Beware! Blood in stool may not be hemorrhoids, it may also be a sign of cancer! Be sure to do these tests!

As the saying goes, "Nine out of ten people have hemorrhoids." The high prevalence of hemorrhoids has made bloody stools very common, making people feel that bloody stools are not so scary.

When blood in the stool appears, many people think it is hemorrhoids and that it can be cured with simple medicine. It is embarrassing for such an embarrassing area, so there is no need to go to the hospital and they just "get through it".

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There are many diseases that cause blood in the stool, hemorrhoids are just one of them. Often due to our misjudgment or self-righteousness, the diagnosis and treatment of other diseases will be delayed, which may lead to very serious consequences.

So if you have blood in your stool, don’t simply assume that it’s caused by hemorrhoids. It may be, or it may not be.

Let’s take a brief look at the causes of blood in the stool.

01

What are the causes of blood in the stool?

There are many diseases that cause bloody stools, which can be divided into perianal, rectal, colon, and upper gastrointestinal tract diseases.

For example, internal hemorrhoids may bleed in the form of drips, spurts, or rubs; anal fissures may also bleed, and may be accompanied by pain; rectal polyps may bleed after they rupture or are damaged; rectal inflammation, such as radiation proctitis, may also bleed due to vascular dilation and inflammatory exudation caused by radiotherapy; colorectal inflammatory diseases, such as ulcerative colitis and ulcerative proctitis, may also bleed, and may be accompanied by an increased frequency of bowel movements, abdominal pain, general discomfort, and weight loss.

Malignant diseases can also cause bleeding, such as rectal cancer and colon cancer. In the early stages of rectal cancer, blood in the stool may be bright red, but in the later stages it may turn dark red and may be accompanied by other symptoms. When the rectum is blocked by a tumor, the stool will become thinner, and some patients may also experience a feeling of anal prolapse, and they cannot tell whether they have stool or not. Early bleeding from colon cancer may not be very obvious, and a routine stool examination may reveal positive occult blood, which should be taken seriously.

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There are some less common diseases that can also cause blood in the stool:

For example, familial polyposis of the colon is very much related to heredity and is relatively rare. It can also cause blood in the stool, which is dark red in color. As the frequency of bowel movements increases, the blood and stool become mixed.

For example, in case of amoebic dysentery, the stool is mucous and jelly-like, dark red, and routine stool examination will reveal the presence of amoeba trophozoites in the stool;

For example, dysentery is familiar to everyone. Unhygienic diet can lead to dysentery, which is mainly caused by Shigella dysenteriae and bloody stools.

For example, ischemic ulcers are rare in young people but more common in the elderly. They cause heavy dark red blood in the stool, dizziness, and sometimes stomach pain. This is because the superior or inferior mesenteric artery becomes sclerotic or blocked, leading to ischemia of the intestinal wall and eventually causing ulcers and bleeding.

All of the above diseases occur in the lower gastrointestinal tract. In fact, upper gastrointestinal bleeding can also cause bloody stools . For example, if you suffer from chronic gastric ulcers or duodenal ulcers, the ulcers will rupture and bleed. Cirrhosis of the liver can cause esophageal varices, which can lead to rupture and bleeding. This type of bleeding is very dangerous.

When the blood from the upper digestive tract reaches the anus, it is no longer fresh blood, because the bleeding point is relatively far away. When it passes through the entire colon from the upper digestive tract and is discharged through the stool, it is no longer fresh blood. The stool is dark red, tarry, black and shiny.

These are probably the diseases that cause blood in the stool. So if you have blood in the stool, don’t be foolish and think it’s just hemorrhoids . Once blood in the stool occurs, go to the hospital in time, identify the site of bleeding and the cause, and give symptomatic treatment.

02

What tests can help diagnose blood in the stool?

There are many examination methods, and you should choose an effective examination method based on the color of the bloody stool, the amount of blood in the stool, and other accompanying symptoms.

For example, routine stool examination, including occult blood test, colorectal endoscopy, gastroscopy, etc., if no bleeding point is found, angiography can be done to see where the bleeding is coming from.

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The doctor will check one by one, first excluding the perianal area, then the rectum, and then the colorectal and upper digestive tract diseases. In order to exclude other diseases, sometimes it is necessary to do B-ultrasound examination of the liver, gallbladder and spleen, pelvic CT, MRI examination, etc. to see if there are any lesions outside the gastrointestinal tract. After all the exclusions, the final diagnosis can be made, and we just need to cooperate with the doctor's examination.

After a clear diagnosis, symptomatic treatment is carried out according to the cause. For some benign diseases, it is relatively easy to cure. For malignant diseases, if they are discovered and treated in time, the prognosis will be relatively much better.

Is blood in the stool scary? It is scary and not scary. Don't underestimate it, and don't be afraid. Just seek medical attention in time when symptoms appear.

Produced by: Chinese Medical Association

Author: Fan Xueshun, Chief Physician of China-Japan Friendship Hospital

Review | Liu Zhengxin Chief Physician, Beijing Chaoyang Hospital, Capital Medical University Member of the Oncology Group, Gastroenterology Branch, Chinese Medical Association

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