Oleg Katcher, MD

Gastroenterology, Endoscopy, Hepatology and Clinical Nutrition

Blood in stool / GI bleeding

Gastrointestinal (GI) bleeding refers to bleeding from any of the GI tract organs ( esophagus, stomach, small intestine, large intestine).

There are two common type of GI bleeding:

  • Upper GI bleeding: occurs from esophagus, stomach or the first part of the small intestine.
  • Lower GI beeding: occurs from colon or rectum.

The symptoms of upper GI bleeding may include:

  • Vomiting blood or emesis that looks like “coffee grounds”
  • Stool (bowel movements) that look like black tar

The symptoms of lower GI bleeding may include:

  • bright red blood on toilet paper after wiping
  • blood in toilet after bowel movements
  • blood on the surface of or mixed with stool
  • “maroon-colored” stool

If upper GI bleeding is suspected the following tests may help to make diagnosis:

  • Upper endoscopy - a thin flexible tube with a small camera (an endoscope) is inserted into esophagus and stomach through the mouth. It helps examine upper GI tract and determine the source of bleeding
  • Capsule endoscopy - patient swallows a capsule with a camera which sends pictures to a recording device. This test allows examination of the small intestine, which is hard to see with upper endoscopy or colonoscopy. The capsule will pass spontaneously with a bowel movement.
  • The main tool for evaluation of a patient with suspected lower GI bleeding is colonoscopy (a thin flexible tube with a camera inserted through the rectum to inspect the colon and rectum for a source of bleeding).

Bright blood in stool (bowel movements) may be due to many reasons. Two common benign causes are:

  • Hemorrhoids: swollen anorectal blood vessels. Our office provides minimally invasive treatment of hemorrhoids.
  • Anal fissure: tear in the lining of the anus.

Other tests to evaluate anorectal cause of bleeding may include:

  • Anoscopy – visual examination of the anus and lower part of the rectum
  • Flexible sigmoidoscopy – evaluation of the rectosigmoid part of lower GI tract

Sometimes blood in stool can be a sign of a serious disease such as cancer, colitis, or other problems of the digestive system. Therefore any of sign of blood in stool is a serious symptom that needs to be promptly evaluated by a gastroenterologist.

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