Blood in the Stool: Causes, the Color of the Blood and When to See a Doctor
Blood in the stool frightens almost everyone and is always a reason for an examination, but the most common causes are harmless and treat well: hemorrhoids and an anal fissure. What tells you most about where the blood comes from is its color, where it is seen and the symptoms that come with it. This article explains what bright red and dark blood mean, when a black stool is not bleeding at all, which signs call for an examination without delay and what a proctology and a gastroenterology appointment look like.
The color of the blood and where the bleeding comes from
| How it looks | Where from and possible causes |
|---|---|
| Bright red blood on the toilet paper or on the surface of the stool | The final part of the bowel and the anus: hemorrhoids, an anal fissure, irritation after a hard stool or diarrhea. |
| Dark red blood mixed into the stool | The large bowel: diverticula, inflammation of the bowel, polyps, more rarely a tumor. |
| A black, sticky stool with an unpleasant smell | The stomach and the duodenum: bleeding from an ulcer or damaged lining; calls for urgent assessment. |
| Blood with mucus, alongside diarrhea and pain | The large bowel: a bowel infection, inflammatory bowel disease. |
When a dark stool is not blood
Iron and bismuth preparations, blueberries, red wine and activated charcoal can all color the stool, and beetroot gives it a reddish tint. Such a stool is dark but not sticky and tarry, and it is not accompanied by weakness or dizziness. If you are not sure what you are seeing, see a doctor rather than waiting for it to pass.
The most common causes of blood in the stool
- Hemorrhoids: painless bleeding of bright red blood, dripping or a trace on the paper, sometimes a lump that comes out during a bowel movement.
- Anal fissure: a sharp pain during and after a bowel movement, like a cut, with a little fresh blood, most often after a hard stool.
- Polyps of the large bowel: most often with no symptoms at all, sometimes occasional bleeding; they are found and removed at colonoscopy.
- Diverticula: in older people, sudden and painless bleeding, sometimes heavier.
- Inflammatory bowel disease: diarrhea with blood and mucus, abdominal pain, weight loss, symptoms that last for weeks.
- Cancer of the large bowel: it does not have to bleed visibly; a change in bowel habit, anemia and weight loss are the important signs.
Signs that call for an examination without delay
- blood in the stool appearing for the first time after the age of 45;
- a change in bowel habit, diarrhea or constipation, that lasts longer than a few weeks;
- unexplained weight loss, weakness, pallor or anemia in the blood count;
- dark blood or blood mixed into the stool, not just a trace on the paper;
- cancer of the large bowel or polyps in a parent, brother or sister;
- abdominal pain or an urge to open the bowels that wakes you from sleep.
Call emergency services (194) for heavy bleeding, a black tarry stool with weakness, dizziness or fainting, and for vomiting blood.
How the cause is established
With fresh blood and symptoms around the anus, the first step is a proctology appointment with anoscopy: a conversation, an examination and a short look at the final part of the bowel with an instrument, which takes a few minutes and is usually not painful. It shows hemorrhoids, a fissure and changes in the final part of the bowel. If the examination does not explain the bleeding, or one of the signs from the previous section is present, the doctor recommends a colonoscopy and explains the preparation. With a dark stool, pain in the upper abdomen or anemia, the work-up is led by a gastroenterologist, and the blood count shows whether the bleeding has already caused anemia.
What an appointment at Miren Medic looks like
At the Miren Medic clinic the proctology appointment with anoscopy is carried out by Dr med. Branimir Nešković, surgical oncologist, discreetly and in a single visit. Gastroenterology appointments are held by Assist. Prof. Dr Stanko Petrović and Dr Miloš Jovićević, and with Dr Petrović the appointment can be combined with an abdominal ultrasound. The blood count is run in the clinic laboratory. All of it without a referral.
Prices
| Service | Price |
|---|---|
| Proctology appointment with anoscopy | 14.000 RSD |
| Sclerotherapy of hemorrhoids under local anesthetic | 14.000 RSD |
| Surgical oncology appointment (Dr med. Branimir Nešković) | 10.000 RSD |
| Gastroenterology appointment (Dr Stanko Petrović) | 10.000 RSD |
| Full appointment with abdominal ultrasound (Dr Stanko Petrović) | 14.000 RSD |
Frequently asked questions
Is blood in the stool dangerous?
Most often it is not: most cases are caused by hemorrhoids and an anal fissure. It is still always checked by examination, because the same sign can have a serious cause, especially after the age of 45 and alongside a change in bowel habit, weight loss or anemia.
What does bright red blood on the toilet paper mean?
That the bleeding most likely comes from the final part of the bowel or the anus. The most common reasons are hemorrhoids and an anal fissure, and they are confirmed by a proctology appointment with anoscopy.
What does a black stool mean?
A black, sticky, tarry stool with an unpleasant smell can mean bleeding from the stomach or the duodenum and calls for urgent assessment. A dark stool without those features is often caused by iron and bismuth preparations and by certain foods.
When is a colonoscopy needed?
When an examination of the final part of the bowel does not explain the bleeding, when the blood is dark or mixed into the stool, with a change in bowel habit, anemia or weight loss, after the age of 45 and where there is cancer of the large bowel in the family. Whether it is needed, and how to prepare, is decided by the doctor at the appointment.
Which doctor do you see for blood in the stool?
For fresh blood, pain or a lump around the anus, a proctology appointment. For dark blood, abdominal pain, diarrhea that persists or anemia, a gastroenterologist. Both appointments are booked without a referral.
Can hemorrhoids bleed every day?
They can, especially with a hard stool and straining. Daily bleeding, even from hemorrhoids, can lead to anemia over time, so it should not be put up with but examined and treated.
Book an appointment
If you have noticed blood in your stool, book a proctology or gastroenterology appointment at the Miren Medic clinic. The examination, the diagnosis and a proposal for the next steps come in a single visit, discreetly and without a referral.
