What does it mean if I see blood in my stool?
First, don’t panic. At least for the youngest, the reason is not always serious. It could be hemorrhoids, it could be a drug you’re taking, it could be colitis, and (usually in older people) it could be cancer.
If you really see blood, it is most likely red, but it can sometimes be black. Blood that mixes with stomach acid turns black and means that the bleeding is coming from the upper part of the gastrointestinal tract (the stomach or duodenum). If you see stools that are unusually dark or black in color (called melena), or that look like tar, it may be blood that has passed from the stomach into the intestines. A stomach ulcer or irritation is usually the cause. Since this can be serious, see your doctor right away.
Now if the blood is red, first a question: is it a streak on the outside of the bowel movement, or blood in the toilet water, or blood mixed with the stool (poop)?
If there is a streak on the outside of the bowel movement, it is often caused by external hemorrhoids. There may be pain associated with this type of bleeding, which is commonly seen with constipation or large stools.
If there is blood in the stool and perhaps something is dripping into the toilet water, it may be internal hemorrhoids, which are often painless. These are also associated with constipation and hard stools, but also with diarrhea and straining.
You should confirm these conditions with your doctor, but hemorrhoids are probably the “best case scenario” and are easily treated (most of the time). Occasionally, a tumor (such as cancer) will also present itself this way. Anyone over 50 should be screened for colon cancer.
If the blood mixes with the stool but you have no other symptoms, cancer is again a possibility, along with colitis, diverticulitis, and drug effects. If you are taking aspirin, ibuprofen, naproxen, or other anti-inflammatory or blood-thinning medications, it is recommended to discontinue these medications and consult your doctor. If you have an infection or inflammation (such as diverticulitis, colitis, or inflammatory bowel disease) you probably have some type of symptoms other than bleeding: abdominal discomfort, cramps, gas, bloating, diarrhea. However, some patients just bleed. Either way, mixing of blood with stool is usually serious and should be evaluated immediately.
Sometimes people have diarrhea (with or without blood) after taking an antibiotic. This may be due to antibiotic-related colitis (clostridium difficile colitis, “c. Diff”) and requires immediate attention. Report these symptoms to your doctor immediately, as you will probably need a second antibiotic to treat this condition. However, certain antibiotics can cause diarrhea on their own without causing c. diff colitis.
Lastly, sometimes red dye or red food may look like blood, but it is not. Beets, red jelly, and other red foods are known to be mistaken for blood, but don’t attribute red discoloration to foods unless you are sure.
Copyright 2010 Cynthia J Koelker MD
