Stool with blood/blood in the stool: what does it mean, what does it look like (color)?

If you notice a stool with a mixture of blood, this does not necessarily mean something very bad. However, it is necessary to find out the cause and address it to avoid unnecessary complications.

Any person who finds blood on the toilet paper or in the toilet bowl after a big urge is frightened by what is happening to him.

Blood after a bowel movement doesn't mean you need to panic right away.

If fresh blood appears without other symptoms, such as cramps and abdominal pain, it is most likely bleeding from hemorrhoids. This is common when they enlarge and after constipation or hard stools.

But it is necessary to be monitored and if bleeding recurs, contact your doctor and undergo an examination.

Before you start finding out the cause of blood in your stool, try to think if you have consumed any foods that cause stool discoloration and may have stained it.

Is your stool a different colour than usual?

It is important to pay attention to the colour of the blood in your stool. This is how you can tell where the blood is coming from.

Blood can be bright red, dark, wine red to black. It can be unadulterated stool, on stool, mixed in stool or with coagula (blood clots).

Occult bleeding is not visible and is only detected by an occult bleeding test as evidence of blood in the stool. Patients present with anemia, general weakness, shortness of breath, sudden fainting with short-lived unconsciousness, and complaints that resemble ischemic heart disease.

The causes are inflammation of the intestine, benign tumors, polyps, tumors of the intestine, hemorrhoids.

Hemorrhoids are the most common cause of blood on stool.

What foods affect the colour of stools?

Where does the blood in the stool come from?

Blood in the stool can be caused by bleeding from the stomach, small intestine, colon and rectum.

If the bleeding occurs in the upper part, that is, in the stomach, small intestine or upper part of the colon, it is in most cases the secretion of black stool called as melena.

If bleeding occurs in the transverse and lower part of the colon, the blood is bright to dark red and is called enterorrhagia.

Enterorrhagia is bleeding most often from parts of the colon or rectum. It may also be from the small intestine when there is rapid passage through the intestines and when there is large bleeding from esophageal varices or stomach ulcers.

Bleeding may be:

• occult
• massive
• acute
• chronic

When bleeding from the digestive tract, the problem must be dealt with immediately and it is important to stop the bleeding.

Acute bleeding usually stops spontaneously after medication. But the problem must be addressed. Otherwise, the bleeding may return again, a life-threatening condition.

Bleeding in the digestive tract according to the direction of bleeding

• Upper gastrointestinal bleeding from the duodenum to the mouth - oral
• Bleeding into the lower part from the duodenum to the colon - aboral

Forms of bleeding and their manifestations (table)

Symptoms of blood in stool

• Bright red blood on toilet paper
• Blood on the outside of the stool, streaks of blood on the stool
• Pink coloured water in the toilet bowl
• Blood in stool and bloody diarrhea
• Dark to black strong smelling stool
• A small amount of blood in the stool, which has occurred only once, may be due to haemorrhoids or a rectal tear during constipation

Associated symptoms with blood in the stool that indicate a problem

• abdominal pain in various forms, such as cramps
• dizziness
• increased fatigue
• indigestion - bloating, feeling full, vomiting, lack of appetite
• intestinal problems - diarrhoea, constipation, feeling of incomplete emptying, frequent and painful passing of gas
• changes in stools - typical stools are in the shape of a thin strip
• weight loss
• anaemia as a result of microscopic blood loss in the stool

The most common origins and causes of bleeding from the digestive tract part of the colon

Bleeding from the colon

• Diverticular disease
• Ischaemia - local anaemia of the intestinal tissue
• Anorectal disease - haemorrhoids, abscess
• Neoplasia - new tissue formation, neoplasm on the colon
• Infectious colitis - Clostridium difficile infection, bacterial, viral bowel disease
• Postpolypectomy bleeding - bleeding after removal of polyp
• IBD - inflammatory bowel disease
• Angiodysplasia - malformation of blood vessels in the wall of the intestine
• Postradiation colitis/proctitis - inflammatory disease of the colorectal mucosa after radiotherapy
• Unknown

Bleeding from the small intestine

• Angiodysplasia - malformation of blood vessels in the wall of the intestine
• Erosion, ulceration of the intestine - superficial damage to the mucosa and ulceration of the intestine
• Crohn's disease
• Postradiation enteritis - postradiation inflammation of the small intestine
• Meckel's diverticulum - a congenital developmental disease of the small intestine, a blind-ending bulge in the small intestine
• Neoplasia - neoplasms of the small intestine
• Aortoenteric fistula - a rare disease in which the aorta is pathologically connected to the intestine

Bleeding from the upper digestive tract

• Ulcer disease of the stomach and duodenum - the most common cause is chronic stress, alcoholism
• Esophageal varices - bulging veins in the esophagus
• Portal hypertension
• Mallory-Weiss syndrome - occurs after repeated strenuous vomiting when fissures form in the esophageal mucosa
• Tumours

Classification according to diseases and their symptoms

In the case of the appearance of clear, fresh blood with stool or after stool on toilet paper

Hemorrhoids

Haemorrhoids present with bright red blood on stool or on toilet paper, often as a result of strenuous pushing during defecation and when constipated.

They may be accompanied by pain when passing stools, itching of the rectum, a feeling of dull pressure, burning.

Internal haemorrhoids are formed in the inner part of the rectal wall, approximately 3 cm from the anus. They are often the result of excessive pressure on the abdominal muscles and straining to pass hard stools.

They are manifested by bleeding and mucus production. The pain appears at an advanced stage.

External haemorrhoids are located around the anus. Soreness occurs in case of inflammation.

Fissure in the rectum

It is manifested by bleeding, the blood is bright red. You can see it on toilet paper, on stool or on underwear.

It is manifested by pain when passing stool, often after constipation, itching of the rectum and with an admixture of pus.

The fissure may be visible on the rectum. A small lump may be nearby.

Sexually transmitted diseases

This group includes genital warts, lesions of the anus, which are manifested by bleeding with or without haemorrhoids, itching and pain.

Rupture of a blood vessel in the intestine

A rupture of a blood vessel in the intestine may be the result of blood thinning medication (warfarin, aspirin). The symptom is only the presence of bright red blood, without accompanying pain.

Cancer in the anus

It is accompanied by:

• bleeding of clear blood from the rectum
• pain in the rectal area
• anal itching
• weight loss
• changes in defecation
• abdominal discomfort
• when palpated, a growth or mass is felt in the anal canal

Blood in the stool or blood with mucus

Anal fistula

An anal fistula is a small tunnel located around the anal opening under the skin. Its most common cause is purulent inflammation in the anal area.

It is manifested by:

• continuous pain in the anus
• redness
• swelling in the rectal area
• there may be fluid oozing from the created opening, which smells
• there is also blood and mucus when stool is passed
• irritation of the rectum
• painful bowel movements

Gastroenteritis

It is one of the common diseases manifested by vomiting and diarrhoea. In case of a severe course, for example in food poisoning, salmonellosis, intestinal flu, it may include bloody diarrhoea with translucent mucus.

Inflammatory bowel disease

This group includes both ulcerative colitis and Crohn's disease, which are quite similar to each other.

They manifest themselves as:

• abdominal pain
• abdominal cramps
• fatigue
• weight loss
• feeling of bloating
• lack of appetite
• irregularity in bowel movements, which may be with the presence of blood or mucus

Crohn's disease

Crohn's disease is an autoimmune disease of the digestive tract. Its symptoms can appear suddenly, ranging from mild to severe.

Manifestations:

• pain and cramps in the abdomen
• weight loss
• diarrhoea
• fatigue
• fever
• blood in the stool
• pain around the rectum
• severe iron deficiency in the blood

Ulcerative colitis

Ulcerative colitis is an inflammatory bowel disease with ulcers located in the digestive tract.

Symptoms come on gradually, not suddenly.

At the beginning, diarrhea appears with an admixture of mucus or blood.

Other symptoms include:

• bleeding from the rectum in small amounts
• pain in the rectum
• pain and cramps in the abdomen
• sudden pressure to pass stool, inability to defecate despite the urge to pass stool
• weight loss
• fatigue
• fever

Bleeding in the lower bowel or rectum - blood bright to dark red in the stool

Proctorrhagia

Is bleeding from the anus or rectum. The blood is bright red and without stool admixture.

Intestinal polyps

Intestinal polyps form without symptoms and can be detected by performing an occult bleeding test.

To detect them, it is best to undergo an occult bleeding test, which is performed on a stool sample and sent to a laboratory for analysis.

A blood sample taken during a routine examination will detect anaemia. This is indicative of long-standing bleeding that has not yet been visible in the stool.

For large polyps located near the rectum, blood in the stool may appear from clear to dark colored as well as streaks of blood on the stool.

Other symptoms include:

• changes in bowel habits (diarrhoea, constipation)
• crampy abdominal pain when the bowel is partially blocked by a polyp
• fatigue and shortness of breath

Colon cancer

Colon cancer is accompanied by symptoms:

• Changes in stool elimination - diarrhea, constipation, or change in stool consistency, sometimes in succession
• bleeding from the rectum or blood in the stool
• a feeling of discomfort in the abdomen
• cramps
• flatulence
• pain
• feeling of incomplete emptying of the bowel
• fatigue and weakness
• weight loss

At an advanced stage of cancer, the tumour can block the passage of the intestine. The patient therefore develops symptoms of intestinal obstruction, such as crampy abdominal pain, a feeling of fullness and bloating, and vomiting.

Ischaemic colitis

Ischaemic colitis is an inflammation of the colon caused by reduced blood flow in part of the colon and an underblooded intestinal wall.

Symptoms depend on its extent.

Typical symptoms are:

• sudden abdominal pain
• nausea and vomiting
• abdominal cramps
• urge to pass stool
• diarrhoea with bright red or dark red blood in the stool
• blood may appear without stools
• abdominal discomfort with a feeling of weak peristalsis

Proctitis

This name refers to inflammation of the lining of the rectum, which is manifested by a sensation of frequent to continuous defecation.

Manifestation:

• bleeding from the rectum, with blood or mucus in the stool
• pain in the rectal area
• abdominal pain, often on the left side
• feeling of residual stool in the rectum
• diarrhoea
• painful bowel movements
• painful defecation
• temperature
• fatigue
• in some cases, spontaneous leakage of stool

Pseudomembranous colitis

Pseudomembranous colitis is an inflammation of the colon caused by infection with the bacterium Clostridium difficile.

Symptoms are:

• watery or mushy, persistent diarrhea
• sensitivity
• pain and cramps in the abdomen
• stools with mucus or blood
• fever
• nausea
• dehydration

Dark-coloured stools to black blood in stools

If you are taking iron pills, the stool tends to be very dark to black in colour.

Dark to black stool coloration is seen when:

• bleeding in the stomach or upper intestines
• ruptured stomach ulcer
• oesophageal varices
• ulceration of the stomach and duodenum

If bleeding from oesophageal varices and gastric ulcer occurs, vomiting of fresh, deep red undigested blood called haematemesis is also a symptom, after vomiting of digested coffee grounds melanemesis.

Bleeding in the middle part of the gastrointestinal tract is manifested by stools of a dark to black colomose colour. In case of rapid peristalsis of the intestines and depending on the intensity of the bleeding, the colour of the blood is tinged with red.

Gastric ulcer

A stomach ulcer that has ruptured is manifested by dark blood in the stool with pain or cramps in the abdomen and vomiting of blood.

Diverticulitis

Diverticulitis is the presence of a bulge in the intestinal wall that manifests:

• a feeling of abdominal rigidity
• crampy abdominal pain
• impaired defecation
• flatulence
• fresh blood in the stool
• vomiting
• increase in body temperature

When taking blood thinners and as a result of bleeding in the digestive tract, dark stools appear, without pain and other symptoms.

Melena

Melena is the passing of black stool of a slimy appearance, which has its own specific smell.

Melena occurs when there is bleeding in the amount of 50-100 ml of blood within 24 hours.

It breaks down into:

• Fresh melena, when it leaves the intestines in the form of thin, oily stools as a result of acute, fresh bleeding
• Emptying melena is already in the form of drier black stool, which no longer has a thin appearance and is expelled from the body after earlier bleeding

Hematochezia is stool with admixture of dark to fresh light red blood, sometimes with the presence of blood clots.

Read also:

• These are their most common causes
• What diet and foods are suitable for stomach ulcers?
• When is black stool normal and when to see a doctor?