Adult hematochezia is mostly caused by hemorrhoids, anal fistula, anal fissure, rectal polyp, colon polyp, rectal cancer, colon cancer and bacillary dysentery. Most of them belong to anorectal diseases and should be paid attention to. The proportion of young people under 30 years old with bloody stools has increased from 8% before 10 to 15%. With the increase of age, the malignant lesions (including benign and malignant) of sigmoid colon and rectum in human body increase obviously. Patients over middle age should be suspicious of changes in stool habits, diarrhea or constipation, thin stools, mucus and pus in stools. A few patients may only show fixed abdominal pain. Among many anorectal diseases, not only hemorrhoids can cause hematochezia, but other anorectal diseases can also cause hematochezia, such as anal fissure, rectal polyp, colon polyp, ulcerative colitis and even rectal cancer. 1. Hemorrhoids: Blood in the stool usually occurs during or after defecation, showing a drop of blood or a jet, with bright red blood, and blood and stool are not mixed; 2, anal fissure: the stool caused by anal fissure is bloody, the blood is bright red, there is blood after dripping or wiping with toilet paper, and there is severe pain in the anus after defecation; 3, colorectal polyps: bright red blood, slight pain, blood is not mixed; 4, ulcerative colitis: bleeding mixed with mucus or purulent bloody stool, accompanied by abdominal pain, fever, frequent stool and so on. ; 5, rectal cancer: the blood color is bright red or dark red, and it is attached to the surface of the stool in a drop shape; Late purulent stool is often accompanied by anorectal decline, emaciation and changes in stool habits. Characteristics of haemorrhoids and hematochezia. Bleeding. How much is different, the light is just bloody stool, and the heavy one flows a few milliliters to a dozen milliliters at a time. 2. Bleeding frequency. The light person has intermittent bloody stool, and the heavy person will inevitably bleed every time he defecates. 3. Timing of bleeding. It is most likely to occur or aggravate when the feces are dry and hard or when irritating foods such as peppers are eaten. 4. Bleeding pattern. Generally, blood is attached to feces or blood drops after defecation. Color analysis of stool bleeding Most of the blood is instantaneous bleeding, which flows out of blood vessels for a short time and then is discharged through anus with feces, or directly after defecation. The appearance of blood is similar to traumatic bleeding, and the color is bright red or purple red and dark red, which can be solidified into blood clots after a little time. Blood is common in the following diseases: 1. Hemorrhoids: internal hemorrhoids and mixed hemorrhoids in all stages can cause bleeding in the stool, usually with blood in the stool or after defecation. External hemorrhoids generally do not have stool bleeding. 2, rectal polyps: painless stool bleeding. Bleeding during defecation stops after defecation, and the amount varies. Generally speaking, blood does not mix feces, or polyps are high and many, and feces can also be mixed. 3, rectal prolapse: after a long illness, bleeding may occur during defecation. 4. Anal fissure: bloody stool. The way of bleeding is that there is blood on one side of the stool surface, which is not mixed with feces, and some patients drop blood after defecation. In order to determine whether the above diseases are the cause of hematochezia, electronic anorectal mirror can be used for diagnosis. At present, some hospitals use imported high-definition anorectal endoscope (for example, the anorectal surgery center of the first branch of the 309 Hospital of Beijing People's Liberation Army), which can enlarge the focus several times and effectively find out the cause of hematochezia. Purulent blood refers to both pus and blood in the discharged feces. The blood is thin in appearance and sometimes contains a lot of mucus. Purulent bloody stool or blood containing mucus is more common in tumors and inflammation of rectum or colon. The following are several common diseases: 1, rectal cancer: blood is bright or dark red, and there may be mucus in feces, often mixed with blood, mucus and feces. 2, colon cancer: With the extension of the course of disease, stool bleeding gradually appears, mostly bloody stools containing pus or mucus, and the blood color is dark. 3, ulcerative colitis: mucus or purulent bloody stool, accompanied by left lower abdominal pain or lower abdominal pain. Black stool refers to black or brown stool, also known as cypress oil stool, which is one of the most common symptoms of upper gastrointestinal bleeding. Upper gastrointestinal bleeding is mainly manifested as melena, often accompanied by hematemesis, palpitation, fatigue, anemia and other symptoms and signs. If the amount of bleeding is small, the speed is slow, and the blood stays in the intestine for a long time, the stool discharged by the intestinal fluid is black; If the amount of bleeding is large, the retention time in the intestine is short, and the discharged blood is dark red; The amount of bleeding is particularly large, and it can be bright red soon after discharge. Concealed blood stool is called occult blood stool only when a small amount of gastrointestinal bleeding does not cause color change of stool. All diseases that cause gastrointestinal bleeding can cause occult bloody stools, such as gastric ulcer and gastric cancer. Fecal occult blood test can detect a small amount of blood components in stool. Repeated and continuous occult blood test is positive, suggesting chronic gastrointestinal bleeding, which should be further examined to be alert to the existence of digestive tract tumors. Common symptoms of damp-heat in gastrointestinal tract: bloody stool, dry lips, liking cold drinks, swollen gums, bad breath, bitter taste, sores on mouth and tongue, constipation, burning anus, red tongue with yellow fur and strong pulse. Damp-heat steaming: blood first, then stool, bright red blood, uncomfortable stool, swollen limbs, anorexia, bitter taste, short and red urine, red tongue, yellow and greasy fur, and rapid pulse. Deficiency and cold of spleen and stomach: stool with blood first, or blood mixed with stool, or pure blood, purple and dark, or the stool is tar-like, with dull complexion, mental fatigue, abdominal pain, anorexia, thin stool, cold limbs, pale mouth without thirst, pale tongue, white and wet fur and thready pulse. Yin deficiency of liver: bloody stool, dizziness, blushing, nervous fever, restless night sleep, night sweat due to bone steaming, dreaminess, insomnia, backache, limb fatigue, emaciation, red tongue and rapid pulse. Hemorrhoid hematochezia: bloody stool, unbearable anal pain, or swelling of hemorrhoid nucleus, or anal fissure, red tongue with yellow coating and rapid pulse. Introduction of bloody stool disease (1) Hemorrhage from hemorrhoids (2) Hemorrhage from colonic diverticulum (3) Hemorrhage from isolated rectal ulcer (4) Hemorrhage from anal fissure (5) Polyps of large intestine (6) Causes of bloody stool caused by digestive tract diseases of colorectal cancer (1) Hematemesis caused by upper digestive tract diseases is usually accompanied by black stool, and bloody stool can occur when the bleeding amount is large and rapid. (2) Lower gastrointestinal diseases 1. Small intestinal diseases: common in tuberculosis, typhoid fever, acute hemorrhagic necrotizing enteritis, hookworm disease, Crohn's disease, small intestinal tumor and hemangioma, jejunal diverticulitis, ulcer, intussusception, etc. 2. Colonic diseases: bacillary dysentery, amebic dysentery, schistosomiasis, ulcerative colitis, colonic diverticulitis, tumor, polyp, ischemic colitis, etc. Diagnosis of bloody stool 1. To understand the occurrence and development of hematochezia. Hemorrhoids and anal fissure often bleed after defecation; Chronic nonspecific colitis, colonic polyps, etc. Often repeated and intermittent, accompanied by a small amount of blood in the stool; In the middle and late stage (colorectal cancer), it may be a persistent small amount of bloody stool. 2. Distinguish hematochezia, bleeding mode, color and amount of bleeding. For example, internal hemorrhoid bleeding is dripping or spraying; Anal fissure is that blood adheres to the surface of feces or is stained with blood by toilet paper, and the amount of bleeding is small. If there is a lot of bleeding, the blood is stored in the intestinal cavity and can be black, dark red or blood clots when discharged. 3. Pay attention to the symptoms of bloody stool, such as proctitis, rectal canceration, etc. , and bloody stool is often accompanied by anal distension and urgency; Internal hemorrhoids, polyp bloody stool with or without anal pain; Anal fissure with anal pain and constipation; Chronic colitis is often accompanied by diarrhea and dull pain in the left lower abdomen; Hemorrhagic necrotizing colitis, intussusception with severe abdominal pain. How to distinguish blood in stool 1 and the color of stool? If the color is tar or black stool, the blood mostly comes from the upper digestive tract, but if the patient eats pig blood, Chinese medicine and so on. The stool may be black; If it is purplish red, mixed with mucus and smelly, we should think of the possibility of rectal malignant transformation; If the blood is bright red, it mostly comes from the lower digestive tract. 2. From the age analysis, children's bloody stool mostly comes from rectal polyps, which is characterized by no pain; Bloody red, not mixed with shit. The blood in intussusception is usually mucinous and jam-like. The child has paroxysmal severe abdominal pain, and sometimes the intussusception lump can be felt in the abdomen. How to check blood in stool is different, internal hemorrhoids and anal fissure often bleed after defecation; Chronic nonspecific colitis, colonic diverticulum, amebic dysentery, colonic polyposis, etc. Often repeated and intermittent, accompanied by a small amount of blood in the stool; Malignant transformation of advanced colorectal cancer can be a persistent small amount of bloody stool. Blood in the stool is different, and the disease is different. Adult hematochezia is mostly internal hemorrhoids, anal fissure, inflammatory bowel disease and so on. Hemorrhage from internal hemorrhoids is more common in men, and bleeding from anal fissure is more common in young women and constipation patients. Children's bloody stools are mostly rectal polyps and intussusception. Familial polyposis is more common than adolescence, mostly mucus and bloody stool. The possibility of colorectal malignant transformation and colonic diverticulum should be ruled out in middle-aged and elderly people with hematochezia. The title of TCM analysis of Lingshu all diseases begins with: "post-blood"; Treatise on Febrile Diseases is called "blood"; Synopsis of the Golden Chamber talks about "bleeding", and puts forward the names of "distant blood" and "near blood" according to the order of bleeding and defecation. Zhang Jingyue pointed out: "Blood is far from stool, far from the small intestine or kidneys. . ..... Blood comes nearby, and people who are close are either in the intestine or in the anus. " Later doctors followed the name of turbid blood and established intestinal wind and dirty poison. The key points of syndrome differentiation and treatment says: "bright red serum is intestinal wind, and turbid serum is dirty poison." "Introduction to Medicine" says that "blood arrow" will be very powerful if there is blood in stool, for example, the arrow is far away. This disease should be differentiated from dysentery and purulent blood. Diarrhea and purulent blood are often accompanied by purulent blood, with obvious abdominal pain, acute diarrhea and severe diarrhea. But this disease is characterized by blood flowing from the stool, no pus, no obvious symptoms such as abdominal pain, acute diarrhea and severe diarrhea.

The name of the certificate. Blood in stool, Su Wen's theory of yin and yang: due to damp-heat, blood stasis, poison invading the stomach, or wind-heat causing coke and blood vessel injury. "Three Causes and One Disease Syndrome" Volume 9: "The patient's blood in the stool is clear, turbid, fresh, black, before or after defecation, or there is discharge, so it is called blood in the stool." In synopsis of the golden chamber, the blood in the front row is far blood, and the blood before blood is near blood. Close blood can be divided into intestinal wind and dirty poison. According to the etiology, there are damp-heat hematochezia, accumulated heat hematochezia, toxic heat hematochezia, wet toxic hematochezia, alcoholic hematochezia, moderate cold hematochezia, intestinal hematochezia, manual hematochezia and so on. See the article for details. Persistent hematochezia is mostly due to the loss of dirty qi, or liver loss due to long-term illness, spleen deficiency can not suck blood, and kidney deficiency can not be consolidated. Therefore, to be properly treated, it is still necessary to eliminate evil and strengthen the body. Dysentery can also be seen in bloody stool. See dysentery for details. "Intestinal wind", "dirty poison" and "yin stagnation" in traditional Chinese medicine all refer to blood in stool. Or before blood in the stool, or before blood in the stool, or simply bleeding. The synopsis of the golden chamber can be divided into distant relatives and close relatives. "Jing Yue Quan Shu" further clarifies that people with distant blood are either in the small intestine or in the stomach; Close to the blood, either in the large intestine or in the anus. The Essentials of Syndrome and Treatment regards those with fresh blood color as intestinal wind, and those with turbid and dark color as dirty poison. "Sheng Ji Tong Zhi" says that Yin Qi's internal stagnation is yin stagnation, and hemorrhoid disease is also included. There are two reasons for hematochezia, one is that spleen deficiency can't control blood, and the other is that damp-heat downward flow hurts the yin collateral of large intestine. Spleen deficiency syndrome is characterized by thin and light blood, continuous dripping, or purple blood in stool, accompanied by dull complexion, fatigue, dizziness, tinnitus, abdominal pain, aversion to heat and cold, thin and white fur or tooth marks. It belongs to spleen deficiency and weak qi, and the overall control is dereliction of duty. It is advisable to warm the middle warmer and strengthen the spleen. Prescriptions include Huang Tu decoction, Guipi decoction and Buzhong Yiqi decoction. And it is forbidden to use products that suffer from cold injury to prevent frosting on the ice. Drugs such as Radix Pseudostellariae, Atractylodis Rhizoma, Pericarpium Citri Tangerinae, Radix Astragali, Poria, kitchen soil, Radix Angelicae Sinensis, Radix Glycyrrhizae, Rhizoma Dioscoreae, and Coicis Semen. Damp-heat bleeding, clear stool color, fever in hands and feet, dry throat and dry mouth, belong to heat forcing large intestine, hurting blood collaterals, so it is advisable to cool blood and stop bleeding. Add and subtract Sophora powder, Sanguisorba powder, and white yellow soup. Medicinal raw Sanguisorba officinalis, Cortex Moutan, Radix Rehmanniae, Flos Sophorae Immaturus, Radix Asparagi, Radix Ophiopogonis, Radix Scrophulariae, Radix Glehniae, Folium Bambusae, Flos Lonicerae, Fructus Corni, Radix Paeoniae Alba and Herba et Gemma Agrimoniae; If the blood is thick, the stool is not smooth, and the urine is hot and astringent, it is mostly damp-heat in the large intestine. With the method of clearing away heat, promoting diuresis and detoxicating, Rhizoma Atractylodis and Cortex Phellodendri are often added to Sanguisorba powder, and Zanglian Pills are also used, or Alisma orientalis is added with Taraxacum, Rhizoma Osmundae, Rhizoma Smilacis Glabrae, Fructus Forsythiae and Radix et Rhizoma Rhei. If the bloody stool lasts for a long time, the damp-heat is unclear, and Yin Ying is deficient, then the treatment should be combined with deficiency and excess, and the heat should be removed. Chinese medicine prescription for hematochezia (1) rhubarb charcoal powder, 3-6g each time, twice a day, swallowed with warm water. (2) Dry the eggplant leaf tile and grind it into powder, 6g each time, twice a day. Swallow rice soup. (3) 60 grams of Eclipta prostrata, decocted for tea. Seven methods to prevent hematochezia to keep the stool unobstructed and prevent constipation. Eat some vegetables with more cellulose, such as leeks, celery, Chinese cabbage and spinach. Bananas are the best fruit. Drinking a proper amount of cold water every morning and eating a good breakfast are helpful for defecation; Have a regular life, defecate regularly every day, keep the anus clean, and don't squat for a long time or use too much force when defecating; Take part in some physical activities properly to promote gastrointestinal peristalsis and blood circulation; Be cheerful, don't be angry and hot, and your mood is not wide. Irritability and depression will cause intestinal mucosa to contract and blood circulation to be poor; Combine work and rest to avoid overwork or sedentary, standing for a long time, walking for a long time, etc. One posture for a long time is not conducive to blood circulation. Strengthen anal exercise, actively contract anus, and then contract after relaxation, 3 times in a row, 3-7 times a day. Precautions in the diagnosis of hematochezia 1 Regardless of age and sex, adult hematochezia is mostly internal hemorrhoids, anal fissure, inflammatory bowel disease, etc. And internal hemorrhoid bleeding is more common in men.

Anal fissure bleeding is more common in young women and constipation patients. Children's bloody stools are mostly rectal polyps and intussusception. Familial polyposis is more common than adolescence, mostly mucus and bloody stool. Middle-aged and elderly people with bloody stool should rule out the possibility of colorectal cancer and colonic diverticulum. 2. Avoid hematochezia, bleeding mode, color and amount of bleeding. Hemorrhage of internal hemorrhoids is dripping or spraying; Anal fissure is blood attached to the surface of feces or stained with toilet paper, with little bleeding. If there is a lot of bleeding, the blood is stored in the intestinal cavity, and it can be black, dark red or with blood clots when discharged. 3. Avoid asking about the occurrence and development of hematochezia. Internal hemorrhoids and anal fissure often bleed after defecation; Chronic nonspecific colitis, colonic diverticulum, amebic dysentery, colonic polyposis, etc. Often repeated and intermittent, accompanied by a small amount of blood in the stool; Advanced colorectal cancer can be a persistent small amount of bloody stool. 4. Regardless of the accompanying symptoms such as dysentery, rectal inflammation, rectal cancer and other bloody stools, it is often accompanied by anal distension, urgency, and then heavy; Internal hemorrhoids, polyps, bloody stool, no anal pain; Anal fissure with anal pain and constipation; Hematoma caused by anorectal injury with recent history of injection or operation; Chronic nonspecific colitis is often accompanied by diarrhea and dull pain in the left lower abdomen; Hemorrhagic necrotizing colitis and intussusception with severe abdominal pain; Bacillary dysentery, epidemic hemorrhagic fever, leptospirosis and amebic enteropathy are mostly acute diseases, accompanied by fever and abdominal pain. Diagnosis of mild bloody stools (1) Ulcerative colitis should first exclude colitis with definite causes such as bacillary dysentery and amebic colitis. (2) It has typical clinical manifestations such as recurrent diarrhea, abdominal pain and mucus pus, and at least one characteristic change of colonoscopy X-ray. (3) The clinical manifestations are atypical, but there are typical colonoscopy or X-ray findings or histological findings of mucosal biopsy. Diagnosis of true and false bloody stool Sometimes, after eating certain foods and medicines, the stool will change color. For example, after taking Chinese herbal medicines that supplement iron, carbon powder, bismuth and blood, or eating food such as pig liver, animal blood, tomatoes and beets. The stool can be dark brown, black or red. Sometimes bleeding in the mouth or nasal cavity will cause the change of stool color after swallowing. Some are fake bloody stools. After stopping drugs and food, "bloody stool" will disappear. If the child has black, dark red, jam-like or red bean soup-like feces, it may be bleeding in the esophagus, stomach and intestines. If the intestinal wall around the anus is broken and bleeding, it means that the blood is attached to the surface of the formed feces. Children also have hematochezia, and often have abdominal pain, diarrhea, fever, vomiting, systemic bleeding and other symptoms. Diagnostic measures Diagnostic measures for hematochezia in patients with various diseases: (1) Stool examination is a routine item for hematochezia in liver disease: it can sometimes help to diagnose the cause. (2) Blood routine: The decrease of hemoglobin and red blood cell count can reflect the blood loss; The number of white blood cells increases, with toxic particles or vacuoles, suggesting infection. (3) The examination of blood non-protein nitrogen or urea nitrogen can indicate uremia. (4) Liver disease, hematochezia also includes liver function test and jaundice index: abnormal can indicate liver disease. (5) Urine routine: If the protein is positive, there are red blood cells or casts under the microscope, suggesting hemolytic uremia syndrome and uremia. Examinations and tests 1. Hemoglobin and red blood cell count may not change significantly in the early stage after hematochezia, but the determination of red blood cell count, hemoglobin and hematocrit is helpful to judge the amount of blood loss during isotonic fluid supplementation and volume expansion.

The degree of blood urea nitrogen increase is also helpful to judge the amount of bleeding (called intestinal urea nitrogen increase). 2. Red blood cell count, hemoglobin and hematocrit no longer decline progressively, or blood urea nitrogen drops to normal, all indicating that bleeding has stopped. 3. Abdominal B-ultrasound, CT and MRI have auxiliary diagnostic value for advanced colon cancer. If lymphadenopathy is found in abdominal cavity or retroperitoneal cavity, it will be of reference value for the diagnosis of intestinal tuberculosis, lymphoma and other diseases. 4. When selective angiography is used to check hematochezia, selective intubation of superior mesenteric artery and inferior mesenteric artery can identify the bleeding site, which is also beneficial to the diagnosis of vascular malformation and other diseases. Therefore, for patients with hematochezia with unknown causes, selective angiography is very important to determine the location or cause of bleeding. 5. Wireless capsule endoscopy In recent years, wireless capsule endoscopy (also known as capsule endoscopy) has been applied in clinic. This kind of examination is non-invasive and can be tolerated by patients without adverse reactions. 6. A new type of push enteroscope P.E Now a new type of push enteroscope has been applied in clinic, which can biopsy the diseased part. It is said that it is of great value in the diagnosis of difficult small intestinal diseases. The new colonoscopy overcomes the shortcomings of the old colonoscopy, such as difficult operation and difficult to pass through the junction of duodenum and jejunum (flexion ligament), and has broad application prospects. Whether the blood in the stool hurts or not indicates different diseases. 1. Painless hematochezia is common in: 1. Internal hemorrhoids are characterized by bright red blood dripping or spouting when hematochezia occurs. Bleeding during defecation or after defecation, due to hard feces rubbing against mucosa, or excessive force during defecation, the pressure in blood vessels increases, leading to varicose veins rupture and bleeding. 2. The bloody stool of rectal cancer is characterized by dark red blood, often mixed with mucus attached to the stool surface, often accompanied by symptoms such as increased stool frequency and anal swelling. 3. Rectal polyp Rectal polyp bloody stool is common in minors. It is blood, which covers the surface of feces and does not mix with it. Pedicled polyps at the lower end of rectum can escape from anus when defecating. Second, painful stool bleeding is common in: 1. The bloody stool of anal fissure is characterized by tearing or knife pain during defecation, and the pain often lasts for tens of minutes or hours after defecation. 2. External hemorrhoids are inflamed with bloody stool, and there is tumor, pain and swelling in the anus, and there is a small amount of blood when wiping toilet paper after defecation. Conservative treatment is the same as hip bath for anal fissure, but surgical treatment is the best. 3. Patients with anal canal cancer can find lumps in the anus, which can be painless in the early stage and painful and bloody in the late stage. The best treatment for anal canal cancer is surgery. 4. Anal abscess or anal foreign body When a pustule breaks around the anus or a fishbone and other foreign bodies get stuck in the anus, it can cause infection, accompanied by pain and bloody stool. At this point, the symptoms must be relieved by surgery. Examination items of patients with hematochezia 1, anal digital examination. Digital rectal examination is a reliable and simple method to find rectal cancer in time. 2, colonoscopy. To determine whether the hemorrhoid mucosa has bleeding point or bleeding tendency. 3. Abdominal examination. Ulcerative colitis can touch a sausage-like mass in the left lower abdomen, which is a contracture and thickening colon. 4. Laboratory inspection and analysis. (1) stool examination: people suspected of infectious bowel disease should do stool bacterial culture to find the pathogenic bacteria, so as to choose antibacterial drugs for the pathogenic bacteria. (2) Blood and bone marrow examination should include platelet count, coagulation mechanism and bone marrow smear. (3) The diagnostic rate of colonoscopy for intestinal mucosal surface lesions is high. (4) The fecal occult blood test is a method to measure gastrointestinal bleeding, which is mainly used to detect a small amount of bleeding that is invisible to the naked eye. Also known as o-toluidine method (OB). Fecal occult blood test is still the most widely used and evaluated test in colorectal cancer screening. This experiment is quick, simple and painless. New technology of hematochezia 1. (South Korea's Dr.camscope electronic anorectal imaging system) is an internationally recognized excellent anorectal imaging system. It can collect images of deep anorectal lesions, so that doctors and patients can clearly, accurately and intuitively understand the condition. 2. (Olympus Electronic Gastrointestinal Endoscope) The world leader of similar gastrointestinal endoscopic equipment, known as "intelligent electronic gastrointestinal endoscope". The system has the characteristics of high resolution and high definition, and can display some images of patients' lesions on the computer screen most clearly. Its mirror body has high toughness and small diameter, and the lens can be examined and treated from multiple angles and directions. It is a brand-new, highly intelligent computer workstation, which can trace randomly and facilitate the comparison, inquiry and consultation of lesions. It plays a decisive role in the diagnosis and treatment of gastritis, ulcer, gastrointestinal bleeding, esophageal cancer, gastric cancer, colorectal cancer, colorectal polyps and various enteritis. Examinations and tests 1. Hemoglobin and red blood cell count may not change significantly in the early stage after hematochezia, but the determination of red blood cell count, hemoglobin and hematocrit is helpful to judge the amount of blood loss during isotonic fluid supplementation and volume expansion.

The degree of blood urea nitrogen increase is also helpful to judge the amount of bleeding (called intestinal urea nitrogen increase). 2. Red blood cell count, hemoglobin and hematocrit no longer decline progressively, or blood urea nitrogen drops to normal, all indicating that bleeding has stopped. 3. Abdominal B-ultrasound, CT and MRI have auxiliary diagnostic value for advanced colon cancer. If lymphadenopathy is found in abdominal cavity or retroperitoneal cavity, it will be of reference value for the diagnosis of intestinal tuberculosis, lymphoma and other diseases. 4. When selective angiography is used to check hematochezia, selective intubation of superior mesenteric artery and inferior mesenteric artery can identify the bleeding site, which is also beneficial to the diagnosis of vascular malformation and other diseases. Therefore, for patients with hematochezia with unknown causes, selective angiography is very important to determine the location or cause of bleeding. 5. Wireless capsule endoscopy In recent years, wireless capsule endoscopy (also known as capsule endoscopy) has been applied in clinic. This kind of examination is non-invasive and can be tolerated by patients without adverse reactions. 6. A new type of push enteroscope P.E Now a new type of push enteroscope has been applied in clinic, which can biopsy the diseased part. It is said that it is of great value in the diagnosis of difficult small intestinal diseases. The new colonoscopy overcomes the shortcomings of the old colonoscopy, such as difficult operation and difficult to pass through the junction of duodenum and jejunum (flexion ligament), and has broad application prospects. Whether the blood in the stool hurts or not indicates different diseases. 1. Painless hematochezia is common in: 1. Internal hemorrhoids are characterized by bright red blood dripping or spouting when hematochezia occurs. Bleeding during defecation or after defecation, due to hard feces rubbing against mucosa, or excessive force during defecation, the pressure in blood vessels increases, leading to varicose veins rupture and bleeding. 2. The bloody stool of rectal cancer is characterized by dark red blood, often mixed with mucus attached to the stool surface, often accompanied by symptoms such as increased stool frequency and anal swelling. 3. Rectal polyp Rectal polyp bloody stool is common in minors. It is blood, which covers the surface of feces and does not mix with it. Pedicled polyps at the lower end of rectum can escape from anus when defecating. Second, painful stool bleeding is common in: 1. The bloody stool of anal fissure is characterized by tearing or knife pain during defecation, and the pain often lasts for tens of minutes or hours after defecation. 2. External hemorrhoids are inflamed with bloody stool, and there is tumor, pain and swelling in the anus, and there is a small amount of blood when wiping toilet paper after defecation. Conservative treatment is the same as hip bath for anal fissure, but surgical treatment is the best. 3. Patients with anal canal cancer can find lumps in the anus, which can be painless in the early stage and painful and bloody in the late stage. The best treatment for anal canal cancer is surgery. 4. Anal abscess or anal foreign body When a pustule breaks around the anus or a fishbone and other foreign bodies get stuck in the anus, it can cause infection, accompanied by pain and bloody stool. At this point, the symptoms must be relieved by surgery.