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What are bloody stools? — "Stools" is another word for "bowel movements." If you have bloody stools, you might see bright red blood:
●On the toilet paper after wiping
●In the toilet after you go to the bathroom
●On the surface of or mixed in with your bowel movements
In some cases, bloody stools look more like black tar. Stools that look like tar are usually caused by bleeding high up in the digestive system (figure 1).
What causes bloody stools? — The 2 most common causes are not usually serious:
●Hemorrhoids – These are swollen blood vessels in the anus. Hemorrhoids can itch or hurt.
●Anal fissures – These are tears in the skin on the anus.
Sometimes, bloody stools are serious. They can be a sign of polyps (small growths), cancer, or other problems in the digestive system.
Should I see a doctor or nurse? — Yes. See your doctor or nurse right away if you notice any blood with your bowel movements. Most cases are not serious. But anyone with bloody stools should be seen by a doctor or nurse.
Should I have tests? — Your doctor or nurse will decide which tests you should have based on your age, other symptoms, and individual situation.
The most common tests doctors use to find the cause of bloody stools:
●Rectal exam – The doctor looks at the outside of your anus. They also use a finger to feel inside the opening.
●Anoscopy – In the office, your doctor puts a small tube into your anus. The tube goes a few inches into the rectum (the lower part of the large intestine). It has a light on it so the doctor can see inside.
●Sigmoidoscopy or colonoscopy – For these tests, the doctor puts a thin tube into your anus. Then, they gently push the tube into your large intestine. The large intestine is also called the colon. The tube has a camera attached to it, so the doctor can look inside your intestines. During these tests, the doctor can also take samples of tissue to look at under a microscope (figure 2).
How are bloody stools treated? — Treatment depends on what is causing your bloody stools.
If you have hemorrhoids or an anal fissure, there are some things you can do on your own. You can:
●Keep your bowel movements soft – Drink lots of water, and eat lots of fiber. Fiber is common in fruits, vegetables, and breakfast cereal (table 1). You can also take fiber supplements. Your doctor might suggest medicines, too.
●Soak your buttocks in 2 or 3 inches of warm water – You can do this up to 2 to 3 times a day for 10 to 15 minutes. Do not add soap, bubble bath, or anything to the water.
●Use creams and medicines that go on or inside your anus – These can help with pain, itching, and swelling.
●Get regular physical activity – Even gentle forms of exercise, like walking, are good for your health.
If your doctor finds a more serious cause for your bleeding, they will talk to you about your treatment options.
What other symptoms should I watch for? — Certain symptoms can help your doctor figure out what is causing your bloody stools. Some of these can be signs of a serious problem, so it's important to see a doctor.
These symptoms include:
●Itching or pain in the anus
●Feelings of ripping or burning during bowel movements
●Fever, weight loss, and heavy sweating at night
●Diarrhea
●Feeling like you need to have a bowel movement, but not being able to go
●Belly pain
●Bowel movements that look black or dark red
●Changes in how often you have bowel movements, or how hard or soft they are
●Bleeding that goes on for a long time or that comes back again and again
Patient education: Hemorrhoids (The Basics)
Patient education: Anal fissure (The Basics)
Patient education: Constipation in adults (The Basics)
Patient education: GI bleed (The Basics)
Patient education: Bloody stools in children (The Basics)
Patient education: Blood in the stool (rectal bleeding) in adults (Beyond the Basics)
Patient education: Anal fissure (Beyond the Basics)
Patient education: Hemorrhoids (Beyond the Basics)
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