Blood in the stool is a common symptom of anorectal disease, what should I do when I encounter blood in the stool? First of all, patients should clarify the extremely dangerous nature of blood in the stool, actively search for the cause of blood in the stool, treat the symptoms, and kill the hidden problems in the cradle.
I. What is blood in stool? Blood is discharged from the anus, and the color of the stool is bright red, dark red or tar-like (black stool), or the color of the stool is normal and the stool is positive in the occult blood test is called blood in stool. Meng Yong, Department of Anorectology, Jinan Hospital of Traditional Chinese Medicine
It is commonly seen in the following diseases.
1, hemorrhoids blood in stool: its blood in stool occurs during or after defecation, blood is bright red, blood and feces do not mix.
2, anal fissure blood in the stool: its blood is bright red, dripping or hand paper wipe visible, fresh anal fissure after the stool with severe pain in the anus.
3, digestive tract disease blood in the stool: the stool is tarry or black-red, the bleeding site is mostly in the upper gastrointestinal tract; if the blood is pure red, it is mostly lower gastrointestinal tract disease bleeding.
4, rectal malignant blood in the stool: its blood in the stool is bright red, drops attached to the surface of the stool; the late stage is accompanied by anorectal drop and general wasting, the number of stools increases, constipation and diarrhea alternately.
5, intestinal polyps: its blood is bright red, painless, blood and stool do not mix. Ulcerative colitis, dysentery mostly mixed with mucus or pus and blood stool, and accompanied by lower abdominal pain, fever, frequent stools and other symptoms.
6, systemic diseases blood in the stool: such as leukemia, hemophilia, uremia and some rare infectious diseases, blood in the stool at the same time, there will be bleeding in other parts of the body.
Second, the typing of blood in the stool
1. Fresh blood stool
Mostly acute (immediate) bleeding, blood flows out of the blood vessels for a short time and is discharged through the anus with the stool, or directly after the stool. The appearance of the blood flow resembles traumatic bleeding, bright red or purple-red, dark red, and can coagulate into blood clots after a little time. It is often seen in the following diseases.
(1) Hemorrhoids External hemorrhoids and mixed hemorrhoids of all periods can cause fecal bleeding, usually with fresh blood in the stool or dripping blood after the stool. External hemorrhoids usually do not bleed in the stool.
(2) Intestinal polyps are painless fecal bleeding. The amount of bleeding varies. Generally, the blood does not mix with the stool, or the polyp may mix with the stool if the polyp is in a high position and the number is large.
(3) Rectal prolapse may bleed during defecation after a long period of illness.
(4) Anal fissure Blood in stool, bleeding in the form of blood attached to one side of the surface of stool, not mixed with stool, some patients drip blood after stool.
2. Pus blood/mucus blood stool
That is, there is both pus (mucus) and blood in the excreted stool. Pus (mucus) blood stool is often seen in the rectum or colon tumors and inflammatory diseases. The following diseases are commonly seen.
(1) Rectal cancer Blood is fresh or dark red, and mucus may be present in the stool, often mixing blood, mucus, and stool.
(2) Colon cancer Gradually appear with the prolongation of the disease, stool bleeding, mostly blood stool containing pus or mucus, blood color is dark.
(3) Ulcerative colitis Mucus stool or pus-blood stool, accompanied by left lower abdominal pain or lower abdominal pain.
(4) intestinal infectious diseases such as bacterial dysentery, amoebic enteropathy, etc.
3. Black stool
Also known as tarry stool, the stool is black or brownish black. It is one of the most common symptoms of upper gastrointestinal bleeding. If the amount of bleeding is small, and the bleeding rate is slow, the blood stays in the intestine for a long time, the stool is black; if the amount of bleeding is large and stays in the intestine for a short time, the blood discharged is dark red; the bleeding is particularly large and can also be bright red when discharged quickly.
4. Occult blood stool
Small amount (trace) of gastrointestinal bleeding will not cause a change in stool color, but only a positive stool occult blood test, called occult blood stool. Occult blood stools can occur in all diseases that cause GI bleeding, commonly ulcers, inflammation and tumors. The stool occult blood test detects a small (trace) amount of blood in the stool. Regular stool occult blood testing is an important way to screen for colorectal tumors (primary screening).
5. Accompanying symptoms
(1) Anal and perianal lesions Bright red blood in stool, unbearable anal pain, or swelling with hemorrhoid nucleus, or accompanied by anal fissure.
(2) Upper gastrointestinal tract diseases Vomiting of blood is usually accompanied by black stools, and bloody stools may be present when the bleeding is heavy and rapid.
(3) Lower gastrointestinal tract diseases Depending on the primary cause of bleeding, the accompanying symptoms may vary.
3. Diagnostic notes for blood in stool
1. Pay attention to the characteristics of blood in stool
(1) Understand the process of occurrence and development of blood in the stool. Internal hemorrhoids and anal fissures often bleed after defecation; chronic non-specific colitis and colon polyps often show recurrent, intermittent small amount of blood in stool; middle and late stage (colorectal) malignancy can be persistent small amount of blood in stool.
(2) Distinguish the nature of blood in the stool, bleeding mode, color and bleeding volume.
2. Pay attention to the accompanying symptoms of blood in stool
Such as proctitis, rectal polyps (cancer) and other blood in the stool is often accompanied by anal cramps, urgency; internal hemorrhoids, polyps blood in the stool without anal pain; anal fissure is accompanied by anal pain and constipation; chronic colitis is often accompanied by diarrhea, left lower abdominal pain; hemorrhagic necrotizing colitis, intestinal stasis with severe abdominal pain or even shock.
In particular, blood in the stool with wasting, pus (mucus), difficulty in defecation, thin or unshaped stool, abdominal pain, persistent small amount of bleeding should cause great attention and timely medical consultation.