Normally, people are a little alarmed when they find blood in their stools or on their toilet paper. Some people are also surprised to find blood in the stool during a physical examination. In fact, blood in the stool does not mean that there is a serious disease. Here are some of the causes of bloody stools. And what you should do if you find blood in your stool; or if you go to the doctor because of blood in your stool, what the doctor will ask you to do in order to find out which part of your body is wrong and needs to be dealt with in a timely manner. A special note here is that some people already have bleeding stools but do not notice or realize it. In fact, some patients exhibit symptoms such as abdominal pain, vomiting, weakness, breathlessness, diarrhea, and experiencing weight loss. All these symptoms are related to different causes/sites of bleeding in stool, duration of bleeding and severity of bleeding. 1. Causes of blood in stool There is no doubt that blood in stool means that somewhere in the digestive tract there is bleeding. But sometimes the amount of bleeding is so small that the blood hidden in the stool can only be detected by the hospital when checking for occult blood test; other times blood is found in the hand towel or toilet bowl cleaner after going to the toilet. However, sometimes when bleeding occurs higher up in the digestive tract, the stool will be black or have a tarry color. To summarize, the causes of blood in the stool are broadly as follows: ① Hemorrhoids. Most internal or mixed hemorrhoids are manifested by the appearance of fresh blood on the hand towel or sanitary ware after a bowel movement, and there is no discomfort other than the inner feeling of panic. Hemorrhoids are mainly due to the anal opening to close the anus of the venous vascular plexus transition expansion and prolapse of the formation of a rupture when there is fresh blood stool. ② Polyps or cancer. Polyp is a benign disease, but it will grow and have bleeding, of course, there will be cancer. Colorectal cancer is a very common tumor in our country, and it often causes bleeding in the stool, but sometimes it is not detected by the naked eye. ③ Anal fissure. Small fissures appear on the anus, somewhat like the cracks that occur on the lips of the mouth. Most of the fissures are caused by frequent hard, dry bowel movements and are painful to relieve. ④ Enteritis. It is caused by inflammation of the colon. The most common cause is infection of the intestines or inflammatory bowel disease. ⑤ Diverticular disease. Examination reveals small pockets protruding outward from the colon wall. In the cross-section of the diseased colon, the ears can be seen, resembling those protruding from the head of Mickey Mouse. Usually the diverticula are not harmful, but sometimes they bleed or become infected. (6) Peptic ulcer. Are ulcers that appear along the lining of the stomach or duodenum. Many peptic ulcers are caused by a bacterial (Helicobacter pylori) infection. Also, prolonged or high doses of anti-inflammatory and analgesic medications such as aspirin, ibuprofen and naproxen can cause ulcers. (vii) Malformation of blood vessels. Malformed abnormal blood vessels are prone to rupture and cause bleeding. (8) Esophageal diseases. Esophageal varices or esophageal tears can cause severe hemorrhage. 2.Diagnosis of bleeding in stools When bleeding in stools, you need to consult a doctor in time to check the cause of bleeding. And you should provide as detailed medical history as possible, which is helpful for doctors to diagnose the bleeding site. For example, the presence of black or tarry stools, it may be a peptic ulcer, or other upper gastrointestinal problems; there is fresh blood stools or purplish saucy stools, predicting that the location of the lesion may be in the lower gastrointestinal tract, such as hemorrhoids or diverticulitis of the colon and so on. After the doctor asks for a history and physical examination, there will be a number of ancillary tests to determine the cause of the bleeding. Common tests are summarized as follows: Esophagogastroduodenoscopy. The procedure involves sending a flexible tube with a camera on its head, known as an endoscope, through the mouth, esophagus, and into the stomach and duodenum for observation. With this examining instrument, the doctor is able to detect areas of bleeding. Endoscopically the doctor is also able to take a portion of a tissue sample for examination (also known as a biopsy). Colonoscopy. The procedure is similar to an esophagogastroduodenoscopy, except that the entire colon is viewed through the anus, and a tissue biopsy can also be done. Small Bowel Scopy. The process is similar to gastroscopy colonoscopy and can be used to examine the small intestine. Sometimes a capsule endoscopy is used, which involves swallowing a capsule that has a camera function, and as the capsule passes through the digestive tract, an image is taken of the small bowel intestines to check for areas of bleeding. Barium X-ray. By using a contrast material, barium, images of the digestive tract are shown on X-rays. The barium can be swallowed directly or instilled into the rectum. Gastric lavage. This test primarily tells the examining doctor whether there is bleeding in the upper or lower GI tract. The procedure involves inserting a thin tube through the nose into the stomach and suctioning out the stomach contents. If no bloody contents are aspirated from the stomach, the bleeding may have stopped or the bleeding may be in the lower gastrointestinal tract. Radionuclide scan. After a small amount of a radioactive substance is injected into a vein, special imaging equipment is used to look at the specific site of bleeding as blood flows through the gastrointestinal tract. Angiography. A special contrast material is injected into a vein and the blood vessels are viewed by X-ray or CT. The area where the contrast agent is found to leak out of the blood vessel is the bleeding site. Cesarean section. The doctor opens the abdominal cavity to examine the bleeding site. A method used only when all other tests fail to find the bleeding site. Other tests. These include coagulation, the presence of anemia and the presence of Helicobacter pylori. 3, Treatment of Bleeding in the Stool For acute bleeding, doctors may use different methods. The most common are to first endoscopically inject a hemostatic agent into the bleeding area, electrocoagulate or laser to stop the bleeding, or use hemostatic clips to clamp the bleeding vessel. If endoscopy fails to stop the bleeding, the doctor will use angiography to close the bleeding vessel with medication. In addition to controlling acute bleeding, the cause of the bleeding is treated to prevent recurrence. For example, antimicrobials are used to treat Helicobacter pylori, medications are used to control stomach acid secretion, and anti-inflammatory drugs are used to treat enteritis. Polyps, GI tumors, colonic diverticula or inflammatory bowel disease are treated by surgery. For different causes, there are treatments that are simple and effective that patients can manage on their own. These include eating a high fiber diet to relieve constipation, effectively treating hemorrhoids and anal fissures, and also using warm water sitz baths for effective relief from anal disorders.