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Blood in the Stool: Is It Cancer? (Possible Causes, Diagnosis, and Treatment)

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One of our website visitors posted this comment which we will answer thru this article. The question asked is: “These past few days I experienced bleeding in my stool but I don’t experience the other symptoms, should I say it’s cancer?”

Seeing blood in the toilet, on your stool, or with wiping after a bowel movement is common. Fortunately, most of the causes of such rectal bleeding are not life-threatening; common causes include anal fissures and hemorrhoids.

Blood in the stool is not always caused by cancer. However, the only way to be certain of the cause is to be evaluated by a healthcare provider.

In this article, we review when to seek help for blood in the stool, the most common causes of blood in the stool, and tests that may be necessary to diagnose your condition.

When to Talk to Your Doctor

Most people with minor rectal bleeding do not have colon cancer or some other serious condition. However. It is not possible to know the cause of rectal bleeding without a proper medical examination. Thus, anyone who notices rectal bleeding must talk to their healthcare provider to determine if an examination is necessary.

Blood in the Stool: What Does It Mean?

Bloody stool is a sign that there is bleeding somewhere along your digestive tract. The blood can range in color from maroon to bright red, and it can even appear black and tarry if the bleeding is occurring higher up in your digestive tract.

The signs of bleeding in the digestive tract hinge on the severity and site of the bleeding. If blood is coming from the lower colon or the rectum, bright red blood will mix or coat with the stool. The cause of the bleeding may not be serious, but locating the source of the bleeding is crucial.

The gastrointestinal tract includes the esophagus, stomach, small intestine, large intestine, rectum, and anus – bleeding can come from one or more of these areas. It can come from a small area like an ulcer on the stomach lining or from a large surface, such as a colon inflammation.

Also, bleeding can sometimes occur without the person noticing it – this type of bleeding is called hidden or occult. Fortunately, simple tests can detect occult blood in the stool.

Most episodes of rectal bleeding are mild and stop on their own. Many patients report only observing a few drops of fresh blood that turns the toilet water pink or observing blood spots on the tissue paper after they wipe. Others report a brief passage of blood.

Usually, mild rectal bleeding can be evaluated and treated in the doctor’s office without hospitalization or the need for urgent diagnosis and treatment.

Bleeding may also be moderate or severe. People with moderate bleeding will repeatedly pass larger quantities of bright red or maroon-colored blood, often mixed with blood clots and/or stool. People with severe bleeding may pass several bowel movements or a single bowel movement containing a large amount of blood.

Moderate or severe rectal bleeding can quickly deplete a person’s body of blood, leading to symptoms of dizziness, weakness, low blood pressure, or fainting. Rarely, the bleeding may be so severe that it can cause shock from the blood loss. Moderate or severe rectal bleeding is normally evaluated and treated in the hospital.

People with signs and symptoms of a reduced blood volume often require emergency hospitalization and a blood transfusion.

What Causes Blood in the Stool?

Many conditions and diseases can cause blood in the stool. Common causes include:

  • Anal Fissures

An anal fissure is a common, painful condition in which the lining of the anal canal is torn. It is normally caused by physical trauma due to constipation or a forceful bowel movement through a tight anal muscle. Once the skin is torn, each succeeding bowel movement can be painful – and the pain is usually severe.

The amount of bleeding that occurs with an anal fissure is small and is usually noticed in the toilet bowl or on the toilet paper as bright red in color. The symptoms of an anal fissure are usually mistaken for hemorrhoids – but hemorrhoids typically don’t cause pain with bowel movements. 

  • Hemorrhoids 

Hemorrhoids – also known as piles or almoranas – are swollen veins in your lower rectum and anus, similar to varicose veins. Hemorrhoids can develop inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids). Although most people think that hemorrhoids are abnormal, they are actually present in everyone.

It is only when the hemorrhoidal cushions enlarge that hemorrhoids become susceptible to trauma after passing stool and cause problems such as anal discomfort or bleeding, and are considered a disease. Similar to anal fissures, bleeding from hemorrhoids is usually mild and does not cause low blood pressure or anemia. 

  • Polyps and Colon Cancer

Tumors of the colon and rectum are masses (growths) arising from the wall of the large intestine. Benign tumors of the large intestine are usually called polyps because of their shape. Malignant tumors of the large intestine are cancers, and most are thought to have developed from polyps.

Bleeding from colon polyps and cancers tends to be mild, and intermittent, and generally does not cause shock or low blood pressure. 

Colon cancer symptoms can often be confusing. Common stomach ailments or changes in bowel habits are common occurrences – they don’t always mean that you have a serious condition such as colon cancer.

However, not everything should be ignored. Learn about the symptoms of colon cancer and when it’s a good idea to call your doctor. Common colon cancer symptoms include:

  • Anemia
  • Unexplained fatigue
  • Unexplained weight loss
  • Cramping pain in the lower stomach
  • Blood in the stool or rectal bleeding
  • An urge to have a bowel movement when there’s no need to have one
  • Change in bowel habits 
  • Blood in the toilet after having a bowel movement
  • Change in the appearance of your stool or dark/black-colored stools 

Not having any symptoms at all?

Note that many people who are diagnosed with colon cancer report having no symptoms before their diagnosis. Don’t wait for symptoms to appear to get screened for colon cancer if you are over 50 years old or if you have a family history of the disease.

Talk to your doctor to get more information about cancer screening options. 

Blood in the Stool: Diagnosis

An accurate diagnosis of the cause and location of rectal bleeding is crucial for proper treatment and prevention of further bleeding. There are different examinations that can be done to diagnose blood in the stool.

  • Stool Analysis

A stool analysis is a series of tests performed on a stool sample to help diagnose certain conditions affecting the digestive tract. These conditions can include infection (i.e. from bacteria, viruses, or parasites), poor nutrient absorption, or cancer. 

  • Flexible Sigmoidoscopy

Flexible sigmoidoscopy utilizes a flexible sigmoidoscope – a fiberoptic viewing tube with a light at the tip. It is inserted through the anus and is used by a doctor to examine the rectum, sigmoid colon, and descending colon.

It is useful for detecting colon polyps and cancers located in the sigmoid colon, descending colon, and rectum. It can also be used to diagnose ulcerative proctitis, ulcerative colitis, and sometimes ischemic colitis. 

  • Colonoscopy

A colonoscopy is a procedure that allows the doctor to evaluate the inside of the entire colon. This is done by inserting a flexible viewing tube into the anus and then advancing it slowly under direct vision through the rectum and the entire colon.

A colonoscopy is a most widely used procedure for evaluating rectal bleeding as well as occult bleeding. It can be used to detect ulcerative colitis, Crohn’s colitis, angiodysplasias, polyps, and cancers. 

  • Fecal Occult Blood Tests

The fecal occult blood test (FOBT) is used to check stool samples for hidden (occult) blood. Occult blood in the stool may indicate polyps or cancer in the colon or rectum – though not all polyps or cancers bleed. If blood is detected through an FOBT, additional tests may be required to determine the source of the bleeding.

Note that FOBT can only detect the absence or presence of blood – it can’t determine what’s causing the bleeding. 

Blood in Stool Treatments

A doctor may use different techniques to stop acute bleeding. Typically, endoscopy is used to inject chemicals into the bleeding site, treat the bleeding site with a laser or electric current, or apply a clip or band to close the bleeding vessel.

If endoscopy doesn’t control the bleeding, the doctor may use angiography to inject medicine into the blood vessels to get the bleeding under control. 

Beyond stopping the immediate bleeding, blood in the stool treatment involves addressing the cause of the bleeding to keep it from returning. Treatment depends on the cause and may include medications like antibiotics or anti-inflammatory drugs.

Surgery may be necessary to remove polyps or parts of the colon damaged by inflammatory bowel disease, diverticulitis, or cancer.

However, depending on the cause, treatment may involve simple things that you can do on your own. These include eating a high-fiber diet to relieve constipation that can cause and aggravate anal fissures and hemorrhoids. 

Your doctor will recommend the appropriate treatments based on the diagnosis.  

The Bottom Line

If you have been experiencing bleeding in your stool, don’t jump to conclusions immediately – blood in the stool is not always caused by cancer.

For an accurate diagnosis, consult your doctor.

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