Blood in stool is often discovered with some panic, accompanied appropriately by exclamations of bloody (not the expletive but the adjective). Stools are coated with scarlet red blotches of blood. Maroon red drops of blood spots  the toilet tissue. Down the legs and into the toilet bowl dribbles bright red spots of blood. Quite naturally, alarm bells ring and cause a sudden pang of alarm.

It is definitely premature to panic for any number of 7 possibilities could explain the rectal bleeding. Disruptive they will be but most of the 7 causes are treatable with early detection and the right approach. Be vigilant. Pay close attention. If persistent bleeding and pain drags on for more than a week, consult a doctor immediately. 

Correct diagnosis will confirm the precise ailment so that relevant treatment can be applied to resolve the problem. More alarmingly, blood in stool may be the result of some class of cancer. 

Hematochezia and Melena

Hematochezia (maroon or bright red colored blood) or melena (black sticky or tarry stools) are two medical identifications for the less technical term rectal bleeding. 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. In the colon, the 7 known causes are cancer, colon polyps, diverticulosis, Crohn’s disease, ulcerative colitis, intestinal ischaemia and peptic ulcer. 

Colorectal Cancer

The 3rd most prevalent reason behind cancer-related death, with a yearly toll of 640,000, colorectal cancer is also the 3rd most frequent cancer on a worldwide basis. For this very reason one should visit a medical specialist for constant blood in stool.

Tumours in the colon, appendix and rectum are classified as colorectal cancer. Ascertained primarily via colonoscopy (visual diagnosis with a camera mounted on a flexible tube inserted through the anus), colorectal cancer treatment requires surgical excision accompanied by chemotherapy. Complete healing is possible with early detection. Those over 50 and those with family history of cancers are categorised under the higher risk group. Gender makes no difference as colorectal cancer is among the top death-causing cancers among both women and men.. 

It is vital to know this next bit of information. Quite in contrast to what is reported elsewhere, colorectal cancer typically results in occult (invisible to the naked eye) blood in feces i.e it is NOT a frequent reason for visible blood in stool! The University of Michigan Health System has done research that shows that colorectal cancer may produce blood that is not perceived by the naked eye, i.e. occult bleeding, which can only be determined with laboratory tests. Constant fatigue, appetite loss, weight loss, constipation, diarrhea and abdominal pain are accompanying symptoms to watch out for. 

Colon Polyp

Affixing 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. Smoking, alcohol, obesity and lack of exercise are contributory causal factors. So it seems that the real cause is unknown. 

Although of benign origin, some polyps can become malignant so they are commonly removed during colonoscopy. The majority of with polyps show no symptoms at all|Symptoms may not show up at all in most who have polyps|Polyps do not usually cause discernible symptoms. But in some people, blood in stool occurs.  

Diverticulosis 

Diverticulosis causes pouches (diverticula) to extend out of the colon wall. Abnormal colon pressure is assumed to be the cause of diverticula growth. Ancillary factors include shortage of dietary fiber. If food gets stuck in diverticula, infection may set in causing diverticulitis. Complications from diverticulitis can arise if a diseased diverticulum ruptures and disseminates bacteria to the abdominal cavity lining. The potentially deadly peritonitis can materialise. 

The majority of people with diverticulosis do not note any symptoms at all. Others are vexed by mild cramps, bloating and constipation. Yet others suffer more intensely, including nausea, vomiting and rectal bleeding as the most common symptoms. The dangers posed by peritonitis reaffirm the view that blood in stool should in the first instance be examined by a doctor. A CT (computed tomography) scan is 98% effectual in diagnosing diverticulitis. 

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 is a positive response of the body when its tissues are injured. Tissue mended by the inflammation process can also be damaged by it if the process becomes uncontrolled. Erosion of the mucous membrane lining, i.e. ulcers, can erupt to cause ulcerative colitis. 

Apart from other symptoms, blood in stool is common. Identifying colitis as the cause of rectal bleeding is important as it can result in perforation of the colon and ultimately, peritonitis.  

Crohn’s Disease 

Crohn’s disease is an inflammatory bowel disease but is also an auto-immune disease in which the body’s immune system turns on the gastrointestinal tract causing ruinous inflammation. It can manifest anywhere in of the gastrointestinal tract, from the mouth to the anus. However, the large intestine (colon) and small intestine, are the main sites~But it generally affects the small and large intestine (colon)~The small and large intestine (colon), however, are the main affected areas.

Industrial environmental exposure, genetic makeup and smoking are believed to be contributory causal factors even though exact causes are unknown. 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 throughout life or permanent abeyance both typify Crohn’s disease, also known as granulomatous colitis. Whether pharmaceutical or surgical, there is currently no known medical cure. Early detection is vital for effectual control of the symptoms and inhibiting relapses. 

Intestinal Ischemia 

The suppression of blood supply to any part of the body is termed as ischemia. Tissue damage results due to the denial of nutrients and oxygen by dysfunctional arteries. Intestinal ischemia or ischemic colitis refers to inflammation of the large intestine due to lack of blood supply as a result of 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 restoration of intestinal blood supply is a medical emergency if there is consistent pain. Bypassing blocked blood vessels and removing blood clots and damaged tissue may require surgery. Medications include anticoagulants to stave off blood clot formation and antibiotics to treat infections. 

Peptic Ulcer 

This is an acutely painful ulcer in the gastrointestinal tract. An erosion of the mucosal membrane that is at least 0.5cm in diameter is an ulcer. Peptic ulcers do not manifest in the stomach, contrary to popular belief, but in the duodenum or the initial part of the small intestine. A bacterium that causes chronic gastritis is believed to be a primary cause of peptic ulcers. 

Symptoms include blood in stool (melena), vomiting of blood, appetite and weight loss, bloating, nausea and more seriously, intestinal perforation. This can lead to potentially deadly peritonitis and requires emergency surgery. Acidity and bacteria, in milder cases, can be cured by antacids and antibiotics respectively.

Hemorrhoids 

Narrated above are 7 very good reasons for consulting a doctor for a definite diagnosis when rectal bleeding is experienced. Proper treatment and medication, possibly including surgery, can expedite the path to recovery. 

Having come this far, you may find comfort, ironically, in finding that the most common causes of blood in stool are 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.