Blood In Stool

10 January 2025

Find out about the wide range of factors from minor concerns to more serious conditions that could cause the symptom of rectal bleeding.

Introduction

Blood in stool, also known as rectal bleeding, is a concerning symptom characterized by the passage of bright red or maroon-coloured blood from the rectum during bowel movements.

This can manifest as blood on toilet paper, in the toilet bowl, or mixed with stool.

While it may sometimes be due to minor issues such as haemorrhoids or anal fissures, it is essential not to ignore rectal bleeding, especially if it is persistent, recurrent, or accompanied by other symptoms.

By seeking medical attention, undergoing appropriate evaluation, and following your healthcare provider’s recommendations, you can receive timely diagnosis and treatment to address the underlying cause and promote your gastrointestinal health.

Causes of Blood In Stool

Blood in stool can be caused by a wide range of factors, including:

Anal Fissures: Small tears or cracks in the lining of the anus, often caused by passing hard stools, constipation, or straining during bowel movements.
Haemorrhoids: Swollen blood vessels in the rectum or anus, which can bleed during bowel movements, especially if they are irritated or inflamed. Haemorrhoids can be internal or external and may cause pain, itching, or a lump near the anus.
Gastrointestinal Infections: Bacterial, viral, or parasitic infections of the digestive tract, such as gastroenteritis or food poisoning, can cause inflammation and bleeding in the intestines. Infections may be accompanied by symptoms such as diarrhoea, abdominal pain, fever, nausea, or vomiting.
Inflammatory Bowel Disease (IBD): Chronic conditions such as Crohn’s disease or ulcerative colitis can cause inflammation and ulceration in the digestive tract, leading to rectal bleeding, diarrhoea, abdominal pain, fatigue, weight loss, and other symptoms.
Diverticular Disease: Diverticula are small pouches that develop in the colon, particularly in older adults. When these pouches become inflamed or infected (diverticulitis), they can cause rectal bleeding, abdominal pain, fever, changes in bowel habits, and other symptoms.
Colorectal Polyps: These are abnormal growths or precancerous lesions that can develop in the colon or rectum. While most polyps are harmless, some can bleed, especially if they are large, located near the anus, or become cancerous over time.
Colorectal Cancer: Malignant tumours in the colon or rectum can cause rectal bleeding, changes in bowel habits (such as diarrhoea or constipation), abdominal pain, fatigue, unintended weight loss, and other symptoms. Colorectal cancer is more common in older adults but can occur at any age.

When to Seek Medical Attention

While rectal bleeding may sometimes be due to minor causes such as haemorrhoids or anal fissures, it is essential to seek medical evaluation if you experience any of the following:

Rectal bleeding that is persistent, recurrent, or increases in severity, especially if it is accompanied by other symptoms such as abdominal pain, changes in bowel habits, or unexplained weight loss.
Blood in stool that is dark or black in colour, which may indicate bleeding higher up in the digestive tract, such as the stomach or small intestine. This type of bleeding is known as melena and can be a sign of a serious medical condition.
Severe rectal bleeding, dizziness, light-headedness, or fainting, which may indicate significant blood loss and require urgent medical attention. This type of bleeding is known as hemodynamic instability and can be life-threatening if not promptly treated.
Rectal bleeding in children or elderly individuals, or if you have a history of gastrointestinal conditions, bleeding disorders, or colorectal cancer. These populations may be at higher risk of complications and require specialized evaluation and management.

Diagnosis and Treatment

If you experience rectal bleeding, your healthcare provider will perform a thorough evaluation to determine the underlying cause, which may include:

Medical History and Physical Examination: Your doctor will ask about your symptoms, medical history, medications, and lifestyle factors, followed by a physical examination, including a digital rectal examination (DRE) to assess the rectum and anus.

Diagnostic Tests: Depending on your symptoms and risk factors, your doctor may order additional tests such as stool tests (faecal occult blood test, faecal immunochemical test), blood tests (complete blood count, coagulation studies), colonoscopy, sigmoidoscopy, or imaging studies (such as CT scans or MRI) to evaluate the gastrointestinal tract and identify the source of bleeding.

Treatment Options

Treatment for rectal bleeding depends on the underlying cause and severity of symptoms, and may include:

Medications: Depending on the cause of bleeding, your doctor may prescribe medications such as stool softeners, fiber supplements, anti-inflammatory drugs (such as mesalamine or corticosteroids), antibiotics, or medications to treat underlying conditions such as IBD or colorectal cancer.

Lifestyle Modifications: Making dietary changes, increasing fiber intake, staying hydrated, and avoiding straining during bowel movements can help prevent or alleviate rectal bleeding caused by conditions such as haemorrhoids or constipation.

Procedures or Surgery: In some cases, procedures such as rubber band ligation, sclerotherapy, or surgical removal may be necessary to treat haemorrhoids, polyps, or other structural abnormalities causing rectal bleeding. For more serious conditions such as colorectal cancer or diverticular bleeding, surgical intervention may be required to remove the affected tissue or stop the bleeding.

Prevention and Follow-Up

While some causes of rectal bleeding may not be entirely preventable, you can take steps to reduce your risk by:

Maintaining a healthy lifestyle, including a balanced diet rich in fruits, vegetables, and fiber to promote regular bowel movements and prevent constipation. Dietary fiber can help soften stools and reduce the risk of straining during bowel movements, which can aggravate haemorrhoids and other anal conditions.
Staying hydrated by drinking plenty of fluids, especially water, to prevent dehydration and maintain soft, bulky stools that are easier to pass. Adequate hydration can also help prevent constipation and reduce the risk of anal fissures and haemorrhoids.
Avoiding straining during bowel movements and practicing good toilet habits, such as taking your time, using a footstool to elevate your feet, and avoiding prolonged sitting on the toilet. Straining can increase pressure on the veins in the rectum and anus, leading to haemorrhoids or rectal prolapse.
Seeking prompt medical attention if you experience rectal bleeding or other concerning symptoms, especially if you have a family history of gastrointestinal conditions or colorectal cancer. Early detection and treatment can improve outcomes and reduce the risk of complications associated with rectal bleeding.

Arranging To Visit A Private GP

To discuss any issues related to blood in the stool make an appointment with one of our private GPs. Appointments are available to everyone and can often be booked for the same day. There is no need to be registered with our Buckinghamshire hospital, or live locally.

Should you have insurance which covers a GP visit, we can in most cases invoice. Where you are paying directly, the cost for a 30 minute consultation is £125.

Any additional costs will always be discussed. They could apply if you are referred for an MRI scan, or to a consultant, or for other agreed decisions to support your health.

Our Resident Private GP

Dr Chamali is welcoming and highly experienced. He offers his patients sound diagnosis and treatment, along with individual care focused on their future health.