piles) are the most common cause of bloody stools. They’re swollen, inflamed veins around the anus (external) or inside your rectum (internal). 1 in 20 Americans has hemorrhoids, affecting more than half of people over 50. Hemorrhoids are similar to varicose veins.
Hemorrhoids are caused by rectal pressure. This includes straining during bowel movements, obesity, anal intercourse, chronic constipation, sitting on the toilet for a long time, and regularly lifting heavy objects.
Hemorrhoids can be internal or external. Internal hemorrhoids are located inside your rectum and are often undetectable, while external hemorrhoids surround your anus. They may hurt, itch, and bleed. There are also prolapsed hemorrhoids, which bulge outside your anus, and thrombosed hemorrhoids, which are caused by blood clots.
To diagnose hemorrhoids, your doctor will give you a physical exam. After this, they may give you a digital exam (inserting a gloved finger into your anus) to check for swollen veins.
Your doctor may also perform endoscopic tests, including a sigmoidoscopy, anoscopy, or colonoscopy. Each of these tests involves the insertion of a lighted tube into various sections of your digestive tract to diagnose hemorrhoids.
Often, you can treat hemorrhoids at home by applying an over-the-counter hemorrhoid cream, sitting in a warm bath for 10 to 20 minutes a day, using stool softeners, or taking oral pain relievers.
Severe symptoms may need surgery. These procedures include hemorrhoid removal, laser therapy, rubber band ligation (a rubber band around the base of the hemorrhoid cuts off its blood flow), stapling (a procedure that blocks blood flow to the hemorrhoid), or sclerotherapy (injection of a chemical that shrinks the hemorrhoid).
Ulcerative Colitis
Ulcerative colitis is a chronic inflammatory bowel disease (IBD) that affects the lower intestine’s lining. It causes inflammation and open sores (ulcers) and is related to an abnormal reaction from your immune system. This means that your immune system malfunctions and attacks your body. Ulcerative colitis typically develops between the ages of 15 and 30.
Symptoms of this illness progressively worsen. You may initially have abdominal cramping, diarrhea, anemia, and weight loss. Later, more serious symptoms develop, including severe cramping, bloody bowel movements, fever, and liver disease.
Although ulcerative colitis is incurable, medications such as immunomodulators, aminosalicylates, corticosteroids, and targeted synthetic small molecules can control flare-ups and reduce inflammation. A proper diet is also essential. Avoid sugary foods and drinks, carbonated drinks, alcohol, and fried foods that can aggravate inflamed tissue.
If your intestine is significantly damaged, your symptoms are debilitating, or your medication isn’t working, you may be a candidate for surgery. Surgery is the only treatment option that will permanently eliminate your symptoms. Surgery involves removing the large intestine and rerouting the small intestine to the anus or passing it outside the body, where feces are collected in a bag. About 30% of people who have ulcerative colitis eventually need surgery.
Crohn’s Disease
Crohn’s disease is a form of IBD (inflammatory bowel disease). It is chronic and can target any part of your gastrointestinal tract (GI tract) from your anus to your mouth. It can affect several segments or be continuous. It’s also a progressive condition that worsens over time. There is no cure for Crohn’s disease.
When you have Crohn’s disease, your immune system mistakenly attacks and destroys the body’s healthy GI tissue. This is known as an autoimmune disorder. Mild symptoms include bloody stool, diarrhea, abdominal pain, and weight loss. Severe Crohn’s disease may cause non-digestive symptoms such as kidney stones, inflammation of the liver, and inflammation of the joints, skin, and eyes.
There are four types of Crohn’s:
- Ileocolitis, which involves the small and large intestines.
- Ileitis, which affects the small intestine.
- Gastroduodenal, which develops in the stomach and on top of the small intestine.
- Jejunoileitis produces patchy areas of inflammation in the upper part of the small intestine.
Crohn’s symptoms vary depending upon what part of the GI is affected. The most common symptoms are abdominal pain and cramping, weight loss, and diarrhea. Symptoms such as arthritis, liver or bile duct inflammation, eye inflammation, and joint pain can indicate a more severe condition.
Crohn’s treatment aims to calm intestinal inflammation and keep you in remission. This can involve a variety of medications, such as aminosalicylates, steroids, biological therapies, and antibiotics. The severity of your illness will dictate which treatment is best for you. Part or all the large intestines are removed in severe cases.
You can help control your symptoms by avoiding butter, greasy foods, carbonated drinks, alcohol, and spicy food and instead opting for bananas, fatty fish, pasta, and spinach. Be sure to drink plenty of water too.
Anal Fissures
An anal fissure is a tear, like a paper cut, in the anus’ lining. A fissure can be caused by straining to pass a stool, chronic constipation, diarrhea, anal sex, or childbirth. Less common causes include Crohn’s disease, HIV, syphilis, anal cancer, and tuberculosis. You may also be susceptible to anal fissures if you have a tight anal sphincter muscle. About 1 in 10 people get an anal fissure during their lifetime.
Anal fissures cause sharp pain and bleeding during or even hours after passing a bowel movement. Other symptoms include bloody stools, burning and itching, uncomfortable urination, and vile-smelling discharge.
You can usually treat anal fissures at home. These simple methods heal 80 to 90% of most fissures in a few weeks or months. Try using stool softeners, avoid straining on the toilet, lubricate the area with Vaseline, or sit in a warm bath several times daily. If fissures resist these treatments, hydrocortisone suppositories, medicated cream, anesthetic ointments, Botox injections, or surgery may be needed. Anal fissure surgery is a simple outpatient procedure involving cutting a small section of the anal sphincter muscle to eliminate spasms and pain.
An essential part of healing fissures and preventing new ones is avoiding constipation. Do this by eating plenty of fiber, staying hydrated, going to the bathroom as soon as you feel the urge, and regularly exercising.
Diverticulitis
Diverticula are marble-sized pouches that develop in weak areas of your colon’s lining. High pressure in your intestine causes these pouches to protrude through its wall. This can occur when your intestine must use considerable force to pass a bowel movement or when stool remains in your colon for too long. Diverticulitis happens when the diverticula burst under pressure and become inflamed or infected.
Diverticulitis occurs in 10% of people over age 40, 50% of people over age 60, and most people over 80. Symptoms of the condition include rectal bleeding or blood in your stool (maroon or bright red), abdominal pain or tenderness, bloating, constipation, chills, or fever.
Doctors usually diagnose diverticulitis by first ruling out other diseases. They may conduct stool and urine tests, liver enzyme tests, blood tests, colonoscopies, or CT (computed tomography) tests. If you have mild diverticulitis, you may be put on a liquid diet or receive oral antibiotics such as Cipro or Flagyl. If your diverticulitis is severe, a drainage tube may be inserted in your abdomen, or you may receive intravenous antibiotics.
Surgery may be an option if you’ve had many incidents of minor diverticulitis, a weakened immune system, or a complication such as an abscess or a fistula (an abnormal connection between two body parts). There are two primary surgical options for severe diverticulitis. One is a primary bowel resection, which involves the removal of diseased portions of your intestine and reconnecting it to healthy sections. The other is bowel resection with colostomy. This surgery involves redirecting your colon from its average direction to a new opening in your abdomen’s wall.
You can prevent diverticulitis by avoiding constipation, preventing straining, and regularly having bowel movements. This can be done by eating more fiber, exercising 30 minutes daily, and drinking plenty of water.
Contact Us
Seeing blood in your stool or toilet paper after you wipe can be unnerving. Although a serious condition may not cause rectal bleeding, it’s crucial to have a professional evaluation.
Contact us today! The team of professionals at GastroMD looks forward to working with you. We are one of the leading gastroenterology practices in the Tampa Bay area. We perform many diagnostic procedures using state-of-the-art equipment in a friendly, comfortable, and inviting atmosphere where patient care is always a top priority!
