Hematochezia, which is also called rectal bleeding, refers to the passing of blood from the anus mixed with stools or sometimes blood clots. Bloody stools are often signs of any injury or disorder present in the digestive tract. Once the presence of blood is noticed in stools, medical attention should be sought so that it can be evaluated and possible cause detected.
The colour of the blood is determined by the location of the injury or disorder in the digestive tract. It can come from anywhere along the digestive tract. The closer the location is to the anus, the brighter the blood will be. Accordingly, bleeding from the anus, the rectum or the sigmoid colon is usually bright red while bleeding from the transverse colon and the right colon is darker or of a maroon colour. There is situation referred to as Melena which occurs when blood stays in the colon so long that bacteria break it down into chemicals causing it to be black. Melana in patients is signified by black, tarry and foul smelling stool. It is a sign of bleeding in the upper gastrointestinal tract. In situations where the blood is bright red, it means that the blood is moving fast so there is not enough time for bacteria to turn it black.
Sometimes bleeding is occult which means that it cannot be seen by the naked eye but can only be detected by fecal occult blood test. This occurs when bleeding is so slow that it does not pass through the anus.
There is a wide range of causes for blood in stool.
Causes of blood usually black stools are
- Abnormal blood vessels
- A tear in the esophagus caused by vomiting
- Bleeding stomach or ulcers
- Gastritis – inflammation of the stomach lining
- Bowie ischemia – improper blood flow to the intestines
- Trauma or the presence of a foreign body in the upper gastrointestinal tract.
- Esophageal and stomach varices – widened, overgrown blood vessels
Causes of maroon or bright red, bloody stools are
- Anal fissures – cuts or tears in the anus due to straining.
- Bowel ischemi
- Colon polyps (clump of cells bulging from the lining of the colon or colon cancer
- Diverticulitis – pockets of blood protruding from the bowel wall
- Hemorrhoids – swollen veins in the anus or rectal area
- Crohn’s disease or ulcerative colitis – inflammation of the walls of the bowe
- Intestinal infection
- Small bowel tumor
- Presence of foreign body in the lower gastrointestinal tract.
Hematochezia may be accompanied by abdominal pain, vomiting blood, diarrhea, fever and excessive gas. Treatment is dependent on the cause of the bleeding. The patient may be admitted to hospital for observation. If bleeding is severe, a blood transfusion may be necessary for excessive bleeding.
To prevent hematochezia
- Eat plenty vegetables and fiber-rich foods
- Do not smoke.
- Avoid stress
- Avoid alcohol
- Limit your use of drugs like ibuprofen, aspirin and naproxen.