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There are many causes of blood in stool.
Some of the benign causes includes
- Passing of hard stools resulting in anal fissure
- Hemorrhoids or piles
Other more serious conditions include :
- Infection of the intestines by viruses or bacteria
- Inflammation of the colons due to inflammatory bowel disease like Crohn’s or Ulcerative colitis
- Abnormalities of the blood vessels in the rectum and intestines resulting in them bleeding
- Diverticulosis or diverticulitis ( which are structural out pouching of the intestines with infection )
- Cancer of the rectum or colon
If the bleeding is continuous and massive with large amounts of blood filling the toilet bowl. It is definitely an emergency. Or if you are exhibiting signs of low blood pressure due to severe blood loss like
- Giddiness or almost blacking out episodes
- Ff your fingers and toes are pale and cold
- If you are breathless or having fast heart rate
When you have blood in your stool associated with a fever, then the causes may likely be infective or inflammatory, such as :
- Viral or bacteria gastroenteritis ( which means infection of the intestines )
- Inflammatory bowel disease like Crohn’s and ulcerative colitis - which are autoimmune in origin.
When you have blood in stool with severe pain of the abdomen or the rectum.
Severe pain usually indicates a serious condition such as infection, inflammation or even rupture of the intestines.
Small Amounts of Blood
if you have been having small amounts of blood in the stool for a long time associated with weight loss or loss of appetite or even change in size of your stool, there is a chance of cancer in the colon or rectum.
Thankfully, the vast majority of patients presenting with bleeding in stool is usually due to piles
Bleeding due to piles are usually :
- Small in amount
- The blood is usually seen on the toilet paper when you clean your rear end
- The blood is usually fresh
- Almost always occurs only on defecation
- There should be no fever and there should be no abdominal pain
Having said that, please do not self diagnose piles and ignore your symptoms and signs. Do visit your family physician or colorectal surgeon for a confirmatory diagnosis.
Ways to prevent piles
To avoid developing piles, please adopt these few lifestyle changes.
1) Avoid straining during toileting
2) Avoid prolonged sitting on the toilet bowl
3) Ensure adequate fruits and vegetable and whole grain in your diet
4) Drink plenty of plain water : up to 6-8 glasses a day.
6) Do not hold your bowel as it may make the stool harder and more difficult to pass subsequently.
Treatment of Piles
Conservative methods would include :
1) Stool softening medications if your motion is very hard
2) Daflon to reduce venous congestion of the piles
3) Minimally invasive methods like rubber band ligation of piles or injection of chemical to shrink the piles
4) Severe cases - pile removal surgery
Bleeding in your stool is a very common problem. Recognise the signs and symptoms which requires you to seek immediate medical attention.
Thankfully most of it is caused by piles. Again whenever in doubt, please get a consultation with your friendly family physician or colorectal surgeon.
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)