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Bright Red Blood in the Stools (Haematochezia): What are the Possible Causes?

man sitting in the toilet with pants down

Bright red blood in the stools is a concerning symptom that can indicate a variety of underlying health issues. While it can be alarming to see blood in your stool, it is important to understand that there are many possible causes, some of which are relatively minor and easily treatable, while others may require more extensive medical intervention. 

In this article, we will explore the possible causes of blood in stools and what you can do if you experience it:

Hemorrhoids

One very common cause of blood in the stools is hemorrhoids. They are swollen congested tissue in the anorectal mucosa that can become irritated or inflamed, causing bleeding during bowel movements (especially when stools are hard and dry).

Hemorrhoids are a common condition, affecting up to 75% of adults at some point in their lives. They can be caused by a variety of factors, including constipation, pregnancy, and obesity. 

In many cases, hemorrhoids can be treated with over-the-counter creams or ointments, as well as lifestyle changes such as increasing fiber intake and staying hydrated, having good bowel habits – i.e., to avoid straining during defecation.

Anal Fissures

Another possible cause of blood in stools is anal fissures. These are small tears in the lining of the anus that can cause pain and bleeding during bowel movements. Anal fissures are often caused by constipation or diarrhea. 

Other less common causes of persistent anal fissures are infective or inflammatory causes. Just like hemorrhoids, anal fissures can be treated with topical creams and ointments, as well staying hydrated and increasing fiber intake. For persistent cases, surgical intervention may be necessary. 

Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease (IBD) is another possible cause of blood in stools. IBD is a chronic condition that causes inflammation in the digestive tract, and includes conditions such as Crohn’s disease and ulcerative colitis. 

In addition to blood in stools, symptoms of IBD can include abdominal pain, diarrhea, and weight loss. Treatment for IBD typically involves a combination of medication and lifestyle changes, and in some refractory cases may require surgery.

Colorectal Cancer

Colorectal cancer is one of the more serious possible causes of blood in stools. Colorectal cancer occurs when abnormal cells grow in the lining of the colon or rectum, and can cause symptoms such as blood in stools, abdominal pain, and changes in bowel habits. 

While colorectal cancer can be a serious and life-threatening condition, it is also highly treatable if caught early. Screening for colorectal cancer is recommended for all adults over the age of (45) 50, and may involve a colonoscopy or other tests.

Other Possible Causes

Other possible causes of blood in stools include diverticular disease,  infections such as salmonella or E. coli; and some side effects of certain medications (e.g. NSAIDS) which result in erosions or ulcerations of the mucosa. 

In some cases, blood in stools may be a sign of a more serious underlying condition, such as a bleeding disorder or a vascular abnormality (angiodysplasia), in the digestive tract. It is important to consult with a healthcare provider if you experience blood in your stools, particularly if the bleeding is persistent or accompanied by other symptoms.

Diagnosis and Treatment

In order to determine the cause of blood in stools, healthcare providers may perform a variety of tests and procedures. These may include a physical exam, blood tests, stool tests, imaging tests such as a colonoscopy or CT scan, or a biopsy to examine tissue samples from the digestive tract. Treatment for blood in stools will depend on the underlying cause, and may involve medication, lifestyle changes, or surgery.

Prevention

It is important to note that not all cases of blood in the stools are cause for concern. In some cases, the bleeding may be caused by minor irritation or injury to the digestive tract, and may resolve on its own without treatment. However, it is always best to consult with a healthcare provider if you experience blood in your stools, particularly if the bleeding is persistent or accompanied by other symptoms.

In order to reduce the risk of developing conditions that can cause blood in the stools, it is important to maintain a healthy lifestyle. This includes eating a balanced diet rich in fiber, staying hydrated, and engaging in regular physical activity. It is also important to avoid smoking and excessive alcohol consumption, as these habits can increase the risk of developing digestive tract disorders.

Conclusion

Blood in the stools can be a concerning symptom that can indicate a variety of underlying health issues. While it can be alarming to see blood in your stool, it is important to understand that there are many possible causes, some of which are relatively minor and easily treatable, while others may require more extensive medical intervention. 

If you experience blood in your stools, it is important to consult with a healthcare provider to determine the underlying cause and receive appropriate treatment. By maintaining a healthy lifestyle and seeking prompt medical attention when necessary, you can reduce your risk of developing conditions that can cause blood in stools and maintain optimal digestive health.

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