Last month, a colleague’s father came to our department for examination due to "blood in the stool for half a year". After a digital examination and routine anoscopy, he was found to be hospitalized with a mass of about 2*2 cm in the front wall of the rectum about 5 cm from the anus. Improve other related examinations, and the results show rectal cancer. This is a typical Chinese-style parent with blood in the stool for half a year. Because of fear of causing trouble to the child, he stubbornly carried it down, thinking it was a minor illness, and thus delayed the best treatment time. There are also people who bleed every time they have a bowel movement. They often happen for a few days from time to time, acting like a woman’s aunt, and even being teased about it, so that every time they talk about hemorrhoids, they are ashamed to talk about it. What's more, people who refuse a doctor's examination based on the difference between men and women when seeing a doctor are often encountered clinically.
What should we do if we have blood in the stool?
First of all, I want to tell you that 95% of bloody stool diseases are benign and benign, so you don't have to worry about suspecting tumors at all times. Then let me tell you this, does it make you relax your guard? Of course not. We despise him strategically and we must value him tactically.
Secondly, I want to tell some friends who are overly nervous that when they use toilet paper with blood or a few drops of blood, there is no need to see the emergency department in the middle of the night. The emergency department often encounters people who go to the emergency department at two or three in the middle of the night and tell the doctor: I have a heavy bleeding. As a result, the intestines were clean, no bleeding sites were found, and there were no problems. It may be a small problem with hemorrhoids and anal fissures, and a false alarm. Spending a lot of money, not to mention, it also hurts parents, grandparents, grandparents and grandparents. The seven aunts and eight aunts worry about it! Therefore, there is usually a small amount of bleeding once or twice, so you don't need to go to the emergency department. You can temporarily observe it and go to the clinic the next day or electively. Under what circumstances should I see the emergency department? That's heavy bleeding, or bleeding. How to estimate the amount of bleeding? You can use the disposable cup that you usually use. A cup is about 100ml, and 1ml is about 15-17 drops.
When we encounter heavy bleeding or the bleeding does not stop, of course we should immediately go to the hospital for related examinations to identify the bleeding site and stop the bleeding.
After having a bowel movement, turning our heads and looking, apart from being surprised, we should first remember the color of blood deeply. Is it bright red, dark red, or black. Black stool should be completely black, as black as head and tar. It is called tarry stool, which is mostly upper gastrointestinal bleeding. The red ones are mostly lower gastrointestinal bleeding.
If the stool is black, the bleeding site is from the upper digestive tract. Including bleeding of the esophagus, stomach, duodenum, pancreas and biliary tract. Medium ulcer disease accounts for about half, and esophageal and gastric varices account for 25%. In recent years, cases of acute hemorrhagic gastritis and erosive gastritis with bleeding have also occurred. In about 5% of cases, the bleeding lesions have not been determined, and even the cause of bleeding cannot be found even with laparotomy. Its clinical manifestations are mainly hematemesis and melena, often accompanied by clinical manifestations of hypovolemia, which are common emergencies.
The red blood indicates that the bleeding site is not too far from the anus, and the blood stays in the intestine for not very long. If the blood is dripped, the blood must be the lower digestive tract, and it is the intestinal bleeding that is closer to the anus. If it is farther away, the blood will be dark red, and farther away will be black. When dripping out, the bleeding site must be a few cm away from the anus, not more than 10 cm. It is common in hemorrhoids, rectal polyps, and anal fissures.
If it is dark red, it is often accompanied by blood clots, which are more common in lower gastrointestinal bleeding, such as colorectal polyps, rectal bleeding, etc.;
The second issue to pay attention to with blood in the stool is to observe the amount of bleeding. A small amount of bleeding can be temporarily observed, and a large amount of bleeding needs to be checked in time at the hospital.
(For popular science, tell the doctor about bleeding. It is best not to use major bleeding or minor bleeding. It should be quantified. Adults with gastrointestinal bleeding of more than 5mL may have a positive stool occult blood test, and a bleeding of more than 50mL may cause tarry stools. Short-term gastric bleeding can reach 250-300mL can cause vomiting blood. A small amount of bleeding <100ml, a moderate amount of bleeding <400ml, heavy bleeding>600ml, there will be dizziness, palpitation, fatigue and other uncomfortable symptoms.)
Bleeding from anal fissures is bright red and is more common on the surface of dry stool or stained on toilet paper. There is less bleeding and jet-like bleeding is rare. An anal canal skin crack can be seen under anoscopy.
The blood is bright red and there is no pain. It is more common in hemorrhoids. Hemorrhage is often caused by the hemorrhoids being rubbed by the stool. The blood may drip or eject;
Rectal polyps (within about 8cm) can be palpable with spherical masses on the anus. Hard, pedicled, if it is a sessile polyp, clustered particles will be touched in the rectal department, and a low-position pedicled polyp will have a high degree of palpation. It is easy to protrude outside the anus during defecation, and may be accompanied by blood in the stool.
Patients with rectal cancer may have irregular bowel movements in the early stage, and the feeling of incomplete defecation is obvious. Immediately appear tenesmus, loose stools, pus blood or mucus inside, blood in the stool purple-brown or dark red, mixed blood and stool, and heavy bleeding may occur if the tumor falls off. On digital anus examination, the palpable surface is rough and uneven, showing a cauliflower shape. The mass is connected to the intestinal wall, is hard, has poor mobility, and the finger cuff is stained with blood.
There are so many problems with blood in the stool, blood in the stool occurs, what should I do?
1. First, digital anus examination can detect most of the problems of the rectum, which is economical.
2. Anoscopy can reveal rectal and anal problems below 7cm.
3. Proctoscopy revealed problems in the rectum, upper rectum, and part of the sigmoid colon.
4. Electronic fiber colonoscopy can find problems with the whole colon.
Most of the cause of hemorrhoids is bleeding from hemorrhoids. Of course, there are drugs to treat it. In addition, a small amount of bleeding requires surgical treatment. Although the possibility of blood in the stool is only 2% of intestinal malignancies, if you have blood in the stool, do not take it lightly. You must go to the hospital to see a specialist and perform necessary examinations to rule out malignant tumors.
What are the early manifestations of colorectal tumors:
What are the symptoms of people who need colonoscopy to exclude intestinal tumors?
In clinical practice, patients often encounter a small amount of blood in the stool, and worry that they have a tumor. The possibility of intestinal malignant tumor is only 2%. However, if you have blood in the stool, do not take it lightly. You must go to the hospital to see a specialist for treatment and perform necessary examinations to rule out malignant tumors.
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