In general, people are bound to be a little alarmed when they find blood in their stool, or blood on the toilet paper. Some people are also shocked to find blood in their 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. If you go to the doctor with blood in your stool, what will he or she tell you to do to find out what is wrong with your body and what needs to be done. It is important to note 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 the appearance of weight loss. All these symptoms are related to different causes/areas of stool bleeding, the length of bleeding and the severity of bleeding. Causes of blood in stool There is no doubt that blood in the stool means that there is bleeding somewhere in the digestive tract. However, sometimes the bleeding is so small that it can only be found hidden in the stool through an occult blood test at the hospital; other times it is found in the toilet paper or toilet bowl sanitaryware after using the toilet. However, sometimes the stool will be dark or have a tarry color when bleeding is higher up in the digestive tract. In summary, the causes of blood in the stool are roughly as follows: ① Hemorrhoids. Most internal hemorrhoids or mixed hemorrhoids present as fresh blood on hand towels or sanitary ware after a bowel movement, with no discomfort other than an internal feeling of panic. Hemorrhoids are mainly formed by the transitional expansion and prolapse of the venous plexus that closes the anal opening, and when they appear to break there is fresh blood in the stool. ②Polyp or cancer. Polyp is a benign disease, but it will grow and have bleeding, and of course, cancer will occur. Colorectal cancer is now a very common tumor in China, and it often causes bleeding in the stool, but sometimes it is not detected by the naked eye. ③Anal fissure. A small fissure that appears on the anus, somewhat like a cracked opening that occurs on the lip of the mouth. Most anal fissures are caused by frequent dry, hard stools and are painful when relieving them. ④Colitis. It is caused by inflammation of the colon. The most common cause is an infection of the intestine or inflammatory bowel disease. ⑤ Diverticular disease. Examination may reveal small pockets bulging outward from the wall of the colon. Ears that resemble protruding ears on the head of Mickey Mouse can be seen in cross-section of the diseased colon. Usually the diverticula are not harmful, but sometimes they bleed or become infected. (6) Peptic ulcer. These are ulcers that appear along the lining of the stomach or duodenum. Many peptic ulcers are caused by a bacterial (Helicobacter pylori) infection. In addition, prolonged or high doses of anti-inflammatory and analgesic drugs such as aspirin, ibuprofen and naproxen can also cause ulcers. (7) Vascular malformation. Malformed abnormal blood vessels can easily rupture and cause bleeding. (viii) Esophageal disease. Esophageal varices or esophageal tears can lead to severe hemorrhage. Diagnosis of fecal bleeding When you have fecal bleeding, you need to seek medical attention to examine the cause of the bleeding. It is also important to provide as detailed a history as possible so that the doctor can diagnose the site of bleeding. For example, black or tarry stools may be a peptic ulcer or other upper gastrointestinal tract problem; having fresh blood or purple-sauce colored stools is a sign that the location of the lesion may be in the lower gastrointestinal tract, such as hemorrhoids or colonic diverticulitis. 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 hose with a camera on the head, known as an endoscope, through the mouth, esophagus, and into the stomach and duodenum for observation. Through this examination instrument, the doctor is able to detect the site of bleeding. The endoscopist is also able to take a partial tissue sample for examination (also known as a biopsy). Colonoscopy The procedure is similar to esophagogastroduodenoscopy, except that the entire colon is viewed through the anus and a tissue biopsy can be taken. Small bowel microscopy The procedure is similar to gastroscopy and colonoscopy and can be used to examine the small intestine. Sometimes a capsule endoscopy is used, which involves swallowing a capsule with a camera function, and as the capsule passes through the digestive tract, images are taken of the intestinal tract of the small intestine to examine for bleeding. Barium radiography By using the contrast material barium, images of the digestive tract are shown on X-ray. The barium can be swallowed directly or instilled into the rectum. Gastric lavage This test tells the examining physician whether the bleeding is from the upper or lower gastrointestinal tract. The procedure involves inserting a thin tube through the nose into the stomach and suctioning out the stomach contents. If no blood is removed from the stomach, the bleeding may have stopped or there may be bleeding in the lower gastrointestinal tract. Radionuclide scan After intravenous injection of a small amount of radioactive material, special imaging equipment is used to observe the exact site of bleeding as the blood flows through the gastrointestinal tract. Angiography A special contrast agent is injected intravenously and the blood vessels are observed by x-ray or CT. The site where the contrast agent is found to leak out of the blood vessel is the bleeding point. Dissection The doctor opens the abdominal cavity to examine the site of bleeding. A method used only when all other tests fail to find the site of bleeding. Other tests Include coagulation, the presence of anemia and the presence of H. pylori. Treatment of fecal bleeding For acute bleeding, the doctor may use different methods. Most commonly, the bleeding site is first treated endoscopically by injecting a hemostatic agent, stopping the bleeding with electrocoagulation or laser, or using a hemostatic clip to clamp the bleeding vessel. If endoscopy fails to stop the bleeding, the physician will use an angiogram under which the bleeding vessel is closed by medication. In addition to controlling the acute bleeding, the cause of the bleeding is treated to prevent recurrence. For example, antibacterial agents are used to treat H. pylori, drugs are used to control gastric acid secretion, and anti-inflammatory drugs are used to treat enteritis. Treatment of polyps, gastrointestinal tumors, colonic diverticula or inflammatory bowel disease by surgery. For different causes, there are simple and effective treatments that patients can manage on their own. These include eating a high-fiber diet to relieve constipation, effective treatment of hemorrhoids and anal fissures, and also the use of warm water sitz baths to effectively relieve anal disorders.