Blood in Stool

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What it looks like: a mixing of blood with bowel movements, mak-ing the toilet water red or streaking stool or toilet paper.

Eating certain things can change the color of your stool. Forinstance, beets can turn stool red, while iron pills and bismuth(Pepto-Bismol) can turn stool black.

Your Doctor Visit

What your doctor will ask you about: abdominal pain, changes inbowel habits or stool, mucus or pus in stool, pain with bowel move-ments, nausea, vomiting, heartburn, vomiting blood, bruising,weight loss, dizziness when standing, whether you have had a bari-um enema, proctoscope, or abdominal X-ray done in the past, andwhat they showed.

Your doctor will want to know if you or anyone in your familyhas had any of these conditions: hemorrhoids, diverticulosis, coli-tis, peptic ulcers, bleeding tendency, alcoholism, colon polyps.

Your doctor will want to know if you’re taking any of these med-ications: warfarin (Coumadin), adrenal steroids, aspirin, anti-inflammatory drugs.

Your doctor will do a physical examination including the fol-lowing: blood pressure, pulse, pushing on your abdomen, checking your rectum for hemorrhoids, testing your stool for blood, thoroughskin examination.

WHAT CAN CAUSE BLOOD IN STOOL, AND WHAT IS TYPICAL FOR EACH CAUSE?

In Adults:

Cause: Hemorrhoids/ anal fissure  (See chapter on  Anus Problems.)
What is it: Swollen blood vessels in   the anus or rectum  (hemorrhoids) or tears in the tissue lining the anus (fissures)
Typcal symptoms: Rectal pain, light bleeding

Cause: Angiodysplasia/ diverticular  disease
What is it: Swollen, weakened blood vessels in the colon,   leading to loss of blood
Typcal symptoms: Bright red stool, minimal  pain

Cause: Ulcer (See  chapter on  Abdominal  Pain (Adult).)
What is it: Severe irritation of the   stomach or intestinal   lining
Typcal symptoms: Black, tar-like bowel move- ments, vomiting, burning  upper abdominal pain that  is worse when lying down,sometimes relieved by foodor antacids and made worseby aspirin or drugs such asibuprofen

Cause: Ulcerative colitis
What is it: Inflammation of the   colon and rectum
Typcal symptoms: Low-grade fever (less than 101 degrees F), some painin lower abdomen, bloodmay appear in stools,which are small and notwell-formed, sometimesweight loss

Cause: Gastritis
What is it: Infection of the stomach
Typcal symptoms: Black, tarlike bowel move-ments, vomiting, upperabdominal pain and tenderness

Cause: Esophageal  varices
What is it: Swollen blood vessels in  the esophagus
Typcal symptoms: Black, tar-like bowel move- ments, vomiting, vomitingblood, jaundice (skin tak-ing on a yellowish appear-ance), spiderweblike collection of blood vesselsnear the skin surface

Cause: Intestinal  tumors or polyps
What is it: An abnormal growth of  cells, may begin as a  benign growth (polyp)
Typcal symptoms: Blood in stools, constipation, weight loss, pain

In Fants

Cause: Swallowed  blood
What is it: Occurs while breastfeeding or during delivery
Typcal symptoms: Dark, tar-like stools

Cause: Hemorrhagic  disease
What is it: Excess bleeding
Typcal symptoms: Bruising, bright red blood,  dark, tar-like stools

In Children

Cause: Fissures or  polyps
What is it: Tears in the tissue lining   the anus (fissures) or benign growths (polyps)
Typcal symptoms: Red blood streaks in stool

Cause: Constipation  (See chapter onConstipation (Child).)
What is it: Inability to have bowel  movements
Typcal symptoms: Bright red blood in stool

Cause: Meckel’s  diverticulum
What is it: Tiny pouch located on  the wall of the lower bowel, a vestige from the umbilical cord and fetal intestines; rare
Typcal symptoms: No pain

Cause: Volvulus or  intussusception
What is it: Congenital shift in the   position of the intestine,  which sometimes leads  to obstruction; rare
Typcal symptoms: Vomiting, decrease in  bowel movements, abdominal pain


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