There are many causes of blood in the stool. Almost all gastrointestinal bleeding can cause blood in the stool, but the common causes are: ① Upper gastrointestinal bleeding (see hematemesis). ②Small intestinal bleeding, such as intestinal tuberculosis, localized enteritis, acute hemorrhagic necrotizing enteritis, small intestinal tumors, intussusception, etc. ③Colon bleeding, such as dysentery, ulcerative colitis, localized enteritis, colon cancer, etc. ④ Rectal bleeding, such as rectal cancer, rectal damage, hemorrhoids, anal fissure, etc. ⑤ Other diseases, such as various blood diseases, epidemic hemorrhagic fever, typhoid and paratyphoid, hookworm disease, vitamin deficiency, etc.
Upper gastrointestinal bleeding and small intestinal bleeding are mostly dark red or black stools, which are often shiny because the surface is covered with a thin layer of mucus. However, if the bleeding speed is fast, the bleeding volume is large, and intestinal peristalsis increases, the bloody stool may appear dark red or bright red. When colon and rectum bleed, because the blood stays in the intestines for a short time, bright red or brighter bloody stools are often discharged. Bleeding in the right colon, blood often mixed with feces, can lead to "jam-like" bloody stools. Bleeding from the rectum and sigmoid colon, and blood often adheres to the surface of the stool. Patients with acute massive hematochezia may present with acute blood loss anemia and acute peripheral circulatory insufficiency. In addition to medical history and physical examination data, the diagnosis of hematochezia is based on digestive system endoscopy as the first choice. If necessary, X-ray barium angiography, radionuclide, angiography and other examinations can be performed to aid diagnosis. Gastrointestinal excess heat: blood in the stool, dry lips and mouth, thirst for cold drinks, swollen and painful gums, bad breath and bitter mouth, sores on the mouth and tongue, constipation, burning anus, red tongue with yellow coating, and weak pulse. .
Dampness and heat combined with steaming: blood first and then defecation, bright red blood in the stool, unpleasant stool, drowsiness in the limbs and abdominal distention, anorexia, bitter mouth, short red urine, red tongue, yellow and greasy coating, and wet and rapid pulse.
Deficiency of the spleen and stomach: bloody stools first and then blood, or bloody stools, or pure blood, purple and dark blood, or stools like tar, dull complexion, mental fatigue, dull pain in the epigastrium and abdomen, lack of appetite, and loose stools , cold body, cold limbs, light mouth but not thirsty, light tongue, white and moist coating, thin and weak pulse.
Liver yin deficiency: blood in the stool, dizziness and red cheekbones, irritability and heat in the five palpitations, restless sleep at night, bone steaming and night sweats, sperm loss in dreams, backache and limb fatigue, weight loss, tongue The texture is reddish-purple, and the pulse is thready and rapid.
Hemorrhoids: bright red blood in the stool, unbearable pain in the anus, swelling with hemorrhoids, or anal fissure, red tongue with yellow coating, and stringy and rapid pulse. Blood in the stool can occur in a variety of anorectal diseases, and should be judged based on a comprehensive analysis of symptoms such as age of onset, pattern, amount, color, and presence or absence of pain in the blood in the stool. If the stool is tarry or black, the bleeding site is mostly in the upper gastrointestinal tract, that is, the stomach and duodenum are most likely to bleed. If the blood is purple-red, mixed with mucus, and accompanied by a foul odor, you should consider the possibility of intestinal tumors, especially rectal cancer. If the blood in the stool is bright red and adheres to the surface of the stool in drops, then the bleeding site is mostly in the anus or a location not far from the anus. Bleeding from hemorrhoids, anal fissures, and rectal cancer should be considered. However, it is worth noting that if there is a large amount of bleeding in the upper gastrointestinal tract, the blood color may also be bright red due to the short residence time of the blood in the gastrointestinal tract. This needs to be carefully identified.
Hematochezia in children is mostly caused by rectal polyps. Generally, hematochezia caused by polyps is bright red, painless, and the blood does not mix with the stool. If a child has paroxysmal abdominal pain, a mass can be felt in the right lower abdomen, and bloody stool is jam-like, you should be highly vigilant about the occurrence of intussusception in children. If you have the above symptoms, you should go to the hospital in time to avoid delaying the condition.
Mucoid bloody stools in adults, accompanied by lower abdominal pain, frequent bowel movements and other symptoms, are generally symptoms caused by ulcerative colitis.
Blood in the stool is bright red and often hangs on the side of dry and hard stool. Periodic pain in the anus occurs after defecation, which is more common in anal fissures.
It is worth mentioning that the amount of blood in the stool caused by some diseases is often invisible to the naked eye. A small amount of gastrointestinal bleeding is an important symptom of early colon cancer. If blood in the stool can be detected as early as possible, , which is of great significance for diagnosing the disease and obtaining a good opportunity for treatment. Clinically, the fecal occult blood test is generally used to detect a small amount of blood mixed in the stool. When patients find that they have symptoms of blood in the stool, they should go to the hospital as soon as possible. After clinical examination, and through various examinations such as laboratory tests, X-rays, and endoscopy, the disease can be determined and treated as soon as possible.
Diseases that cause anorectal bleeding are generally divided into four categories based on location.
(1) Anal disease: Anal disease is the most common cause of blood in the stool. Blood in the stool caused by hemorrhoids and anal fissures is bleeding after the stool. In severe cases, blood can spurt out. The blood is bright red and does not mix with the stool. Mixed, blood in the stool caused by anal fissure is often accompanied by anal pain after defecation. Hemorrhoids bleed, often when straining to defecate, a small lump protrudes from the anus, and drops or spurts of blood are discharged. The amount of bleeding can be large or small, and bleeding from internal hemorrhoids is often painless.
(2) Rectal diseases: Rectal polyps are benign tumors of the rectum. Blood in the stool is the main symptom of rectal polyps. Rectal polyps that are very close to the anus sometimes prolapse outside the anus. This disease is common in children.
If someone continues to have bloody stools, has a feeling of falling, has increased stool frequency, has alternate constipation and diarrhea, and has experienced significant weight loss in a short period of time, it may indicate the possibility of rectal cancer. Possibly, such a situation must be taken seriously, especially by the elderly.
(3) Colon diseases: Like the rectum, polyps and cancer can also occur in the colon. Ulcerative colitis, dysentery and other diseases can also cause blood in the stool. Most of these large intestinal inflammatory diseases cause blood in the stool. Stool mixed with mucus or pus and blood, accompanied by symptoms such as abdominal pain, fever, and tenesmus. In addition, some relatively rare diseases, such as enteric typhoid, intestinal tuberculosis, intussusception, etc., may also cause symptoms of blood in the stool.
(4) Systemic diseases: leukemia, aplastic anemia, idiopathic thrombocytopenic purpura, hemophilia, coagulation disorder, collagen disease, uremia and some rare infectious diseases such as Plague, typhus, etc. will all cause blood in the stool. However, among these diseases, blood in the stool is only a part of systemic bleeding. Blood in the stool can also occur in other parts of the body, so it is not difficult to identify it.
Why do you have blood in your stool after drinking?
1. Drunk hemorrhoids attack with blood in the stool: clinically, hemorrhoids in stages I and II are more common, often with blood in the stool, mostly after defecation, sometimes bleeding, ejaculation or just on toilet paper It is bloody, the blood does not mix with the feces, and the color is bright red. Generally, there is no tenesmus or pain. When the stool is dry and hard, the amount of bleeding may increase.
2. Blood in the stool after alcoholic enteritis attack:
Chronic colitis: often mucus and bloody stool, accompanied by pain in the lower abdomen or left lower abdomen and a history of diarrhea, with pain, urge to defecate, and relief after defecation. According to the regular pattern, the amount of bleeding is not much, and those involving the rectum have symptoms of tenesmus. Colonoscopy can show mucosal edema, congestion, rough granular texture, brittle and easy to bleed, with purulent secretions, and some can show round cysts of varying sizes. Multiple shallow ulcers.
Amebic colitis: The main symptom is bloody stool, which is mucus, pus and blood, jam-like, with a putrid smell, accompanied by abdominal pain, diarrhea, mild tenesmus, and often tenderness in both lower abdomen. Colon ulcers that invade submucosal blood vessels can cause intestinal bleeding, and some can cause repeated bleeding.