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Blood in stool is often discovered with some fright, accompanied aptly by exclamations of bloody (the adjective, not the expletive). Feces are wrapped with scarlet red blotches of blood. Toilet tissue is stained by maroon red dots of blood. Bright red spots of blood drip into the toilet bowl or down the legs. Quite naturally, alarm bells ring and cause a sudden pang of anxiety.

It is definitely too soon to panic for any number of 7 possibilities could explain the rectal bleeding. Unsettling they will be but the best part of the 7 causes are healable with early detection and the right approach. But complacency is not being advocated. Pay close attention. Visit your doctor without delay if bleeding, with pain, persists for over a week. 

Suitable treatment can be rendered to solve the problem once systematic diagnosis confirms the exact ailment. More crucially, blood in stool may be caused by some form of cancer. 

Hematochezia or Melena

Hematochezia (maroon or bright red colored blood) or melena (black sticky or tarry stools) are two medical categorizations for the less technical term rectal bleeding. Rectal bleeding may leave via the rectum but the root cause may be in the colon (large intestine) or the small intestine. In the colon, the 7 known causes are cancer, colon polyps, diverticulosis, Crohn’s disease, ulcerative colitis, intestinal ischaemia and peptic ulcer. 

Colorectal Cancer

Ranked the 3rd leading cancer on earth, colorectal cancer is also the 3rd leading cause of cancer-related deaths, adding up to 640,000 yearly. It is the reason why one must consult a medical professional for repeated blood in stool.

Tumours in the colon, appendix and rectum are classified as colorectal cancer. Colonoscopy (visual inspection by micro-camera inserted via the anus) is the usual means of spotting colorectal cancer. Treatment focuses on surgical removal and chemotherapy. Timely discovery often leads to a complete cure. Higher risk groups count among them those over 50 years of age and those with family history of cancers. Among the top killer cancers, colorectal cancer afflicts both men and women indifferently.. 

This next point can be extremely vital. Quite the opposite of what is written elsewhere, colorectal cancer routinely produces occult (not visible to the naked eye) blood in feces i.e it is NOT a typical reason for visible blood in stool! Bleeding resulting from colorectal cancer may be visible or occult (unobservable by the  naked eye), necessitating special tests for determination; this based on research by the University of Michigan Health System. Constipation, diarrhea, abdominal pain, appetite loss, weight loss and constant fatigue are associated symptoms to watch out for. 

Colon Polyp

Attaching on the walls of the intestines or the rectum, polyps are in the main benign and may be raised or flat. Those above 50 years of age and with a family history of polyps and colorectal cancer have a preponderance to polyps. The commonplace sedentary lifestyle of too little exercise, obesity, bingeing in fatty foods, smoking and alcohol are blamed as contributors. In truth, the actual culprit has not been confirmed. 

Though of benign origin, some polyps can become malignant so they are generally excised during colonoscopy. Most with polyps show no symptoms at all|Symptoms may not show up at all in the majority of who have polyps|Polyps do not usually cause obvious symptoms. But in some people, blood in stool appears.  

Diverticulosis 

This is the formation of pouches or pockets (diverticula), extending out of the colon wall. Abnormal colon pressure is postulated to be the reason of diverticula growth. Paucity of dietary fiber is believed to be a contributory factor. Infection (diverticulitis) may set in if food gets embedded in the diverticula. Further damage can result if the infected diverticulum ruptures to release bacteria to the abdominal lining. Peritonitis, which is conceivably fatal, can develop. 

Most people with diverticulosis do not see any symptoms at all. Mild cramps, constipation and bloating are some noted symptoms. Yet others suffer more seriously, including nausea, vomiting and rectal bleeding as the most common symptoms. The peril of peritonitis emphasises the need 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 categorized as an inflammatory bowel disease, a group of inflammatory conditions of the small intestine and the large intestine (colon). Inflammation by itself is a positive bodily response to heal wounded tissue. Inflammation must not be too little or too much, for if not stopped, it can proceed to cause damage to the very tissue it has rebuilt. Wearing away of the mucous membrane lining, commonly known as ulcers, can erupt to cause ulcerative colitis. 

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

Crohn’s Disease 

Crohn’s disease is an auto-immune disease whereby the body’s immune system causes harmful inflammation by assailing the gastrointestinal tract. It can arise in any part of of the gastrointestinal tract, from the mouth to the anus. However, the large intestine (colon) and small intestine, are the usual sites~But it typically affects the small and large intestine (colon)~The small and large intestine (colon), however, are the usual afflicted areas.

Contributory causes, though not absolutely identified, include smoking, genetic makeup and industrial environmental exposure. The symptoms are blood in stool, blood in toilet bowl or on toilet tissue, abdominal cramps, severe bloody diarrhea, weight loss and fever.  

Crohn’s disease, also known as granulomatous colitis, can go into abeyance and revert intermittently on a life-long basis. At present, there is no known surgical or pharmaceutical solution for Crohn’s disease. Early detection is vital for effectual management of the symptoms and retarding recurrences. 

Intestinal Ischemia 

Ischemia is a restriction in blood supply to any part of the body. Typically due to dysfunctional arteries, it causes tissue damage from denial of oxygen and nutrients. Ischemic colitis or intestinal ischemia is the inflammation of the large intestine from the lack of blood supply which result from low blood pressure, blood vessel constriction or blood clots. 

Symptoms include blood in stool, urgent and violent bowel movements, weight loss, nausea, diarrhea, abdominal pain and cramps, abdominal bloating and fever. The rejuvenation of intestinal blood supply is a medical emergency if there is continual pain. Surgery may be required to eradicate infected tissue, blockages and blood clots and to bypass blocked blood vessels. Anticoagulants and antibiotics are medications to inhibit blood clots and infections respectively. 

Peptic Ulcer 

An acutely painful ulcer, this is located in the gastrointestinal tract. An deterioration of the mucosal membrane that is at least 0.5cm in diameter is an ulcer. 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 supposed to be a bacterium that inflicts 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. Peritonitis, possibly life-threatening, may manifest and need emergency surgery. Antibiotics and antacids can be used to cure milder cases.

Hemorrhoids 

If any of the 7 above causes is the reason for rectal bleeding, then it can only be concluded by a rigorous diagnosis by a doctor. Prompt recovery can be effected with appropriate treatment, perhaps surgery, and medication. 

Lest you be too unnerved by the above narrated causes, blood in stool is most usually due to the relatively innocuous internal or external hemorrhoids.

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 our site. Do check this out.