Blood in the stool is one of the frequently encountered conditions in the outpatient department of gastroenterology. Patients often come to Dr. Ying Wang to consult about the problem of blood in the stool. In fact, most of the bright red blood drops after the stool are seen in the clinic. Well, in addition to hemorrhoids, there are many other diseases that cause blood in the stool. We need to be alert. I will do a popular science here.
The blood is discharged from the anus, and the stool color is bright red, dark red, and tarry (black stool), which are all called blood in the stool. Its color depends on the location of the gastrointestinal bleeding, the bleeding and the length of time the blood stays in the gastrointestinal tract. Blood in the stool is only a symptom, not a disease. It is more common in lower gastrointestinal bleeding, especially bleeding from colon and rectal lesions, but it can also be seen in upper gastrointestinal bleeding. Hematochezia with bleeding from the skin, mucous membranes or other organs is more common in blood system diseases and other systemic diseases, such as leukemia and diffuse intravascular coagulation. Most patients find that they have blood in their stools. They are terrified and don't know how to cause it. What should I do? Below we will distinguish the color of blood in the stool which is caused by the disease.
1. Bloody stool
(1) Hemorrhoids. Both external hemorrhoids and mixed hemorrhoids can cause fecal bleeding in various stages. Usually, the stool is accompanied by fresh blood or dripping blood after the stool. Internal hemorrhoids can also be accompanied by prolapse of anus during and after stool. External hemorrhoids generally have no stool bleeding. (2) Intestinal polyps are painless stool bleeding. Bleeding during defecation, and stop after defecation, the amount varies. Generally, blood does not mix with feces, or polyps are high in position and large in number, and can also mix with feces. (3) Rectal prolapse may have bleeding during defecation after a long period of illness. (4) Anal fissure blood in the stool, the bleeding method is that there is blood on the side of the stool surface, which does not mix with the stool. Some patients drip blood after defecation, accompanied by anal burning or knife cutting pain during defecation, and pain again after defecation. Most of these patients have a history of constipation.
2. Pus blood/mucus blood in the stool that is discharged from the stool contains both pus (mucus) fluid and blood. Pus (mucus) and bloody stools are often found in tumors and inflammations in the rectum or colon. The following diseases are common:
(1) Colorectal cancer gradually develops stool bleeding with the prolongation of the disease, mostly bloody stools containing pus or mucus. Colorectal cancer is reddish, and colon cancer is darker. Such patients have abdominal distension and indigestion in the early stage, and then have changes in bowel habits and abdominal pain before defecation.
(2) Ulcerative colitis, mucus or pus and blood in the stool, accompanied by pain in the left lower abdomen or lower abdomen.
(3) Intestinal infectious diseases such as bacillary dysentery and amoebic enteropathy.
3. Black stool is also called tarry stool. The stool is black or brown-black. It is one of the most common symptoms of upper gastrointestinal bleeding. If the amount of bleeding is small and the bleeding speed is slow, the blood stays in the intestine for a long time, and the excreted stool is black; if the amount of bleeding is more and the residence time in the intestine is shorter, the discharged blood is dark red; The amount of bleeding is particularly large, and it can be bright red when it is discharged quickly.
4. A small amount of occult blood in the stool (minor amount) of gastrointestinal bleeding will not cause the color of the stool to change, and it is only positive in the stool occult blood test, which is called occult blood in the stool. All diseases that cause gastrointestinal bleeding can cause occult blood in the stool, common ulcers, inflammations and tumors. The fecal occult blood test can detect small (trace) blood components in the stool. Early fecal occult blood of intestinal polyps (cancer) can be positive, and regular fecal occult blood testing is an important way for colorectal tumor screening (primary screening).
Note: It is especially important to point out here that the early symptoms of colon cancer are often not obvious and are often missed. For middle-aged and older patients, medical history and physical examination should be carefully asked. When the following symptoms occur, the possibility of colon cancer should be considered:
1. Recent changes in bowel habits and persistent abdominal pain.
2. The stool occult blood test continues to be positive.
3. Loose stool, or with blood and mucus.
4. The abdomen can be palpable.
5. Unexplained fatigue, anemia, weight loss, etc.
Once suspicious symptoms such as blood in the stool and intestinal dysfunction occur, do not easily conclude that you are suffering from hemorrhoids. Instead, you should consult a specialist in time and do necessary examinations such as digital anus examination, rectal endoscopy, and colonoscopy.