Blood in Stool

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How can I tell if there is blood in my stool?

Blood in your stool may result from bleeding anywhere along the GI tract – from mouth to anus.

Blood in the stool may cause the stool to appear sticky or black, often assuming a tar-like appearance. This is the case if the bleeding arises from the upper organs of the GI tract, like the stomach and esophagus. Other times, bleeding may cause a maroon or burgundy colored stool, or most commonly, you may notice bright red blood in the bowl, or on the tissue when cleaning yourself after a bowel movement. Bright red blood most commonly arises from the colon, rectum and anus.

Is rectal bleeding important?

Often rectal bleeding reflects a minor issue, but it can be very serious. It can be impossible to tell, based on the appearance of the blood, or based on how you feel. Therefore, it is important to get an evaluation if you have blood in your stool or you see blood after having a bowel movement. Gastroenterologists are experts in diagnosing and managing rectal bleeding.

What causes blood in the stool?

The wall of the gastrointestinal tract contains a rich supply of small blood vessels that nourish the organs and transport nutrients. Bleeding into the gastrointestinal tract occurs with the breach of the integrity of one of these vessels.

Rectal bleeding can arise from numerous causes, including:

    • Ulcerations of the GI tract
    • Inflammation of the GI tract, as with Crohn’s Disease or colitis
    • Anal tears (fissures)
    • Hemorrhoidal tears
    • Diverticulosis of the colon
    • Aberrant blood vessels in the wall of the bowel
    • Cancers and benign tumors of the GI tract

How do we diagnose the cause of blood in the stool?

Diagnosis begins with a review of your symptoms, evaluation of your personal and family medical histories, and a physical exam. We will often do blood and stool tests, and then typically need to examine inside your upper or lower digestive tracts – or both – typically by endoscopy and colonoscopy. In some instances, we will proceed to further imaging, such as small bowel capsule endoscopy or CT scan. In most cases, we are able to discern the origin/site of bleeding immediately, but in others, we must perform extensive testing and do repeated exams.

What is the Difference between Upper Endoscopy vs. Colonoscopy?

An upper endoscopy evaluates the health of your upper digestive tract, from the esophagus through the stomach to the upper portion of your small intestine.

A colonoscopy assesses the condition of the lower part of your digestive system, including your colon (also called your large intestine) rectum and anus.

How do we treat GI tract bleeding?

Treatment depends on the underlying cause of bleeding, as well as the severity of the bleeding. In some cases, bleeding we managed with medication, such as medicines used to treat an ulcer or topical ointments to treat hemorrhoids. In other cases, we obliterate the “culprit” blood vessel with cautery or a clip during an endoscopic procedure. We will sometimes engage the help of a colorectal surgeon, who possesses special expertise with bleeding hemorrhoids, anal fissures, or medically and endoscopically uncontrollable bleeding.

By: New York Gastroenteroloy

Reviewed by: Daniel Adler, MD

Published: Dec 10th, 2020

Last Reviewed: Apr 2nd, 2021

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