Blood In Stool - Seven Root Causes In The Colon

Blood in stool is often discovered with some panic, accompanied aptly by exclamations of bloody (not the expletive but the adjective). Scarlet red dots of blood cover the feces. Toilet tissue is spotted by crimson red dots of blood. Down the legs and into the toilet bowl streams bright red spots of blood. A sudden surge of consternation causes our hearts to miss a beat or two.

Fright is understandable but panic is unnecessary at this stage as the rectal bleeding or hemorrhaging could be ascribed to any of 7 possible causes emanating from the colon. Diligent attention to ensure early detection and proper treatment will alleviate any upsetting lifestyle changes as most of the 7 causes are healable. But complacency is not being advocated. Begin monitoring closely. Visit your doctor without delay if bleeding, with pain, drags on for over a week. 

Appropriate treatment can be administered to solve the problem once correct diagnosis discovers the precise illness. More critically, blood in stool may be the result of some form of cancer. 

Melena or Hematochezia

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 exit via the rectum but the root cause may be in the colon (large intestine) or the small intestine. 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 a yearly international fatality toll of 640,000, colorectal cancer ranks as the 3rd most prevailing cancer and also the 3rd leading cause of death. It is the reason why one should see a medical professional for incessant blood in stool.

Tumours in the colon, appendix and rectum are classified as colorectal cancer. Found usually via colonoscopy (visual diagnosis with a camera mounted on a flexible tube inserted through the anus), colorectal cancer treatment requires surgical excision followed by chemotherapy. Despair not for full recovery is possible with timely discovery. Higher risk groups count among them 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 apparent bias for either sex.. 

It is important to know this next bit of information. Contrary to popular internet literature, colorectal cancer commonly produces occult (not visible to the naked eye) blood in feces i.e it is NOT a regular cause of visible blood in stool! Bleeding caused by colorectal cancer may be visible or occult (unseen by the  naked eye), necessitating special tests for diagnosis; this based on work done by the University of Michigan Health System. Constipation, diarrhea, abdominal pain, appetite loss, weight loss and constant fatigue are accompanying symptoms to be alert to. 

Colon Polyp

Usually benign, polyps are raised or flat growths on the intestinal or rectum wall. Polyps have a preponderance to develop in those over 50 and with a family history of colorectal cancer and polyps. Smoking, alcohol, obesity and lack of exercise are contributory causal factors. So it seems that the actual culprit is unknown. 

For safety sake, benign polyps are normally removed during colonoscopy as they may become malignant. Most people who have polyps demonstrate no symptoms at all. But in some people, blood in stool present itself.  

Diverticulosis 

Pouches (diverticula) extending from the colon wall is characteristic of diverticulosis. The reasons behind diverticula, whilst unknown, are presumed to be primarily abnormal colon pressure. A deficiency of dietary fiber is believed to be an ancillary factor. Infection (diverticulitis) may set in if food gets trapped in the diverticula. If a diseased diverticulum ruptures, bacteria will disseminate into the abdominal cavity leading to threatening complications. Peritonitis, which is possibly deadly, can develop. 

Diverticulosis do not cause distinct symptoms in many people. Others are beset by mild cramps, bloating and constipation. Yet others suffer more acutely, including nausea, vomiting and rectal bleeding as the most common symptoms. The dangers posed by peritonitis emphasises the need that blood in stool should in the first instance be examined by a doctor. Efficacious diagnosis of diverticulitis can be achieved with a CT (computed tomography) scan. 

Ulcerative Colitis 

Colitis falls under the classification of IBD or inflammatory bowel disease. Inflammation is a healthy response of the body when its tissues are damaged. Tissue healed by the inflammation process can also be harmed by it if the process becomes unfettered. Colitis in the colon is caused by ulcers which are wearing away of the mucous membrane lining. 

Apart from other symptoms, blood in stool is prevalent. The dire prospect of peritonitis from colitis is the key reason for pinpointing it as the cause of rectal bleeding.  

Crohn’s Disease 

An inflammatory bowel disease, Crohn’s disease is also an auto-immune disease which inflames the gastrointestinal tract in a destructive way. It can manifest 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 generally affects the small and large intestine (colon)~The small and large intestine (colon), however, are the primary affected areas.

Industrial environmental exposure, genetic makeup and smoking are believed to be contributory causal factors even though clear-cut 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 commonly described as granulomatous colitis. As of now, there is no known surgical or pharmaceutical solution for Crohn’s disease. Early detection is helpful for effective control of the symptoms and counteracting recurrences. 

Intestinal Ischemia 

Ischemia is a suppression in blood supply to any part of the body. Usually due to dysfunctional arteries, it leads to tissue damage from deprivation of oxygen and nutrients. Ischemic colitis or intestinal ischemia is the inflammation of the large intestine from the insufficiency 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. Urgent medical attention is required to rejuvenate intestinal blood supply if there is severe incessant pain. It may be unavoidable to surgically circumvent blocked blood vessels and remove blood clots and injured tissue. Medications include anticoagulants to foil blood clot formation and antibiotics to treat infections. 

Peptic Ulcer 

An exceptionally painful ulcer, this is located in the gastrointestinal tract. At least 0.5cm in diameter, an ulcer is an deterioration of the mucosal membrane. Peptic ulcers typically manifest in the duodenum (initial part of the small intestine) and not in the stomach as commonly believed. Peptic ulcers are almost always supposed to be caused by a bacterium that inflicts chronic gastritis. 

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 needs emergency surgery. Antibiotics and antacids can be used to treat milder cases.

Hemorrhoids 

The above 7 causes are the very reasons why rectal bleeding needs the attention of a medical doctor who can render a detailed diagnosis. Appropriate treatment, including surgery, and medication can quicken recovery after early detection. 

Thankfully instead of the above possibilites, the most usual reason for blood in stool is hemorrhoids, both internal and external.

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.