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Blood in Stool: Understand the Causes and When to Seek Medical Help

by Guilherme Sauniti
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Realizing the occurrence of this problem can be an alarming and worrying experience for many people. Therefore, it is important to understand the causes of blood in the stool and know when it is necessary to seek the intervention of a health professional.

Have you ever noticed blood in your stool? In this article, we will explore the causes and when you should seek medical help.

Common causes of blood in the stool

Technically known as lower gastrointestinal hemorrhage, this situation can be a multifaceted symptom that reflects a variety of underlying medical conditions.

Among the most frequently observed causes is the development of hemorrhoids.

These swollen and inflamed veins in the anal region can rupture, resulting in bleeding that is often noticed during or after bowel movements.

In addition to hemorrhoids, anal fissures can also be to blame.

These are small tears or cuts in the skin lining the anal canal, often caused by excessively hardened or traumatic bowel movements.

The bleeding associated with anal fissures is usually perceived as bright red and can occur both during and after bowel movements, generally with associated pain.

Inflammatory bowel diseases, such as ulcerative colitis and Crohn’s disease, are also common causes. In these conditions, the lining of the gastrointestinal tract becomes inflamed and ulcerated, resulting in bleeding that may be mixed in the stool or appear as distinct red spots.

Other causes include the presence of colorectal polyps, abnormal growths on the wall of the colon or rectum that can bleed when irritated or injured.

Colon cancer, although less common, can also manifest as bleeding in the stool, often accompanied by other symptoms such as changes in bowel habits, abdominal pain, and unexplained weight loss.

On the other hand, upper gastrointestinal hemorrhages, such as peptic ulcers in the stomach or duodenum and esophageal varices (dilated veins in the esophagus), can also result in the occurrence of the problem.

In these cases, the bleeding may appear in the form of dark, foul-smelling stools, known as melena, due to the partial digestion of blood in the upper gastrointestinal tract.

Diagnosing the underlying cause of blood in the stool

Diagnosing the underlying cause of bleeding in the stool is a comprehensive process that usually involves a thorough medical evaluation and a variety of diagnostic tests.

The doctor will begin the diagnostic process by conducting a detailed clinical history, during which he or she may ask about the frequency and amount of blood, the presence of other associated symptoms such as abdominal pain, changes in bowel habits or unexplained weight loss, and the patient’s medical history.

After the initial interview, the doctor will perform a complete physical examination, including an anal and rectal exam, to assess the presence of hemorrhoids, anal fissures, or other abnormalities in the rectum and anus.

Depending on the clinical findings and the doctor’s suspicion, a series of diagnostic tests may be requested.

Blood tests may be performed to assess blood cell counts, liver function, and iron levels, which can provide clues about the cause of gastrointestinal bleeding.

In addition, specific tests, such as the fecal occult blood test, can be used to detect the presence of blood that is not visible to the naked eye.

For a more detailed assessment of the colon and rectum, the doctor may recommend a colonoscopy or sigmoidoscopy.

During these procedures, a flexible tube with a small camera on the end is inserted into the rectum to examine the inside of the colon and identify any abnormalities, such as polyps, inflammation, or tumors.

To evaluate the upper gastrointestinal tract, such as the esophagus, stomach, and duodenum, an endoscopy may be performed.

This procedure involves passing a flexible endoscope through the throat to the upper gastrointestinal tract to view the inner lining and identify possible sources of bleeding, such as ulcers or varices.

In some cases, a computed tomography (CT) scan or other imaging tests may be requested to provide a more comprehensive view of the gastrointestinal tract and help identify any structural abnormality that may be causing the bleeding.

Overall, diagnosing the underlying cause of the problem is a process that requires a comprehensive and collaborative approach between doctor and patient.

The goal is to identify the specific condition responsible for the symptom so that appropriate treatment can be initiated.

Preventive measures to reduce the risk of blood in the stool

There are various preventive measures that can be adopted to reduce the risk of bleeding in the stool and promote intestinal health.

Although not all causes of this symptom are preventable, it is possible to take some steps to minimize the risk and maintain a healthy gastrointestinal tract.

One of the main preventive measures is to maintain a balanced diet rich in fiber.

Foods such as fruits, vegetables, whole grains, and legumes are excellent sources of fiber, which help promote digestive health, facilitate the passage of stool, and reduce the risk of constipation.

A diet low in fiber can contribute to the formation of hardened stools, thus increasing the likelihood of irritation of the lining of the colon and rectum, which can lead to bleeding.

It is essential to stay adequately hydrated by drinking plenty of water throughout the day.

Proper fluid intake helps to soften the stool, facilitating its passage through the gastrointestinal tract and reducing the risk of constipation and straining during bowel movements.

Avoiding excessive straining during bowel movements is also important to prevent bleeding. Straining too much during defecation can increase pressure on the veins in the rectum and anus, thereby increasing the risk of hemorrhoids or anal fissures.

Therefore, it is essential to adopt a relaxed posture during the act of evacuating and not to prolong the time in the bathroom.

Beyond these lifestyle measures, regular screening for colon cancer is a necessary preventive strategy.

Early detection and timely treatment of colorectal polyps or other pre-cancerous changes can help prevent the development of colon cancer and reduce the risk of bleeding associated with this condition.

When to seek medical help for blood in the stool?

It is crucial to understand when to seek medical help for a complete evaluation and appropriate treatment. There are certain signs and symptoms that indicate the need for immediate medical assistance.

If you notice blood in your stool and it is accompanied by other concerning symptoms, such as intense abdominal pain, unexplained weight loss, dark and tarry stools (melena), dizziness or fainting, you should seek medical help immediately.

These symptoms may indicate a more serious condition, such as significant gastrointestinal hemorrhage, peptic ulcer, or colorectal cancer, which requires urgent medical intervention.

If the bleeding persists for more than a few days or becomes frequent, it is important not to delay seeking medical consultation, as it may be a sign of an underlying condition that requires investigation and appropriate treatment, such as inflammatory bowel disease, colorectal polyps, or colon cancer.

It is essential to emphasize that the problem should never be ignored or underestimated, even if it is mild or intermittent.

If you notice any change in your stools, including the presence of blood, it is important to seek medical evaluation to determine the cause and receive appropriate guidance.

Blood in the stool can be a symptom of various medical conditions. It is crucial not to ignore this situation and to seek appropriate medical assistance for a complete evaluation.

With early diagnosis and appropriate treatment, many of the underlying conditions can be successfully managed. Always remember that early detection is key to a better prognosis!

Image by benzoix on Freepik

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Doutor em Gastroenterologia pela FM-USP.
Especialista em Cirurgia do Aparelho Digestivo (HCFMUSP), Endoscopia Digestiva (SOBED) e Gastroenterologia (FBG).
Professor do curso de Medicina da Fundação Educacional do Município de Assis - FEMA.
Médico da clínica Gastrosaúde de Marília.


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