Blood In Stool – 7 Possible Causes In The Colon

Bloody (adjective, not expletive) best describes the condition of blood in stool. Bright red spots of blood drip into the toilet bowl or down the legs. Crimson red blood coats the stools. Maroon red blood stains the toilet tissue. Alarm causes our hearts to miss a beat. What gives?

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No panic is called for yet as the reason for the hemorrhaging (technical word for bleeding) could be any one of 7 possible causes. Troublesome to our daily routine but most of the 7 are minor in severity and treatable with the right approach. But complacency is not being advocated. Start monitoring. If bleeding continues over a couple of weeks, and especially if there is persistent pain, visit a medical doctor immediately.

A proper diagnosis will identify the exact cause so that correct treatment can be administered to solve the problem. More critically, blood in stool may be caused by some form of cancer.

Hematochezia or Melena

Medical circles refer to the bleeding as hematochezia (bright red or maroon colored blood) or melena (black colored tarry or sticky stools) or simply the less technically, rectal bleeding. Though termed as such because the bleeding exits the body via the rectum, the 7 causes may have their source in the small or large (colon) intestinal tract. The 7 known causes are cancer, colon polyps, diverticulosis, Crohn’s disease, ulcerative colitis, intestinal ischemia and peptic ulcer.

Colorectal Cancer

This is the third most common form of cancer in the world and the third leading cause of cancer-related death with a fatality toll approximating 640,000 per year. It is the reason why one should see a doctor for persistent blood in stool.

Colorectal cancer includes cancerous tumors in the colon, rectum and appendix. Detected primarily via colonoscopy (visual diagnosis with a camera mounted on a flexible tube inserted through the anus), colorectal cancer treatment involves surgical removal followed by chemotherapy. Early discovery often leads to a complete cure. Higher risk groups include those over 50 years of age and those with family history of cancers. Gender makes no difference as colorectal cancer is among the top 5 death-causing cancers among both men and women.

Another vital piece of information needs to be highlighted. Contrary to popular internet literature, colorectal cancer typically produces occult (not visible to the naked eye) blood in feces i.e it is NOT a common cause of visible blood in stool! According to the University of Michigan Health System, colorectal cancer does cause bleeding but special tests of stools are needed to detect the presence of occult blood. Critical accompanying symptoms to watch out for are constipation, diarrhea, abdominal pain, appetite loss, weight loss and constant fatigue.

Colon Polyp

Polyps are usually benign growths, raised or flat, on the walls of the intestinal tract and the rectum. They are likely to occur in those above 50 years of age, those with a family history of polyps and colorectal cancer. The usual sedentary lifestyle of too little exercise, obesity, over-indulgence in fatty foods, smoking and alcohol are identified as contributors. In short, no one knows the real cause.

Though of benign origin, some polyps can become malignant so they are usually removed during colonoscopy. Most people who have polyps show no symptoms at all. But in others, blood in stool occurs.

Diverticulosis

This is the formation of pouches or pockets (diverticula), extending out of the colon wall. Diverticula growth is believed to be due to abnormal colonic pressure, the causes of which are not entirely clear. A lack of dietary fiber is believed to be a contributory factor. If food gets trapped in diverticula, infection may set in causing diverticulitis. Complications from diverticulitis can result if an infected diverticulum bursts open and spreads bacteria to the abdominal cavity lining. Peritonitis, which is potentially fatal, can develop.

Most people with diverticulosis do not report any symptoms at all. Others suffer from mild cramps, bloating and constipation. Yet others suffer more severely, including nausea, vomiting and rectal bleeding as the most common symptoms. The risks of peritonitis reaffirm the view that blood in stool should first be examined by a doctor. A CT (computed tomography) scan is 98% effective in diagnosing diverticulitis.

Ulcerative Colitis

Colitis is classified as an inflammatory bowel disease, a group of inflammatory conditions of the small intestine and the large intestine (colon). Inflammation in itself is a positive response of the human body to heal itself in the event of an injury to its tissue. But if not terminated upon healing of the damaged tissue, inflammation becomes the cause of further tissue injury. Ulcers or erosion of the mucous membrane lining can erupt leading to ulcerative colitis in the colon.

Among other symptoms, blood in stool is common. Eliminating colitis as the reason behind rectal bleeding is very important as they can become very serious when the colon is perforated.

Crohn’s Disease

Crohn’s disease is classified as an inflammatory bowel disease but is also an autoimmune disease in which the body’s immune system turns on the gastrointestinal tract causing inflammation. It can occur in any part of the gastrointestinal tract, from the mouth to the anus. But it primarily affects the small and large intestine (colon).

Precise causes are not known but it is believed to be due to one or all of several factors including industrial environmental exposure, genetic makeup and smoking. The symptoms are blood in stool, blood in toilet bowl or on toilet tissue, abdominal cramps, severe bloody diarrhea, weight loss and fever.

Known also as granulomatous colitis, Crohn’s disease can go into remission and recur intermittently throughout life. There is no known medical cure, whether pharmaceutical or surgical. Early diagnosis is important for effective control of the symptoms and preventing relapses.

Intestinal Ischemia

Ischemia is a restriction in blood supply to any part of the body. Commonly due to dysfunction in the blood vessels, it results in tissue damage from deprivation of oxygen and nutrients. Intestinal ischemia or ischemic colitis refers to inflammation of the large intestine due to inadequate blood supply caused by low blood pressure, blood vessel constriction or blood clots.

Symptoms include blood in stool, diarrhea, abdominal pain and cramps, abdominal bloating, urgent and violent bowel movements, weight loss, nausea and fever. Persistent pain warrants immediate medical attention to restore regular blood supply to the intestinal tract. Surgery may be needed to remove damaged tissue, remove blockages, remove blood clots and bypass blockage blood vessels. Medications include anticoagulants to prevent blood clot formation and antibiotics to treat infections.

Peptic Ulcer

This is an extremely painful ulcer in the gastrointestinal tract. An ulcer is an erosion of the mucosal membrane that is at least 0.5cm in diameter. Contrary to popular belief, peptic ulcers generally occur not in the stomach but in the duodenum or the initial part of the small intestine. The major cause is believed to be a bacterium that causes chronic gastritis that develops into ulcer formation.

Symptoms include blood in stool (melena), abdominal pain, bloating, nausea, appetite and weight loss, vomiting of blood and at the extreme, perforation of the intestine. This can lead to potentially dangerous peritonitis and requires emergency surgery. Treatment of milder cases includes antibiotics to combat the bacterium and antacids to moderate the acidity.

Hemorrhoids

The above 7 causes are the very reasons why rectal bleeding requires the attention of a medical doctor who can provide an accurate diagnosis. Proper treatment and medication, possibly including surgery, can accelerate the path to recovery.

Ironically, one of the best news the doctor may provide is that the cause of blood in stool is nothing more than hemorrhoids. Both internal and external hemorrhoids are, by and large, the main causes of rectal bleeding.

Further Reading

If you are interested in finding more about this topic, we have a related post on Bowel Movement Bleeding - Six Possible Causes Of Rectal Bleeding at this site. Do check this out.