Blood In Stool, Blood On Toilet Paper & Signs of Rectal Bleeding

Blood in the stool is a very common complaint, but one that should always be evaluated by a gastroenterologist.

Where can digestive tract bleeding occur?

Bleeding can occur from anywhere within the intestinal tract, including stomach, small intestine, colon, rectum, and anus.

Typically, a patient will notice a change in the appearance of the stool. The color may vary – from dark, sticky stool resembling tar, to a red or maroon-colored stool. Sometimes there will be obvious blood in the toilet bowl or on the paper, or there may just be small amounts mixed in with the stool. This wide range in appearance can be due to differences in the underlying cause, location within the intestinal tract, or pace of bleeding.

Are there any other symptoms when there is blood in the stool?

Often there is no pain or discomfort when there is blood in the stool, but there can also be a wide range of associated symptoms depending on the underlying cause. Patients may experience abdominal pain, diarrhea, pain with passing stool, a change in stool pattern, constipation, straining or pain with bowel movements, or even nausea and vomiting.

Some patients may feel a lump or a hemorrhoid near the anus. The presence of any of these symptoms may provide clues suggesting a specific cause of blood in the stool, and your doctor will likely ask you if you are experiencing any additional symptoms.

What are some causes of rectal bleeding?

There are many possible causes of blood in the stool. Some are more common to the upper GI system (esophagus, stomach, small intestine), while other causes are usually found in the colon, rectum, or anus. Dark, tar-like stool often signifies blood loss from the upper GI tract, perhaps due to an ulcer or irritation of the stomach.

Bleeding from the colon, bleeding from the rectum, or bleeding from the anus will generally cause the stool to appear red or maroon, and can be due to hemorrhoids, diverticulosis (pouches in the wall of the colon), and inflammatory bowel disease, among other causes. Cancers of the GI system (including colon and rectal cancer) can also lead to blood in the stool. Many causes of bleeding are not dangerous, but blood in the stool should always be evaluated by your doctor in order to determine if it is a serious condition or not.

How is blood in stool diagnosed?

Identifying the cause of blood in the stool begins with your gastroenterologist interviewing you to obtain a thorough medical history and performing a comprehensive physical examination. This may be followed by laboratory testing of the blood and stool, and often your doctor will recommend an upper endoscopy or colonoscopy, which are the best tests for determining the cause of bleeding.

Upper endoscopy and colonoscopy are procedures performed by your gastroenterologist to directly examine the inside of the intestinal tract with a flexible camera. The procedures offer the ability to obtain biopsies to assist with making a diagnosis, and in some instances, to treat a cause of bleeding.

How is it treated?

It depends on the cause of bleeding. Some causes of blood in the stool may resolve on their own. Others may require medications or further procedures such as endoscopy or surgery. It is extremely important to be evaluated by a physician in order to determine what the underlying cause may be.

For more information or to book an appointment with Gotham Gastroenterology, contact our office at 212-794-0240. Our team of experts strives to provide excellence in gastroenterology for patients in NYC. You can also make an appointment by filling out a form.

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