Author: Fu Wei
The so-called blood in the stool is bleeding in the stool, including the common people often say "blood in the stool", "anal bleeding", "pus and blood in the stool" and "black stool", etc., refers to the bleeding of the digestive tract through the anus, usually manifested as stool Blood, or all blood, bright red, dark red, or tarry stool.
It is more common in lower gastrointestinal bleeding, including bleeding in the colon, rectum, and anus. It can also be seen in upper gastrointestinal bleeding.
1. The color of blood in the stool initially determines the disease
Generally speaking, we can preliminarily judge the lesion in the digestive tract that caused the blood in the stool by simply using the color of the blood in the stool.
Blood in the stool-"bright red"
Bright red blood in the stool considers the benign lesions of the anal canal and rectum, and is generally more common in hemorrhoids, anal fissures, proctitis, rectal prolapse, ulcerative colitis (rectal lesions), colorectal polyps, foreign bodies in the colon or anus, trauma, etc. To.
In stage I and stage II hemorrhoids, hemorrhoid bleeding often manifests as bloody blood in the stool, painless blood in the stool, manifested as fresh blood on the surface of the stool, which does not mix with the stool, or dripping after stool, or bleeding from the anus when squatting. Stage Ⅱ is severe or stage Ⅲ and above, not only manifested as blood in the stool, but also with varying degrees of prolapse of mass after stool.
The blood in the stool caused by anal fissure is usually attached to the side of the stool surface. Some patients drip blood after the stool, or the toilet paper is bloody. It is often accompanied by anal tear-like pain during defecation. This pain is "pain-intermittent-pain intensified". In clinical medicine, it is called "periodical pain", which is usually induced by constipation, which is mutually cause and effect and influence each other.
In patients with proctitis and ulcerative colitis, the blood in the stool is usually manifested as irregular or formed stools, and the blood is attached to the surface of the stool. Usually the patient has irregular stools, frequent stools, and tenesmus. Colonoscopy can be done to confirm the diagnosis. .
Rectal prolapse patients usually manifest as repeated prolapse of the rectum and even the sigmoid colon, accompanied by bleeding during the stool, fresh blood, and other symptoms such as anal dampness, itching, and swelling pain.
Hematochezia caused by colorectal polyps is mostly painless stool bleeding. It usually manifests as bleeding during stool, which does not mix with stool, and stops after defecation. The amount of bleeding varies, but if the position of the colorectal polyp is higher, it can also be manifested To mix with feces.
If there is a lot of blood in the stool and the color is bright red, it is necessary to consider massive bleeding in the digestive tract, or massive bleeding caused by trauma to the rectum and anal canal.
Blood in stool-"mucus, pus and blood in stool, dark red"
Patients with this type of hematochezia are mostly manifested as stool bleeding and mixed stool, dark red in color, or accompanied by mucus, or mucus pus and blood in the stool, pay more attention to colorectal inflammation or tumor lesions. Common diseases include inflammatory bowel disease, bacillary dysentery, amoebic enteritis, colorectal cancer and so on. Hematochezia caused by ulcerative colitis is usually manifested as chronic, recurrent abdominal pain, diarrhea, mucus, pus, and blood in the stool, which requires colonoscopy and pathological specimens.
Bacterial dysentery patients present with fever, abdominal pain, diarrhea, mucus, pus, blood in the stool, tenesmus, and stool culture can confirm the diagnosis, and antibiotic treatment is effective.
The stool of patients with amoebic enteritis is dark red jam-like, and amoebic trophozoites and cysts can be found through stool examination. Colonoscopy and biopsy are helpful to confirm the diagnosis.
Blood in the stool caused by rectal cancer is bright red or dark red. Bleeding is generally not mixed with stool. It may be accompanied by mucus, which may be accompanied by changes in stool habits, thin stools, abnormal stools, incomplete defecation, etc., with special foul smell .
The blood in the stool of patients with colon cancer is mostly bloody stool accompanied by pus or mucus, which is dark red, and the bleeding is mostly mixed with stool, and may be accompanied by abdominal masses, abdominal pain, and chronic progressive weight loss.
If there are a large number of dark red blood clots in the stool and no fecal inclusions, consider the cause of massive upper gastrointestinal bleeding.
Blood in the stool-"tar-like stool", "greasy black hair and shiny"
The stools of some patients are dark black, brown-black, and shiny. We call it tarry stool in clinical practice. In this case, it is usually caused by upper gastrointestinal bleeding, such as gastric ulcer, duodenal ulcer, etc. Because the upper gastrointestinal bleeding stays in the intestine for a long time, if the bleeding is slow and the amount is small, the stools discharged are mostly dark black and tarry stools.
2. Blood in the stool, caused by diet?
Clinically, I often encounter some patients who see a doctor due to blood in the stool. It is not blood in the stool caused by gastrointestinal diseases, but changes in the color of stool caused by the consumption of certain drugs, beverages, or foods. Common examples include consumption of animal blood products and pigs. Liver, blood-enriching Chinese medicine, iron-containing multivitamins, and darker vegetables, beverages, etc., this "blood in the stool" can be stopped by changing diet.
To sum up, blood in the stool is not terrible. We understand that we can use the above methods to initially judge our condition. Of course, if we want to further confirm the diagnosis, we need to go to the local regular public hospital in time, and receive targeted treatment after objective assessment of the condition. Program!