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How to Address Blood in Stools: Medical Tests and Procedures

woman sitting in the toilet holding tissue paper

Blood in stools, also known as rectal bleeding or hematochezia, can be a concerning symptom that warrants medical attention. While it can be caused by various factors, including minor issues such as hemorrhoids or more serious conditions like colorectal cancer, prompt evaluation and appropriate testing are essential for accurate diagnosis and treatment. 

This article explores the medical tests and procedures used to address blood in stools, allowing individuals to understand their options and take proactive steps towards better health.

What Causes Blood in Stools?

Blood in stools can result from a range of conditions affecting the gastrointestinal tract. Common causes include:

  • Hemorrhoids: Swollen blood vessels in the rectum or anus can bleed, especially during bowel movements.
  • Anal Fissures: Small tears in the lining of the anus can cause bleeding, often due to passing hard stools.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn’s disease and ulcerative colitis can cause inflammation and ulcers in the digestive tract, leading to bleeding.
  • Colorectal Polyps: Noncancerous growths in the colon or rectum can bleed, especially if they become irritated or inflamed.
  • Colorectal Cancer: Malignant tumors in the colon or rectum may cause bleeding, particularly in advanced stages.

When to Seek Medical Attention

While minor instances of blood in stools may resolve on their own, it’s essential to seek medical evaluation if:

  • The bleeding persists or recurs over time.
  • The blood appears bright red or maroon.
  • You experience other symptoms such as abdominal pain, changes in bowel habits, or unintended weight loss.
  • You have a family history of colorectal cancer or other gastrointestinal conditions.

Medical Tests for Blood in Stools

Physical Examination

A thorough physical examination is the first step in evaluating blood in stools. The healthcare provider will review the patient’s medical history, including any symptoms and risk factors, and perform a physical examination, focusing on the abdomen and rectal area.

Digital Rectal Examination (DRE)

This involves the insertion of a lubricated, gloved finger into the rectum to check for abnormalities such as hemorrhoids, anal fissures, or tumors.

Stool Tests

Stool tests are commonly used to detect the presence of blood and other abnormalities in the stool. These tests can help determine the cause of rectal bleeding and guide further evaluation.

  • Fecal Occult Blood Test (FOBT): This test detects hidden (occult) blood in the stool that is not visible to the naked eye. It involves collecting a small stool sample and sending it to a laboratory for analysis.
  • Fecal Immunochemical Test (FIT): Similar to the FOBT, the FIT detects occult blood in the stool. However, it uses antibodies to specifically detect human blood, resulting in higher sensitivity and fewer false positives.

Imaging Studies

Imaging studies may be recommended to visualize the gastrointestinal tract and identify potential sources of bleeding.

  • Colonoscopy: A colonoscopy is a procedure that allows for direct visualization of the entire colon and rectum using a flexible tube with a camera (colonoscope). It is considered the gold standard for evaluating rectal bleeding and can help identify conditions such as colorectal cancer, polyps, and inflammatory bowel disease.
  • Flexible Sigmoidoscopy: Similar to a colonoscopy but focusing on the lower portion of the colon (sigmoid colon) and rectum, a flexible sigmoidoscopy can identify sources of bleeding in this area.
  • Upper Endoscopy (Esophagogastroduodenoscopy or EGD): This procedure involves the insertion of a flexible tube with a camera (endoscope) through the mouth to visualize the esophagus, stomach, and upper part of the small intestine. It may be recommended if the source of bleeding is suspected to be in the upper gastrointestinal tract.

Treatment Options

Hemorrhoid Treatment

If hemorrhoids are the cause of blood in stools, treatment options may include:

  • Topical Medications: Over-the-counter creams or suppositories containing hydrocortisone or witch hazel can help reduce swelling and discomfort.
  • Sitz Baths: Soaking the anal area in warm water for 10-15 minutes several times a day can alleviate symptoms.
  • Increased Fiber Intake: Consuming more fiber-rich foods or taking fiber supplements can help soften stools and reduce straining during bowel movements.

Medications for Inflammatory Conditions

For conditions like inflammatory bowel disease, medications may be prescribed to reduce inflammation and manage symptoms. These may include:

  • Anti-Inflammatory Drugs: Corticosteroids or other anti-inflammatory medications can help reduce inflammation in the gastrointestinal tract.
  • Immunosuppressants: Drugs that suppress the immune system may be used to control inflammation and prevent flare-ups.

Surgical Intervention

In some cases, surgical intervention may be necessary to address the underlying cause of rectal bleeding. This may include:

  • Hemorrhoidectomy: Surgical removal of hemorrhoids that are large, painful, or causing persistent bleeding.
  • Polypectomy: Removal of colorectal polyps during a colonoscopy to prevent them from becoming cancerous.
  • Colectomy: Surgical removal of part or all of the colon may be necessary for conditions like colorectal cancer or severe inflammatory bowel disease.


Blood in stools is a symptom that should not be ignored, as it can indicate underlying gastrointestinal issues ranging from minor to serious. Medical tests and procedures play a crucial role in evaluating rectal bleeding and determining the appropriate course of treatment. By seeking timely medical attention and undergoing the necessary tests, individuals can address the underlying cause of blood in stools and receive appropriate care to improve their health and well-being.


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