Medical knowledge about stool bleeding
Ten hospitals chunqiu
Under normal circumstances, people will be a little flustered when they find bleeding in stool or blood on toilet paper. Some people were surprised when they found blood in their stool during physical examination. In fact, blood in the stool does not mean that there is a serious disease. Here are some reasons for bloody stools. And some treatments you should do after you find blood in the stool; or if you go to the doctor because of the blood in the stool, the doctor will tell you to do something to find out which part of the body is wrong in time and need to deal with it in time.
What is particularly stated here is that some people have had stool bleeding but did not notice or realize it. In fact, some patients have symptoms such as abdominal pain, vomiting, physical weakness, poor breathing, diarrhea, and weight loss. These symptoms are related to stool bleeding of different causes/locations, length of bleeding and severity of bleeding.
1. Causes of blood in stool
There is no doubt that blood in the stool means that there is bleeding somewhere in the digestive tract. But sometimes the amount of bleeding is very small, and the blood hidden in the stool can only be found through the occult blood test in the hospital; other blood stains are found in the toilet paper or toilet ware after going to the toilet. But sometimes when bleeding in the upper part of the digestive tract, the stool will be black or have a tarry color.
In summary, the causes of blood in stool are roughly as follows:
① Hemorrhoids. Most internal hemorrhoids or mixed hemorrhoids are manifested by the appearance of blood on toilet paper or sanitary ware after defecation, and there is no other discomfort except for the panic in the heart. Hemorrhoids are mainly caused by the excessive expansion and sagging of the venous vascular plexus that closes the anus. When it is damaged, there will be blood in the stool.
②Polyps or cancer. Polyps are benign diseases, but they will grow up, bleeding, and of course cancerous. Colorectal cancer is currently a very common tumor in China. It often causes bleeding in the stool, but sometimes it is not detected by the naked eye.
③Anal fissure. The small laceration that appears on the anus is a bit like a crack in the lips. Anal fissures are mostly caused by the frequent removal of dry and hard stools, and the pain is obvious when the stool is relieved.
④ Enteritis. It is caused by inflammation of the colon. The most common cause is intestinal infection or inflammatory bowel disease.
⑤Diverticular disease. On examination, there are small pockets bulging from the colon wall. On the cross section of the diseased colon, you can see the ears protruding from the head of Mickey Mouse. Diverticulum is usually not serious, but sometimes bleeding or infection occurs.
⑥ Peptic ulcer. It is an ulcer that appears along the lining of the stomach or duodenum. Many peptic ulcers are caused by bacterial (Helicobacter pylori) infection. In addition, long-term or high-dose anti-inflammatory and analgesic drugs such as aspirin, ibuprofen and naproxen can also cause ulcers.
⑦ Vascular malformations. Deformed abnormal blood vessels are easy to rupture and cause bleeding.
⑧ Esophageal diseases. Esophageal varices or torn esophagus can cause severe bleeding.
2. Diagnosis of stool bleeding
If you have stool bleeding, seek medical attention in time to check the cause of the bleeding. And to provide as detailed a medical history as possible, this will help the doctor diagnose the bleeding site. For example, black stools or tarry stools may be peptic ulcers or other upper gastrointestinal problems; bloody stools or purple sauce-colored stools indicate that the location of the disease may be in the lower digestive tract, such as hemorrhoids Colonic diverticulitis and so on. After the doctor asked about the medical history and physical examination, there will be some auxiliary examinations to determine the cause of the bleeding.
The common inspections are summarized as follows:
Esophageal gastroduodenal endoscopy. The inspection process is to send the head tube with camera function, that is, the endoscope, through the mouth, esophagus, and into the stomach and duodenum for observation. Through this inspection device, the doctor can find the bleeding site. Under the endoscopy, the doctor can also take a part of the tissue sample for examination (that is, a biopsy).
Colonoscopy. The procedure is similar to that of esophagogastroduodenoscopy, except that the entire colon is observed through the anus, and tissue biopsy can also be done.
Enteroscopy. The procedure is similar to that of a gastroscopic colonoscopy and can be used to examine the small intestine. Sometimes a capsule endoscope is used, that is, a capsule with a camera function is swallowed. When the capsule passes through the digestive tract, images of the small intestine are taken to check the bleeding site.
X-ray barium examination. By using the contrast material barium, the image of the digestive tract is displayed under X-ray. The barium can be swallowed directly or injected into the rectum.
Gastric lavage. This test is mainly to tell the examiner whether it is the upper gastrointestinal or lower gastrointestinal bleeding. The inspection process is to insert a thin tube into the stomach through the nose to suck out the stomach contents. If the bloody contents are not sucked out of the stomach, the bleeding may have stopped or bleeding in the lower gastrointestinal tract.
Radionuclide scan. After a small amount of radioactive substance is injected intravenously, special imaging equipment is used to observe the specific bleeding site as the blood flows through the gastrointestinal tract.
Angiography. Special contrast agent is injected intravenously, and blood vessels are observed by X-ray or CT. The place where the contrast agent leaks out of the blood vessel is the bleeding point.
Exploratory laparotomy. The doctor opened the abdominal cavity to check the bleeding site. This method is only used when all other examinations fail to detect the bleeding site.
Other checks. Including blood coagulation function, anemia and the presence of Helicobacter pylori, etc.
3. Treatment of stool bleeding
For acute bleeding, doctors may use different methods. The most common method is to inject a hemostatic agent into the bleeding site under the endoscope, electrocoagulation or laser to stop the bleeding, or use a hemostatic clip to clamp the bleeding blood vessel. If the endoscope cannot stop the bleeding, the doctor will use angiography to close the bleeding blood vessels with drugs.
In addition to the control of acute bleeding, treatment should also be directed to the cause of bleeding to prevent recurrence. For example, antibiotics are used to treat Helicobacter pylori, drugs are used to control gastric acid secretion, and anti-inflammatory drugs are used to treat enteritis. Surgical treatment of polyps, gastrointestinal tumors, colonic diverticulum or inflammatory bowel disease, etc.
For different causes, some treatments are simple and effective, and patients can deal with them by themselves. Including eating a high-fiber diet, alleviating constipation, effective treatment of hemorrhoids and anal fissures, you can also use warm water to bathe the anus to effectively relieve anal diseases.