Introduction
Blood in the stool can have a variety of causes. These causes should always be clarified by appropriate diagnostics, as intestinal cancer can also cause bloody stool. If abdominal pain occurs at the same time, this can possibly narrow down the diagnosis.
However, one must first assess whether the two symptoms are separate from each other or whether they are actually related. Blood in the stool can present itself in two different ways. Firstly, there may be reddish deposits in the stool, which indicates bleeding in the lower digestive tract. On the other hand there is the so-called black tar stool. This is more a sign of bleeding in the upper digestive tract, although it can also occur in cases of bleeding in the lower tract.
Common causes of blood in stool with abdominal pain
Common causes of upper digestive tract bleeding can be Common causes of lower gastrointestinal bleeding may include When investigating the cause, it is important to distinguish between bleeding in the upper digestive tract and bleeding in the lower, as the causes can be completely different. One cause of the upper digestive tract, which can lead to both blood in the stool and abdominal pain, is chronic heartburn. The acid in the stomach leads to an inflammation of the mucous membrane, which can also bleed.
In the course of time, chronic heartburn can also lead to stomach ulcers or ulcers in the duodenum. They are the most common cause of bleeding in the upper digestive tract. Another clinical picture that causes pain, especially in the upper abdomen, and bleeding is Mallory-Weiss syndrome.
This disease causes tears in the already damaged mucous membrane at the transition from the esophagus to the stomach. The tears are caused by fulminant vomiting. A stomach carcinoma can also cause tarry stools.
However, abdominal pain is not typical here. The patients rather report a feeling of fullness and possibly pain on an empty stomach. In the lower digestive tract, if there is blood in the stool and abdominal pain, one must first think of a chronic inflammatory bowel disease, especially ulcerative colitis.
Diverticula can also be the cause of the symptoms. Diverticula are small protrusions of the colon wall. They classically cause pain in the left lower abdomen.
Bowel cancer (colon cancer) often causes bloody stool, but is not usually accompanied by abdominal pain. Nevertheless, colon cancer must always be excluded during the clarification. – Heartburn
- Stomach Ulcer
- Mallory-Weiss Syndrome
- Chronic inflammatory bowel disease (Crohn’s disease, ulcerative colitis)
- Colon Cancer
- Haemorrhoids
Associated symptoms
Depending on the causative disease, a number of specific accompanying symptoms may occur. General symptoms due to blood loss are paleness and weakness. Heavy bleeding can lead to impaired circulation with low blood pressure and palpitations.
Bleeding in the upper part of the digestive tract can also lead to vomiting of blood. This is typical for heavy bleeding in the area of the esophagus. Bleeding in the lower area leads to increased intestinal movements and thus also to an increased stool frequency.
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Cramp-like abdominal pain is not directly typical of any of the above causes. However, it cannot be ruled out that a stomach ulcer or diverticulum, for example, may sometimes be accompanied by abdominal cramps. The most likely cause of abdominal cramps would be a chronic inflammatory bowel disease.
Nausea in combination with blood in the stool and abdominal pain is considered a warning sign and should be clarified by a doctor. The doctor must clarify whether the nausea is related to the other symptoms or has another cause. The same caution should be exercised if vomiting occurs.
The vomit should be examined for blood, as bleeding in the upper digestive tract can cause nausea and this must be treated quickly. Back pain is not a direct symptom of blood in the stool and abdominal pain occurring simultaneously. Many people suffer from back pain and therefore the exact timing of the symptoms must be analysed.
If the back pain was present earlier or if there were certain events that could have triggered the back pain, one can initially assume that it is an isolated symptom. If the back pain develops at about the same time as the other symptomatology and no triggering event or previous history is known, it must be investigated whether the back pain is related to the blood in the stool. A conceivable connection would be, for example, with intestinal cancer.
The back pain could be caused by possible metastases in the spinal column. However, it is much more likely that the back pain is not related to the blood in the stool. A fever is particularly typical for diverticulitis.
In this disease a protrusion of the intestinal wall (diverticulum) becomes inflamed. The consequences are left-sided pain in the abdomen and fever. If there is bleeding of the mucous membrane in addition, blood can also be found in the stool.
An acute flare of ulcerative colitis can also be accompanied by fever. The main symptom of an episode is bloody and mucous diarrhoea with abdominal pain. In addition, colon cancer can cause fever.
If there is weight loss and night sweats in addition to the fever, this is called a positive B symptom. Mucus in the stool initially makes one think of ulcerative colitis. The main symptom of this disease is bloody, slimy diarrhoea.
However, intestinal cancer can also cause mucusy stools. This mucus can take on very different colours. Various infectious diseases such as amoebiasis can also lead to bloody, slimy stools; these deposits are often described as raspberry jelly like. Small amounts of mucus are still okay. However, as soon as larger visible amounts become visible or blood is added, a medical clarification should be carried out.