Hematochezia: Causes, Symptoms & Treatment

Hematochezia is blood in the stool. Many affected people are frightened by a bloody bowel movement. Ultimately, a doctor should already be consulted at the first signs. But serious diseases are not always behind the complaints.

What is hematochezia?

If there is blood in the stool, this is a sign that one of the organs of the digestive tract is losing blood. This is eventually passed through the intestines. Here, the appearance of the blood can provide clues as to where the exact source is located. For this purpose, not only the color but also the exact consistency is examined. Blood in the stool does not always manifest itself with bright red blood. Sometimes the stool takes on a dark color. The color differentiates depending on the amount of bleeding. Due to the contact with the stomach acid as well as the change caused by bacteria, the blood also takes a different expression. If there is bright blood in the excretions, it is called hematochezia. The color indicates that the blood is fresh and that an injury to the esophagus, for example, is unlikely. Instead, doctors may assume that the blood has not had prolonged contact with either stomach acid or bacteria. Furthermore, the stool may be uniformly discolored or have red streaks. Sometimes the blood cannot be detected externally. Instead, it is only discovered during a stool examination. In such a case, it is referred to as occult blood.

Causes

Based on the color and texture, some causes of bloody stool can already be ruled out. In the case of hematochezia, injuries in the area of the colon and rectum are the main candidates. If the excretion is only discolored in some places, hemorrhoids may be present, for example. Hemorrhoids are located at the anus. It is a benign tissue growth, but depending on its stage, it can cause pain, itching and a burning sensation. Traces of blood with a jelly-like consistency indicate small bleedings. Injuries to the mucosa may occur due to obstructions, among other things. Such a change is called a fissure and occurs more frequently in people suffering from inflammatory bowel diseases such as Crohn’s disease. Furthermore, intestinal polyps, intestinal diverticula and cancer cannot be ruled out. Especially after traveling to other countries, a test must take place to reveal any parasites. Finally, food can also lead to confusion. Beet, for example, can stain stools bright red.

Symptoms, complaints and signs

The symptoms that occur depend primarily on the underlying cause. For example, there may be stomach and abdominal pain, nausea and vomiting, lassitude, fatigue, night sweats, and significant weight loss. Heavy bleeding may lead to anemia, which in turn promotes listlessness. With hemorrhoids, pain occurs primarily during bowel movements. In advanced stages, the growths may already be visible externally. Another indication is a strong itching. Hematochezia usually disappears on its own after some time. Nevertheless, blood in the stool is always a reason to consult a doctor. If other symptoms become noticeable at the same time, an early appointment should be made. This is the only way to determine the exact cause. Even if it is often a harmless cause, the diagnosis creates certainty.

Diagnosis and course of the disease

Before the physical examination, a discussion with the doctor takes place. The patient should be able to provide information about his stool habits and changes. Furthermore, any previous illnesses, complaints, a possible fluctuation in weight and information about diet should be provided. A stool sample can confirm the presence of blood. Furthermore, a blood test and various palpation findings are used. The course of hematochezia also depends on the disease from which the symptoms result. If detected early, colorectal cancer can be cured in most cases. Hematochezia is very unpleasant, but numerous treatment approaches now exist that restore quality of life. Anemia must always be treated by a doctor. Otherwise, anemia can lead to further discomfort.

Complications

Hematochezia causes bloody stools.For many people, a bloody bowel movement leads to a panic attack and severe psychological discomfort or anxiety. However, blood in the stool does not always have to indicate a severe health complication. In most cases, severe nausea and vomiting accompany the hematochezia. The patient feels ill and fatigued and usually can no longer actively participate in life. The quality of life is considerably limited and reduced by the disease. There is often a loss of weight. In cases of severe diarrhea, dehydration may also occur if the affected person does not make up for the loss of fluids. Similarly, severe fatigue occurs and the patient is unable to exert himself to a particularly high degree. It is also not uncommon to experience pain during bowel movements if hematochezia is not treated. In most cases, hematochezia can be treated relatively well, always treating the underlying disease. This is usually done with antibiotics or a change in diet. Further complications do not occur and a positive course of the disease is achieved.

When should you go to the doctor?

Hematochezia indicates an injury in the small or large intestine. That is why a doctor should always be consulted if symptoms such as stomach and abdominal pain, nausea and vomiting, and fatigue are present. If further symptoms such as night sweats or a significant loss of weight occur, the affected person should consult a doctor on the same day. Severe pain during bowel movements and signs of anemia are also clear warning signs that need to be clarified. If the symptoms are actually due to a serious cause, this must be treated immediately. Otherwise, serious complications can arise, including intestinal inflammation and deficiency symptoms. Anyone who suffers from bloody excretions after constipation or as part of an intestinal disease should inform the doctor in charge. Medical advice is also required if blood is noticed in the stool after an accident or a fall. This may be due to a major internal injury that needs to be treated immediately. The right contact person for hematochezia is the family doctor or a urologist.

Treatment and therapy

If blood in the stool could be confirmed, it does not always have to come to a therapy. Often, the bleeding stops on its own. Nevertheless, the cause should always be determined by a physician. Especially in the case of heavy bleeding, the source must be found, because otherwise anemia is imminent. Most often, such bleeding is treated during an endoscopy. One of the methods is the hemoclip. This is a clip that compresses the mucosa at the affected site. Furthermore, an adrenaline solution can be injected. This causes the vessels to contract. Fibrin glue has a similar effect. After the bleeding has stopped, further therapeutic measures are taken to treat the underlying cause. In the case of ulcers, certain drugs can inhibit the production of gastric acid so that less of the fluid is produced. In addition, a change in diet should take place. If bacteria have spread, an antibiotic usually helps. Chronic inflammatory bowel disease should also be treated, for example with anti-inflammatory drugs. Hemorrhoids can be removed by rubber band ligation, among other methods. Because intestinal polyps are often the cause of intestinal cancer, removal of the tissue proliferation is significant. Colorectal cancer is treated depending on its severity. The primary goal is usually surgical removal of the tumor.

Prevention

Hematochezia can be prevented to a limited extent. Plenty of fresh fruits and vegetables and adequate dietary fiber can prevent gastric and colorectal cancer. In addition, consumption of animal products should be greatly reduced. Fatty food results in an increased production of gastric acid. Too much stomach acid, in addition to heartburn, causes ulcers in the long run.

Aftercare

The measures of an aftercare are very limited in hematochezia. Thereby, an early diagnosis must take place in this disease in the first place, so that no further complications occur and so that the complaints of the affected person do not continue to worsen. Self-cure cannot occur, so the affected person should see a doctor at the first symptoms and signs of the disease.In many cases, the person affected by hematochezia must take various medications. Here, the doctor’s instructions should always be followed, and attention should also be paid to a correct dosage and also to regular intake of the medication. In case of ambiguity or questions, the doctor should always be consulted. The doctor can also draw up a diet plan for the patient. In general, a healthy lifestyle with a balanced diet has a very positive effect on the course of hematochezia. If antibiotics are taken, they must not be taken together with alcohol. Contact with other sufferers of the disease can also be very useful in this regard, as it is not uncommon for this to result in an exchange of information.

What you can do yourself

Since bloody stools may conceal a serious disease, the cause of hematochezia should be clarified by a doctor before starting any self-treatment. If harmless hemorrhoids or anal fissures are the cause, ointments or suppositories available in pharmacies can help to alleviate the symptoms. Supportive sitz baths with anti-inflammatory additives such as chamomile, witch hazel or arnica bring relief. A high-fiber diet with plenty of fruit, vegetables and whole grain products helps to prevent tears in the sensitive mucous membrane caused by hard stools. Regular exercise and adequate fluid intake also contribute to healthy digestion, and for short-term stimulation of digestive activity, taking psyllium, flaxseed or a digestive herbal tea blend has proven effective. Thorough anal hygiene is important, but vigorous rubbing or the use of overly aggressive cleansing products can damage the sensitive skin and cause bleeding. Heavy pressing during bowel movements should also be avoided. Hematochezia originating from intestinal polyps, ulcers or tumors must always be treated by a physician. Anyone suffering from ulcers in the gastrointestinal tract or wishing to reduce their risk of developing the disease should limit their intake of fatty foods and refrain from excessive alcohol and nicotine consumption. Chronic stress also often causes digestive problems: To counteract this, importance should be attached to a balanced relationship between tension and relaxation in everyday life.