Blood in Stool

There are many causes of blood in stool. The main cause is disease of large intestine. The most common presentation is bright red blood in stool In the form of droplets. Its likely to be haemorrhoids or fissure.

⚉Haemorrhoids

Haemorrhoids are distended veins in the anus. If the patient has constipation and pressure is applied during stool passage. This causes increase pressure in vein, which can cause bleed. Patients with haemorrhoids has painless bleed during defecation. Bleeding is in the forms of drops or jet of blood. Blood is separate from the stool. Haemorrhoids are associated with constipation. Haemorrhoids are most common cause of blood in stool.

Treatment

Constipation should be treated. Initial treatment include life style modification, local ointment. Treatment options are local injection, banding, laser therapy, surgery. Haemorrhoids are diagnosed by proctoscopy. Sigmoidoscopy is done to rule out other causes.

⚉Anal fissure

Fissure cause painful defecation with blood in stool. Severe sharp pain in anus during defecation. Line of blood is seen on the stool in case of fissure.

Treatment

Anal fissure are treated by local ointment and by treating constipation. Surgery is done in refractory cases.

⚉Ulcer

If stool is mixed with blood, bleed is likely from rectum and proximal colon. Blood will be darker in colour. Cause will be ulcer, polyp or tumor. It is call Solitary rectal ulcer syndrome(SRUS) is a common cause and is associated with constipation.

Treatment

SRUS is diagnosed by sigmoidoscopy and biopsy. SRUS is treated by local medication and by treating constipation. Infections are common cause of blood in stool.

⚉Infection

Bacteria and virus are common cause of colonic infection. These patients present with short history of pain and diarrhoea.

Treatment

These patients are treated with medical therapy.

⚉Typhoid Fever

Typhoid fever can cause ulcers in small and large intestine and blood in stool.

Treatment

Condition is diagnosed by colonoscopy and treated by injection and APC and clipping.

⚉Ulcerative Colitis

Another cause of blood in stool is ulcerative colitis. Ulcerative colitis present with bloody diarrhoea of long duration. Urgency and incontinence are other symptoms. Stool is liquid and is mixed with blood, mucus and pus.

Treatment

Ulcerative colitis is diagnosed with sigmoidoscopy with biopsy. Ulcerative colitis is treated with medical therapy. Surgery is reserved for few patients

⚉Tumor or Cancer

Another cause of blood in stool is tumor or cancer of large intestine. Large ulcerated polyp and cancer can lead to blood in stool. Colon cancer is common cause of Iron Deficiency Anaemia in elderly.

Treatment

Polyp and cancer are diagnosed by colonoscopy. Benign polyp can be removed during colonoscopy. Cancer are diagnosed by biopsy and are treated by surgery.

⚉Massive bleed

Some patients present with massive bleed and low blood pressure. Diverticulum and vascular lesions are cause of massive bleed. Typhoid, amoebic and bacterial ulcers can cause massive bleed. Patients with massive bleed are admitted and stablized.

Treatment

Massive bleed is treated with colonoscopic intervention or surgery.

⚉Occult

Another condition is stool occult blood positive. Occult blood is not seen by naked eye, but the stool test will be positive for blood. Common cause of stool occult blood positivity is tumor or vascular lesion.

Causes

There are many causes of blood in stool. Cause vary form benign causes to cancer.

Blood in stool should not be ignored. Medical help should be sought. And should be investigated and treated.