Blood in stool is often discovered with some fright, accompanied suitably by exclamations of bloody (not the expletive but the adjective). Scarlet red blood droplets coat the feces. Toilet tissue is spotted by crimson red drops of blood. Down the legs and into the toilet bowl drips bright red spots of blood. Quite naturally, alarm bells ring and cause a sudden pang of perplexity.

No undue panic is justified yet as the hemorrhaging (technical word for bleeding) could be any one of 7 possible causes originating in the colon. Whilst the 7 causes will be annoying, they are healable with diligent attention to ensure early diagnosis and appropriate treatment. But complacency is not being advocated. Start tracking. Without delay, consult your doctor if bleeding and pain persists for over a week. 

Applicable treatment can be rendered to resolve the problem once accurate diagnosis pinpoints the exact ailment. More alarmingly, blood in stool may be caused by some form of cancer. 

Melena or Hematochezia

Whilst normally known as rectal bleeding, medically it is categorized as hematochezia (bright red or maroon colored blood) or melena (black sticky or tarry stools). Though so called because the blood exits the body via the rectum, the 7 causes may originate in the small or large (colon) intestinal tract. Cancer, colon polyps, diverticulosis, Crohn’s disease, ulcerative colitis, intestinal ischaemia and peptic ulcer are the 7 known causes in the colon. 

Colorectal Cancer

With an annual global fatality toll of 640,000, colorectal cancer ranks as the 3rd leading cancer and also the 3rd most frequent reason behind death. For this very reason one must see a doctor for constant blood in stool.

Colorectal cancer counts among them cancerous tumours in the colon, rectum and appendix. Surgical excision and chemotherapy are standard treatment for colorectal cancer which is usually identified by colonoscopy (visual inspection by micro-camera introduced via the anus. Total healing is possible with early discovery. Higher risk groups encompass those over 50 years of age and those with family history of cancers. Colorectal cancer is gender blind, afflicting both men and women, with no clear bias for either sex.. 

It is critical to be aware of this next bit of information. Contrary to popular internet literature, colorectal cancer normally results in occult (invisible to the naked eye) blood in feces i.e it is NOT a typical reason for visible blood in stool! According to the University of Michigan Health System, colorectal cancer does cause bleeding but special tests are needed to authenticate the presence of occult blood. Constipation, diarrhea, abdominal pain, appetite loss, weight loss and constant fatigue are accompanying symptoms to be alert to. 

Colon Polyp

Raised or flat, polyps are usually benign growths on the rectum or intestinal walls. Polyps have a predisposition to occur in those over 50 and with a family history of colorectal cancer and polyps. Contributory factors include lack of exercise, obesity, alcohol and smoking. So it seems that the true cause is unknown. 

For safety sake, benign polyps are commonly removed during colonoscopy as they may turn malignant. Most with polyps demonstrate few or no symptoms at all|Symptoms may not be demonstrated at all in the majority of who have polyps|Polyps do not usually cause evident symptoms. But in others, blood in stool is present.  

Diverticulosis 

Diverticulosis causes pouches (diverticula) to stretch out of the colon wall. Diverticula growth is deemed to be due to abnormal colon pressure, the causes of  which are not entirely distinct. Inadequacy of dietary fiber is believed to be a contributory factor. Diverticulitis is an infection that may arise if food gets embedded in diverticula. Further damage can arise if the infected diverticulum breaks to disseminate bacteria to the abdominal lining. The conceivably deadly peritonitis can materialise. 

The majority of people with diverticulosis do not report any symptoms at all. Some may be burdened with symptoms of constipation, bloating and mild cramps. Nausea, vomiting and rectal bleeding are the more serious symptoms. The prospect of peritonitis attest to the urgency that blood in stool should first be examined by a doctor. Diverticulitis can be efficaciously diagnosed with a CT (computed tomography) scan. 

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 by itself is a normal bodily reaction to heal damaged tissue. Inflammation must not be too little or too much, for if not aborted, it can proceed to cause impairment to the very tissue it has healed. Ulcers or erosion of the mucous membrane lining can erupt leading to colitis in the colon. 

Among other symptoms, blood in stool is common. The risk of peritonitis from colitis is the key reason for confirming it as the cause of rectal bleeding.  

Crohn’s Disease 

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

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

Sporadically recurrences right through life or permanent remission both distinguish Crohn’s disease, also referred to as granulomatous colitis. As of now, there is no known surgical or pharmaceutical solution for Crohn’s disease. Early diagnosis is essential for effective control of the symptoms and averting recurrences. 

Intestinal Ischemia 

Ischemia is a suppression in blood supply to any part of the body. Usually due to dysfunctional arteries, it results in tissue damage from denial of oxygen and nutrients. Ischemic colitis or intestinal ischemia is the inflammation of the large intestine from the inadequacy blood supply which arise from low blood pressure, blood vessel constriction or blood clots. 

Symptoms include blood in stool, abdominal bloating, abdominal cramps, violent bowel movements, nausea, fever and weight loss. The rejuvenation of intestinal blood supply is a medical emergency if there is continual pain. Surgery may be needed to excise injured tissue, blockages and blood clots and to get around blocked blood vessels. To forestall clots and infections, respective medication includes anticoagulants and antibiotics. 

Peptic Ulcer 

This is an intensely painful ulcer in the gastrointestinal tract. At least 0.5cm in diameter, an ulcer is an erosion of the mucosal membrane. Contrary to popular belief, peptic ulcers generally occur not in the stomach but in the duodenum or the initial part of the small intestine. A bacterium that inflicts chronic gastritis is presumed to be a primary reason for peptic ulcers. 

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. Possibly deadly peritonitis, which needs emergency surgery, can manifest. Treatment of easier cases includes antibiotics to fight the bacteria and antacids to moderate the acidity.

Hemorrhoids 

Rectal bleeding may result from any of the above 7 causes and only detailed diagnosis by a doctor can conclude the exact one, if any. Full recovery can be effected with correct treatment, perhaps surgery, and medication. 

Take heart if the above somber causes have startled you; for the most prevalent cause of blood in stool is simply internal and 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.