This article needs more medical references for verification or relies too heavily on primary sources. Hematochezia typically presents with bright red blood mixed in with the stool. When referring to human feces, blood in stool looks different depending on how early it enters the digestive tract—and thus how much digestive action it has been exposed to—and how much there is. In infants, the Apt test can be used to distinguish fetal hemoglobin from maternal blood based on the differences in composition of fetal hemoglobin as compared to the hemoglobin found in adults. Blood in the stool can come from many sources.
The causes range from not harmful to very serious conditions. A common way to divide causes of bleeding is based on the source of bleeding. The upper GI tract is defined as the organs involved in digestion above the ligament of Treitz and comprises the esophagus, stomach, and duodenum. The transition from the upper to lower GI tract is considered to occur at the duodenal-jejunal junction, therefore small intestine is part of both the upper and lower GI tract. Other organs participate in digestion including the liver, gallbladder, and pancreas. Bleeding of the lower GI tract will typically appear as hematochezia and can vary in degree of seriousness. Slow bleeding from the ascending portion of the colon can result in partial digestion of the blood and the appearance of melena in the stool. The development of blood in a person’s stool results from a variety of conditions, which can be divided into major categories of disease. These broad categories include cancerous processes or abnormal structure of bowel wall, inflammatory disease, colitis caused by infection or medications and vascular compromise.
The gut wall is important for the movement of waste products through the GI tract. This list of diagnoses include diseases in which the wall of the bowel is compromised by disease. Meckel’s diverticulum is a congenital remnant of the omphalo-mesenteric duct that connected the fetal yolk sac to the intestines which is normal closed off and destroyed during the process of development. Diseases causing inflammation in the GI tract can lead to blood in the stool. Inflammation can occur anywhere along the GI tract in Crohn’s disease, or in the colon if a person has ulcerative colitis. Enteritis—inflammation of the small intestine, which may be caused by various forms of as well as by other conditions. Food poisoning—the bacteria that is associated with bloody diarrhea is typically E.
Hemorrhoids Internal hemorrhoids are covered by a layer of mucosa and epithelium, making them more likely to bleed, but typically do not cause pain. Blood in the diet, for example, the traditional diet of the Masai includes much blood drawn from cattle. The following tests are combined to determine the causes of the source of bleeding. Melena is defined as dark, tarry stools, often black in color due to partial digestion of the RBCs. Hematochezia is defined as bright red blood seen in the toilet either inside of, or surrounding the stool. Hematochezia is typically presumed to come from the lower portion of the GI tract, and the initial steps of diagnosis include a DRE with FOBT, which if positive, will lead to a colonoscopy. Mucus may also be found in stool. A texture described as tarry stool is generally associated with dark black stool seen in partially digested blood. This is generally associated with melena.
A person’s age is an important consideration when assessing the cause of the bleeding. Treatment of bloody stool depends largely on the cause of the bleeding. Bleeding is commonly associated with symptoms of fatigue, dizziness, headaches, or even shortness of breath, and these associated symptoms also require treatment. Anemia is a common complication of blood in the stool, especially when there is a large amount of blood or bleeding occurs over a long period of time. Diagnostic measures can be used as interventions to help stop bleeding in some cases. Similarly, gastric cancer is treated depending on the staging, although typically requires surgical and medical therapy. The treatment for motility issues, namely constipation, is typically to improve the movement of waste though the GI tract. Colitis can be divided into infectious and drug induced, as can the treatment for these conditions. With infectious colitis, treatment is pathogen dependent, and generally requires the use of antibiotics.
Structural compromise leading to blood in stool is caused by a variety of conditions, and therefore requires different treatment for each condition. Inflammatory bowel disease is also divided into separate conditions, namely ulcerative colitis and Crohn’s disease, which have different medical treatment regimens, and may require surgical intervention in more serious conditions. Clinical Methods: The History, Physical, and Laboratory Examinations. Approach to the Patient With Hematochezia”. Upper Gastrointestinal Tract – National Library of Medicine”. Lower Gastrointestinal Tract – National Library of Medicine”. Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J.
Gastrointestinal Tract – National Library of Medicine”. What are Early Symptoms of Colorectal Cancer? Colon Cancer Symptoms – Colorectal Cancer Symptoms”. American Gastroenterological Association medical position statement on constipation”. How do NSAIDs cause ulcer disease? Beyond the stomach: An updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment”. Diverticulitis: Diverticular Disease: Merck Manual Home Edition”. Journal of the Royal Society of Medicine. Learn the Facts About Crohn’s Disease”.
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