Etiological symptoms
Bloody stool, also known as "bloody stool", "bloody stool" and "bloody stool", is characterized by bloody stool or rare stool. More common in shangxiao
Hemorrhage due to chemical ulcer, gastrointestinal polyp, small intestine hemorrhage, tumor, bleeding due to perianal diseases, and some hematological diseases and acute diseases.
Sexually transmitted drugs, parasites, etc. Here refers to the damage caused by hemorrhoids, anal fissure, anal sinusitis, rectal mucosa damage
Blood in the stool caused by injury. The stool is soft, shaped or hard, and blood adheres to the surface of the stool. Some blood comes first and then stool, while others.
After defecation, the blood is mostly bright red, and some are dark red and turbid. Blood loss is endless for a long time, and anal pain after defecation.
Aggravate.
Traditional Chinese medicine believes that hematochezia is caused by heat accumulation in the intestine (dampness) or spleen-qi deficiency, which can not control blood circulation. Can clear the intestines.
Treatment with heat, hemostasis, invigorating qi and taking blood.
Matters needing attention in self-treatment
(1) Get into the habit of defecating regularly, and the stool should be thin and pasty.
(2) Reduce the posture of increasing abdominal pressure, such as squatting and holding your breath. Avoid sedentary, long standing, long walking and overwork.
(3) Avoid spicy, hot, greasy, rough and dreary foods, and avoid alcohol, tobacco and coffee.
(4) Eat more foods that have the functions of clearing heat from intestines, moistening nutritious mucosa, relaxing bowels and stopping bleeding, such as raw pear juice and lotus root juice.
Water chestnut juice, reed root juice, celery juice, carrot, white radish (cooked food), bitter gourd, eggplant, cucumber, spinach,
Day lily, cabbage, egg yolk, apple, fig, banana, black sesame, walnut meat, white fungus, etc.
(5) Be cheerful and don't be angry and hot. If the mood is not wide, irritability and depression will cause intestinal mucosa to contract and blood circulation will not be smooth.
(6) Reduce sexual intercourse. Excessive sexual intercourse will make the intestinal mucosa congested. Aggravate bleeding.
Autonomy therapy
1.
(1) Yunnan Baiyao, 0.3g each time, 2-3 times a day. Swallow with warm water.
(2) Piyue Maren Pill, 9g each time, twice a day, swallowed with warm water.
(3) Zanglian Pill, 9g each time, twice a day, swallowed with warm water.
2. Prescription self-treatment
(1) rhubarb charcoal grinding powder, 3-6g each time, twice a day, swallowed with warm water.
(2) Drying and grinding eggplant leaf tiles, 6g each time, twice a day. Swallow rice soup.
(3) 60 grams of Eclipta prostrata, decoction instead of tea.
(4) Sanguisorba officinalis charcoal15g, Sophora japonica charcoal12g, madder charcoal12g, adzuki bean 30g and Saposhnikovia divaricata charcoal10g.
G, rhubarb charcoal 1 0g, phellodendron bark10g, once a day1dose, decocted twice. Used for heat accumulation and dampness in intestine,
Red and turbid blood, bitter taste, yellow and thick tongue coating, and poor stool.
(5) 30g of heartsoil, 0/0g of codonopsis pilosula/kloc-,0/0g of charred Atractylodes macrocephala/kloc-,0/0g of ginger charcoal/kloc-,0/0g of cimicifuga foetida charcoal/kloc-,
Stir-fried Radix Astragali 1 2g, Colla Corii Asini 9g (melted separately) and Glycyrrhrizae Radix 6g, with a paste of1day, and decocted twice. Used for spleen-qi deficiency
Weak, pale, tired and weak.
3. Diet self-therapy.
(1) 250g of pig large intestine, fresh Sophora japonica15g, cooking and drinking soup.
(2) Eat several persimmons every day.
(3) Auricularia auricula10g, red dates15g, stewed with low fire.
(4) 30 grams of day lily, appropriate amount of brown sugar, decoction.
(5) Ginger and Folium Artemisiae Argyi each15g. Decoct Folium Artemisiae Argyi with ginger in thick juice, each serving 1 cup. Folium Artemisiae Argyi Warming Meridian to Stop Hemorrhage, Ginger
Dispelling cold, it is used to treat deficiency-cold bleeding, mainly for bleeding after defecation.
(6) 5 bowls of vinegar and 3 bowls of red beans, cooked and dried into powder, 5 grams each time. This prescription is mainly used for treating intestinal hemorrhoid bleeding.
4. External treatment and self-therapy
(1) fumigation and washing. Soak colla Corii Asini in vinegar to soften, steaming and mel to obtain paste, taking 30g each time, adding 500g vinegar to melt,
After heating and boiling, smoke first and then wash the anus twice a day. The stock solution can be washed many times. Used for patients with anal fissure and hemorrhoid bleeding.
(2) apply medicine. Cool oil mixed with Zhuhuang powder 2 sticks, coated inside and outside anus.
(3) Wild wormwood (Artemisia argyi cotyledons) is pounded like mud and applied to the anus.
(4) Apply egg butter to the anus. (Suitable for dry and ruptured anal mucosa. )
Egg butter method; Take a few cooked egg yolks, stir-fry them in a non-iron tableware with low fire, and filter until the oil seeps out.
5. Other self-therapies
(1) Rub the abdomen. Rub the abdomen twice every morning and evening (before going to bed after waking up), counterclockwise 100 times each.
(2) levator ani. Do anal contraction 2-3 times a day, 30-50 times each time.
Avoid misdiagnosis
In the past, there was no anorectal disease and bloody stool suddenly appeared, or a small amount of dark and turbid bloody stool appeared from time to time, which lasted for a long time; or
There are necrotic and corrupt tissues and thick secretions in the blood in the stool. Patients should not be negligent and should go to the hospital for examination.
Because of fear of pain caused by defecation, forbearing defecation will cause constipation, endogenous heat toxin and aggravated defecation.
Shape.
Unmarried young women must pay attention to rest during menstrual period, and pay attention to the cleanliness of vulva, otherwise it will easily lead to anal mucosal inflammation, rupture and bleeding.
have/pass blood in one's stool
After gastrointestinal bleeding is discharged through the intestine, the feces contain blood or whole blood stool, and the color can be bright red, dark red and tar. The color of bloody stool depends on the location of bleeding, the amount of bleeding and the time that blood stays in the digestive tract. Lower digestive tract (small intestine, colon, rectum, anus) bleeding, stool is often bright red or dark red. Upper digestive tract (esophagus, stomach, duodenum) bleeding, stool is often tarry.
(1) Etiology
Blood in the stool is generally divided into bloody stool, tarry stool and occult blood stool. The common causes are described as follows.
1 bloody stool: it usually comes from the lower end of ileum, colon, rectum and anus, and the stool is bright red or dark red, which can be mixed with mucus and pus. Common diseases are hemorrhoids and anal fissure bleeding. Hemorrhoid hematochezia spouts out during defecation or drops blood after defecation; Anal fissure has less blood in stool, but anal pain is more dramatic. Rectal polyp bleeding, stool blood volume is not large, blood is attached to the stool surface, and sometimes stool becomes thin and strip-shaped or imprinted. Dysentery bloody stool is purulent bloody stool with frequent defecation, accompanied by left lower abdominal pain.
2 tarry stool: that is, black stool. The upper gastrointestinal bleeding did not vomit, and the blood stayed in the intestine for a long time. The hemoglobin in the blood combined with the sulfide in the intestine to form ferrous sulfide, which made the stool black and shiny, like asphalt. The appearance of tarry stool indicates that the amount of bleeding has reached more than 60 ml. However, it should be noted that some foods and drugs can make the stool black, which can be identified by fecal occult blood test.
3 occult blood stool: A small amount of gastrointestinal bleeding does not cause the color change of stool, and only when the stool occult blood test is positive, it is called occult blood stool. All diseases that cause gastrointestinal bleeding can cause occult bloody stools, such as gastric ulcer and gastric cancer.
(2) Rescue measures
Rescue measures are basically the same as hematemesis. Stay in bed quietly, reduce activities, observe the amount of bleeding, use hemostatic drugs appropriately, and send them to the hospital for emergency treatment in case of syncope and shock.
How to register for medical treatment
1.anorectal surgery: patients with bright red blood after defecation or defecation with bright red blood, generally without severe abdominal pain, should be hanged for anorectal surgery.
2. General surgery: patients with bloody stool, severe abdominal pain and even shock should be hanged for general surgery.
3. Intestinal outpatient service: Patients with acute onset and purulent bloody stool should be linked to the intestinal outpatient service.
4. Gastroenterology: Patients with black stool, dark red bloody stool, or a history of chronic colitis who often discharge bright red bloody stool should be hanged in Gastroenterology.
5. Hematology: those with hematochezia accompanied by systemic bleeding tendency should be checked in hematology department for further examination.
6. Nephrology: Those with a history of nephritis and bloody stools should be linked to Nephrology.
7. Infectious diseases department: Patients with hematochezia after fever and life history in epidemic areas should be registered in infectious diseases department.
Blood discharged from anus is called hematochezia, which mainly includes dropping blood, spraying blood or stool with blood. Generally speaking, bloody stool visible to the naked eye often indicates lower gastrointestinal bleeding (especially colon and rectum). The closer the bleeding site is to the anus, the brighter the color.
It is generally believed that hematochezia is caused by hemorrhoids, which is not correct. Hemorrhoids, especially internal hemorrhoids in the first and second stages, are mainly characterized by blood. Bloody stool usually occurs when defecating, when defecating and after defecating, blood drops or there is jet bleeding, and blood is not mixed with feces. The amount of bleeding varies from several milliliters to tens of milliliters. Repeated bleeding can lead to severe anemia. The diagnosis of hemorrhoids is relatively easy, but it must be pointed out that anorectal diseases with bloody stool, such as rectal adenoma and rectal cancer, are often misdiagnosed as internal hemorrhoids. Therefore, other diseases must be excluded when determining the diagnosis of hemorrhoids. It is necessary to perform finger examination on patients with hematochezia, and it is a convenient, economical, safe and accurate examination method to use disposable sigmoidoscopy for routine examination.
Anal fistula often has purulent discharge, less bloody. Because of the repeated attacks of the disease, the condition is aggravated, and surgical treatment is still more reliable at present.
Rectal cancer is a common malignant tumor, and its main clinical manifestations are:
1. bloody stool.
2. Purulent bloody stool and mucus bloody stool.
3. Changes in bowel habits, including constipation, diarrhea or alternation of the two, endless defecation, etc.
4. The shape of stool changes.
5. Abdominal pain, abdominal discomfort, abdominal mass, etc.
Routine examination of patients with hematochezia with disposable sigmoidoscopy can find rectal and low sigmoidectomy early, and colonoscopy can be performed if necessary. Early detection, early diagnosis and early treatment must be advocated for colorectal cancer.
Precancerous lesions:
1. Adenoma: Adenoma is a precancerous lesion, and its common symptoms include bloody stool, change of stool habit, tumor protruding from anus, abdominal pain, etc. One-off sigmoidoscopy should be used for early diagnosis and early surgical resection.
2. Chronic ulcerative colitis: The main symptoms are bloody stool, increased defecation times and abdominal pain.
Others:
1. Systemic diseases: such as blood system diseases.
2. Anal injury, etc.
In short, bloody stool should be checked in a regular hospital in time to eliminate other diseases, so as not to delay the illness. (
Blood in the stool: blood comes out of the anus, or comes down with impurities in the stool, or pure blood.
Soul pivot. The title of "all diseases begin": "post-blood"; "Treatise on Febrile Diseases" called "blood"; Synopsis of the Golden Chamber says "bleeding", and puts forward the names of "far blood" and "near blood" according to the order of bleeding and defecation. Zhang Jingyue pointed out: "The blood comes far from the stool, and the far one is in the small intestine or the kidney. ..... If the blood comes before the stool, it will come near, and the nearest person will be in the intestine or in the anus. " Later generations of doctors followed the name of clear and turbid blood, establishing intestinal wind and dirty poison. The key to syndrome differentiation and treatment says: "The bright red serum is intestinal wind, and the turbid and dark serum is dirty poison." "Introduction to Medicine" is called "blood arrow" if there is blood in the stool, it will be powerful, such as if the arrow is far away.
This disease should be differentiated from dysentery and purulent blood. People with diarrhea and purulent blood are mostly accompanied by purulent blood, and they have obvious abdominal pain, acute diarrhea and severe diarrhea. However, this disease is characterized by blood flowing down from the stool without pus, and there are no obvious symptoms such as abdominal pain and acute diarrhea and severe diarrhea.
"Common syndromes"
Excess heat in gastrointestinal tract: bloody stool, dry lips and mouth, thirst for cold drinks, swollen gums, bad breath and bitter taste, sores on the mouth and tongue, constipation, burning anus, red tongue with yellow fur and strong pulse.
Damp-heat steaming: blood comes first, then stool, blood is bright red, stool is uncomfortable, limbs are sleepy and swollen, anorexia, bitter taste, short and red urine, red tongue, yellow and greasy fur and rapid pulse.
Deficiency and cold of the spleen and stomach: stool first followed by blood, or blood mixed with stool, or pure blood, with dark purple color, or stool like tar, dull complexion, listlessness, abdominal pain, anorexia, loose stool, cold limbs, pale mouth but not thirsty, pale tongue, white and moist fur, and thready pulse.
Yin deficiency of liver: bloody stool, dizziness, red cheeks, feverish nerves, restless night sleep, night sweats due to steaming bones, insomnia in dreams, backache and limb fatigue, emaciation, crimson tongue and rapid pulse.
Hemorrhoid hematochezia: bloody stool, unbearable anal pain, or swelling with hemorrhoid nucleus, or accompanied by anal fissure, red tongue with yellow coating, and rapid pulse.
References:
Abnormal color of stool in children with hematochezia
Key points of differential diagnosis of hematochezia:
Possible diagnosis of complications
Ejecting blood during defecation, or dripping blood after defecation, blood and feces are not mixed, and the amount of bleeding varies, accompanied by anal foreign body sensation or sudden pain hemorrhoids.
Fecal blood volume is less, the color is bright red, and it is filiform and covers the feces. There is pain during defecation and anal fissure in different degrees after defecation.
Intermittent hematochezia, usually with a small amount of blood in the stool, is bright red and does not mix with the stool, sometimes the stool becomes thin and thin, or there is a concave rectal polyp or colon polyp on one side.
With the development of the disease, stool blood volume increases, often accompanied by diarrhea, weight loss, anemia, stool often mixed with thick mucus, rectal cancer with special foul smell, more common in middle-aged and elderly people.
Changes in stool habits, diarrhea or constipation, pus-like stool or mucus-like blood. carcinoma of colon
Sudden onset, accompanied by abdominal pain, diarrhea, nausea and vomiting, low stool volume, often mixed with feces, frequent stools, bacterial dysentery or amebic dysentery with severe feeling after urgency and abdominal tenderness.
Hemorrhage is often intermittent, with a small amount of blood in the stool, and pus or mucus is contained in the stool, which is often accompanied by abdominal pain, diarrhea and ulcerative colitis after acute diarrhea.
The amount of bleeding is small, accompanied by bleeding tendency in other parts of the blood diseases, such as leukemia, hemophilia, thrombocytopenic purpura, aplastic anemia and so on.
Tardiness, often accompanied by hematemesis, is a characteristic symptom of upper gastrointestinal bleeding, such as cirrhosis, portal hypertension and digestive tract ulcer.
There is no change in stool color, only occult blood test is positive, which is mostly caused by a small amount of bleeding in digestive tract.
What kinds of diseases should be mainly considered when stool is bloody?
Blood in stool is a special symptom of lower gastrointestinal bleeding, especially in colon, rectum and anus, which suggests that there are organic lesions in the intestine, so we must attach great importance to it, make a clear diagnosis in time and pay close attention to treatment. The following diseases should be considered when the stool is bloody:
(1) Anal diseases
① The patients with bright red blood and no pain are more common in internal hemorrhoids, and the hemorrhoid nucleus in stage I is characterized by blood, and they often bleed because of rubbing the hemorrhoid nucleus with stool, and the blood dripped continuously, or a line is like an arrow, or only carries blood on toilet paper; There is little or no bleeding in the stool of stage ⅱ hemorrhoid, and it often comes out of the anus.
② bloody stool in anal fissure is often accompanied by anal pain and typical periodic pain after defecation.
③ The main manifestations of anal canal cancer are bloody stool and pain, and the pain is aggravated before defecation.
(2) Rectal diseases
① The main symptom of rectal polyp is hematochezia, which is intermittent, bright red in color and generally small in quantity. This disease is common in children.
② The main manifestations of rectal cancer are increased stool frequency, thinner stool, mucus and blood, accompanied by acute interior, heavy defecation or incomplete defecation. The blood in the stool is bright red or dark red in the early stage, and the amount is not much. In the late stage, there is often foul mucus in the stool, and the weight is reduced, which should be highly valued.
③ Radioproctitis can also be bloody in stool, but there should be a history of radiotherapy.
(3) Colonic diseases
① Colonic polyp: A. Juvenile colonic polyposis, with an average onset age of 6 years old and no family history, is characterized by bloody stool, often accompanied by malnutrition, anemia, hypoproteinemia and growth retardation, and often accompanied by congenital malformations, such as intestinal malrotation, umbilical hernia and brain edema; B. Familial juvenile polyposis coli: there is a family history, and the common symptoms are bloody stool, rectal prolapse and growth retardation; c .Cronknite? Canda syndrome (CCS): it is hamartomatous polyp syndrome, which comes into being in adults, with bloody stools, diarrhea, heavy defecation, and fat, and abdominal pain, anorexia, fatigue, vomiting, sexual desire and taste loss. There are almost always changes in the nails, hair loss and pigmentation.
② Colon cancer: It is common in left colon cancer. Patients often have intractable constipation, and occasionally the frequency of defecation increases. When the cancer is broken, blood or mucus can be stained on the outside of the fecal block, and even pus can be discharged.
(3) Chronic nonspecific ulcerative colitis and bacillary dysentery: Both of them have bloody stools, and most of them are discharged at the same time with mucus or pus, accompanied by abdominal pain.
(4) Amoebic dysentery: so that blood is the main symptom, and its stool is sauce red, with a lot of mucus and a bad smell.
(5) Hemorrhagic Escherichia coli enteritis: it is characterized by acute onset, accompanied by fever and diarrhea, and may have a history of eating rotten meat, often in the form of food poisoning.
In addition, children under 1 year should pay attention to intussusception. Some systemic diseases such as leukemia, aplastic anemia, hemophilia, etc. can also have symptoms of bloody stool.
have/pass blood in one's stool
After gastrointestinal bleeding is discharged through the intestine, the feces contain blood or whole blood stool, and the color can be bright red, dark red and tar. The color of bloody stool depends on the location of bleeding, the amount of bleeding and the time that blood stays in the digestive tract. Lower digestive tract (small intestine, colon, rectum, anus) bleeding, stool is often bright red or dark red. Upper digestive tract (esophagus, stomach, duodenum) bleeding, stool is often tarry.
(1) Etiology
Blood in the stool is generally divided into bloody stool, tarry stool and occult blood stool. The common causes are described as follows.
1? Blood usually comes from the lower end of ileum, colon, rectum and anus, and the stool is bright red or dark red, which can be mixed with mucus and pus. Common diseases are hemorrhoids and anal fissure bleeding. Hemorrhoid hematochezia spouts out during defecation or drops blood after defecation; Anal fissure has less blood in stool, but anal pain is more dramatic. Rectal polyp bleeding, stool blood volume is not large, blood is attached to the stool surface, and sometimes stool becomes thin and strip-shaped or imprinted. Dysentery bloody stool is purulent bloody stool with frequent defecation, accompanied by left lower abdominal pain.
2? Tarry stool is black stool. The upper gastrointestinal bleeding did not vomit, and the blood stayed in the intestine for a long time. The hemoglobin in the blood combined with the sulfide in the intestine to form ferrous sulfide, which made the stool black and shiny, like asphalt. The appearance of tarry stool indicates that the amount of bleeding has reached more than 60 ml. However, it should be noted that some foods and drugs can make the stool black, which can be identified by fecal occult blood test.
3? Occult blood stool is called occult blood stool if a small amount of gastrointestinal bleeding does not cause the color change of stool, but only when the stool occult blood test is positive. All diseases that cause gastrointestinal bleeding can cause occult bloody stools, such as gastric ulcer and gastric cancer.
(2) Rescue measures
Rescue measures are basically the same as hematemesis. Stay in bed quietly, reduce activities, observe the amount of bleeding, use hemostatic drugs appropriately, and send them to the hospital for emergency treatment in case of syncope and shock.
Is hematochezia an internal hemorrhoid?
Blood in the stool is a typical symptom of internal hemorrhoids, especially early internal hemorrhoids, but it cannot be considered that blood in the stool is internal hemorrhoids. Bloody stool is a common symptom, and many diseases in clinic can cause bloody stool.
① Various enteritis: due to inflammation, the integrity of intestinal mucosa is destroyed, and dark purple blood and secretions are mixed in the stool, accompanied by the unique symptoms of various enteritis.
② Anal papillitis and its hypertrophy: On the tooth line, the surface is covered with anal epithelium, with occasional bleeding.
③ Anal fissure: The pain is severe when defecating, and the blood drips after defecating.
④ Rectal cancer: There are often bleeding and a lot of secretions, which are the most easily misdiagnosed and missed. During hand examination, the finger cuff can be stained with blood, and can reach hard lesions with different shapes, rough surfaces and uneven edges. Pathological biopsy is needed to make a diagnosis. Bleeding from the disease can also cause anemia.
⑤ Rectal adenoma or choriocarcinoma: The disease often bleeds. Every time you defecate, there is bloodshot on the stool, and occasionally there is a lot of bleeding. However, the tumor is long and pedicled. Anoscopy shows that the tumor is red in color and can be pedicled.