Blood in Stool: 4 Main Causes, 1 Cause Might Be Colorectal Polyps or Cancer

There are four main causes of blood in stool. Which type of bloody stool may indicate colorectal cancer and stomach ulcers? shisu_ka/Shutterstock

Does blood in stool always indicate a health red flag? Seeing blood in the toilet bowl can be alarming. However, passing bloody stool does not necessarily indicate a serious problem, and only two situations may suggest severe disease (such as colorectal cancer) that requires immediate medical attention.

4 Main Causes of Blood in Stool, Symptoms of Colorectal Cancer That Require Medical Attention

The appearance of stool often reflects the body’s health condition. Dr. Jong Yun-Ni, the general surgeon in the colorectal department of the Dianthus Clinic in Taipei, Taiwan, pointed out that there are four main causes of the presence of blood in the stool, or black stool:

There are four main causes of bloody or black stool. The Epoch Times

1. Anal Fissure

Red blood streaks on the edge of the stool, a tearing or painful sensation in the anus during bowel movements, bright red blood on toilet paper when wiping, and even blood dripping into the toilet bowl, etc., may all be related to anal fissures.

Hard stools can cause anal fissures. Sometimes, although there is a tearing and painful sensation in the anus, there may be no immediate bleeding. However, bleeding may occur a few days later when the wound is rubbed during bowel movements.

Anal fissures are one of the most common causes of blood in the stool. There is usually no need to be overly concerned. Observe the condition for a month; it will usually heal on its own.

2. Internal Hemorrhoids

The characteristic of blood in stool caused by internal hemorrhoids is that there is no pain during bowel movements (regardless of whether the stool is soft or hard), but it may be accompanied by a sensation of swelling or a foreign body in the anus. In addition to bright red blood on the stool, there may also be dripping of blood; if the amount of bleeding is significant, it may even turn the toilet water red.

Internal hemorrhoid bleeding usually occurs after strenuous activity, eating spicy foods, or drinking alcohol. If it happens occasionally, you can observe it for two or three days. However, if it happens too frequently or the amount of bleeding each time is enough to turn the toilet water red, it may lead to chronic anemia, and it is recommended to seek medical attention.

In Jong’s clinic, there were a few male patients who neglected internal hemorrhoid bleeding for months and only sought medical attention after feeling weak. As a result, their hemoglobin levels dropped from 13 gm/dL (the normal range for an adult male is 13.0 to 18.0 gm/dL) to 4 gm/dL due to chronic anemia caused by prolonged internal hemorrhoid bleeding.

3. Colorectal Polyps, Colorectal Cancer

Blood in stool caused by these conditions is mainly characterized by the following symptoms:

• When defecating, the stool is initially solid.
• After a small amount of bleeding, the abdomen may or may not cramp, followed by the excretion of mushy stool mixed with mucus-like intestinal fluid.

Jong explained that during defecation, when the stool rubs against a soft polyp in the intestine or a colorectal cancer polyp, it can irritate the intestine and cause diarrhea. The secretion of intestinal fluid, which is used to lubricate the intestine and is mixed in the stool, also increases due to irritation by tumors or polyps, and becomes visible to the naked eye. “It is like increased nasal discharge when having a cold,” she described.

Therefore, for people who usually have smooth bowel movements, solid stools, or are prone to constipation, if they experience frequent diarrhea and bloody stools without pain or a sensation of a foreign body in the anus, it indicates a change in bowel habits. This may be a sign of colorectal cancer, and they should seek medical attention as soon as possible.

4. Stomach Ulcer, Duodenal Ulcer

Passing black, tarry stools may indicate stomach or duodenal ulcers. Due to the irritating nature of blood, when bleeding occurs in the stomach or upper part of the small intestine, it can cause cramping as it passes through the intestine.

If the black stool is solid, there is no need to be excessively worried, as it may be caused by food coloring. For example, high-iron foods such as pig blood curd and sashimi can affect the color of stool due to the presence of heme iron.

Of the four types of bloody stools described above, the last two require immediate medical attention.

If the bleeding is caused by anal fissures or internal hemorrhoids, it is essential to observe the frequency of bloody stools. If it happens too frequently, you should still seek medical attention. Jong suggested observing the symptom for a month, and if there is no improvement, it is not too late to see a doctor.

She added that if the rectal bleeding is painless and frequent, one must seek medical attention to identify the cause. “It is the painless ones that are worrying; the painful ones are less concerning, and most of them will heal on their own,” she said.

Painful Anal Fissure? Warm Sitz Baths Promote Healing

While anal fissures usually heal on their own, if the fissure is located in a problematic spot, surgery may be necessary.

For example, if the wound happens to be very deep, the body will need more time to heal. However, during this time, the patient will still need to defecate, which can impede the healing process. Additionally, there are many bacteria in feces. If the wound does not heal properly, it may develop into a chronic anal fissure that can last for more than two months.

Scar tissue may form at the wound site, making it difficult for the skin on both sides to reconnect. In this case, surgery to remove the scar tissue may be considered to heal the wound.

In addition, some people may not be aware that they have long-standing hemorrhoids. As a result, swollen hemorrhoids may fall out during an anal fissure and rub against the wound, making it difficult to heal.

Many patients with anal fissures come to Jong’s clinic seeking help because they are afraid or in pain. In addition to relieving the pain with ointment, she also recommends taking sitz baths.

Method

Fill a basin with warm water and soak the lower body in it. Do it once in the morning and once in the evening, for example, once after a bowel movement and at least once after taking a shower.

When the anus is injured, the surrounding muscles will become tense. Warm water sitz baths can help relax the muscles and increase blood flow, thereby promoting wound healing. “Soaking in warm water is more important than using medication. Medication only relieves pain, but warm water can speed up the healing of the wound,” she said.