Blood in stool: Causes and diagnosis
Blood in stool diagnosis continued...
After looking at your medical history and doing a physical examination, your GP may order tests to determine the cause of bleeding. Tests may include:
Endoscopy. A procedure that involves inserting an endoscope, or flexible tube with a small camera on the end, through the mouth and down the oesophagus to the stomach and duodenum. The doctor can use this to look for the source of bleeding. Endoscopy can also be used to collect small tissue samples for examination under a microscope (biopsy).
Colonoscopy. A procedure where the scope is inserted through the rectum to view the colon. As with an endoscopy, colonoscopy can be used to collect tissue samples to biopsy.
Enteroscopy. A procedure similar to endoscopy and colonoscopy used to examine the small intestine. In some cases this involves swallowing a capsule with a tiny camera inside that transmits images to a video monitor as it passes through the digestive tract.
Barium X-ray (barium enema). A procedure that uses a contrast material called barium to make the digestive tract show up on an X-ray. The barium may either be swallowed or inserted into the rectum.
Radionuclide imaging. A procedure that involves injecting small amounts of radioactive material into a vein and then using a special camera to see images of blood flow in the digestive tract to detect where bleeding is happening.
Angiography. A procedure that involves injecting a special dye into a vein that makes blood vessels visible on an X-ray or computerized tomography (CT) scan. The procedure detects bleeding as dye leaks out of blood vessels at the bleeding site.
Laparotomy. A surgical procedure in which the doctor opens and examines the abdomen. This may be necessary if other tests fail to identify the cause of bleeding.
Doctors also request laboratory tests when there is blood in stools. These tests may look for clotting problems, anaemia and the presence of H. pylori infection.
A person with blood in the stool may be unaware of bleeding and have reported no symptoms. On the other hand, they may also have abdominal pain, vomiting, weakness, difficulty breathing, diarrhoea, palpitations, fainting and weight loss depending on the cause, location, duration and severity of the bleeding.
Blood in stool treatments
A doctor may use one of several techniques to stop acute bleeding. Often an endoscopy is used to inject chemicals into the site of bleeding, treat the bleeding site with an electric current or laser, or apply a band or clip to close the bleeding vessel. If endoscopy does not control bleeding, the doctor may use angiography to inject medicine into the blood vessels to control bleeding.
Beyond stopping the immediate bleeding, if necessary, treatment involves addressing the cause of bleeding to keep it from returning. Treatment varies depending on the cause and may include medicines such as antibiotics to treat H. pylori or anti-inflammatory drugs to treat colitis, or surgery to remove polyps or the parts of the colon damaged by cancer, diverticulitis or inflammatory bowel disease. It may include cream and suppositories to treat haemorrhoids, for example.
In many cases, however, treatment involves simple things you can do on your own. These include eating a high-fibre diet to relieve constipation that can cause and aggravate haemorrhoids and anal fissures, and sitting in warm or salt baths to relieve fissure symptoms.
Your doctor will prescribe or recommend treatment based on the diagnosis.