Bloody stools (berak berdarah) or in medical terms, hematochezia means passing of fresh blood through the anus. The blood is either mixed with the stools or comes out separately. Hematochezia is often confused with melena, which means dark, black-colored stools. While both these terms describe gastrointestinal bleeding, bloody stools often indicate active bleeding in the lower gastrointestinal tract such as the colon, rectum, or anus. Melena on the other hand is often associated with bleeding in the upper gastrointestinal tract, mainly the stomach, duodenum, and the lower part of the esophagus.
Bloody stools are often accompanied by other symptoms that can help your doctor to figure out the source of the bleeding. Those symptoms include :
- Changes in bowel habits
- Loose stools
- Pain in the abdomen
- Unexplained weight loss
Your doctor may also ask you additional questions about the color, amount, frequency of passing fresh blood, and if you have noticed any mucous discharge along with bloody stools.
How are bloody stools diagnosed?
When a patient presents with bloody stools, a doctor will first start by taking a medical history followed by a physical examination including a digital rectal examination to look for bleeding in the rectum. After that, your doctor may order a few tests depending on the possible cause of the bleed.
Some of the tests include :
- Full blood count
- Coagulation profile
- Endoscopy (Colonoscopy or Endoscopy)
- CT scan
- Barium X-ray
- Nasogastric lavage
Colour of stools
– Black, tarry stool
Black, tarry stool may show to a bleed in the upper GI tract. In general, the darker the blood, the higher the root of the bleed. The upper GI tract includes the mouth, esophagus, stomach, and upper part of the small intestine, called the duodenum.
– Bright red blood
This is almost always a sign of a bleed in the lower GI tract. This section consists of the large intestine, rectum, and anus.
Causes of bloody stools
It can be quite alarming to find blood in your stool, but bloody stools can be caused by something small that can be easily treated with medications or life-threatening that requires surgical intervention. Either way, if you experience bloody stools (berak berdarah), it is advisable to consult your doctor.
Gastroenteritis is a general term for conditions that cause an upset stomach. Most of these cases are caused from a bacterial or viral infection
- Anal fissure
Anal fissures are small, thin tears in the lining of the anus. Pain arises whenever there is a bowel movement.
Hemorrhoids are swollen veins in the lower rectum. Straining or passing hard stool can rupture these veins, leading to bloody bowel movements.
- Peptic ulcers
Peptic ulcers are open wounds that develop in the lining of the stomach or duodenum. A peptic ulcer that forms on a blood vessel may cause bleeding and bloody stools. These ulcers are a result from infection of Helicobacter pylori bacteria or from the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Diverticula are small pockets that can form inside the colon. They are prone to infection and inflammation and can sometimes rupture and bleed.
- Inflammatory bowel disease
Inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis can cause bloody stool.
- Anal fistula
An anal fistula is a small passageway that forms between the end of the bowel and the skin near the anus. It typically develops when an infection near the anus causes pus to collect in surrounding tissues. As the pus drains, it leaves behind the fistula, which may continue to ooze pus or blood.
A person may experience GI bleeding as a side effect of blood-thinning medications, such as:
– warfarin (Coumadin)
– enoxaparin (Lovenox)
– apixaban (Eliquis)
- Colon polyps
Colon polyps can lead to bloody stools. These small growths may be benign or precancerous.
Cancerous tumors of the GI tract can weaken the lining of the GI tissues, causing them to bleed.