Finding blood in your toilet is disturbing. There are several causes for blood in your stools, ranging from trivial conditions to more severe diseases, like colon cancer.
Hemorrhoids are the most common cause. Because they are so prevalent in the general population, they are behind a large percentage of blood in feces. But how can you be sure it’s not something else?
First, it helps to know about the different types of blood you can find. The appearance of blood varies depending on how early it occurs in the digestive tract.
Red blood
The first scenario is when you find red blood. That means it’s fresh, so the bleeding comes from your anus. Your digestive system didn’t have any time to digest it. As such, fresh red blood usually means hemorrhoids or anal fissures.
Hemorrhoids are little masses inside your anus made up of thick veins. When you press to poo, they can come out, and you can feel them with your finger. They usually don’t hurt; they just bleed.
Fissures, on the other hand, are painful. They are thin cuts on your anus due to constipation, large stools… When you push to poo, they hurt.
Small blood droplets
Another possibility is that you find tiny droplets of blood in your stools. That means the bleeding is further up the colon, as the blood had time to mix with the feces. When your colon is bleeding, it’s either due to diverticulitis or colon cancer.
Diverticulitis usually presents as a tummy ache with fever and bleeding. Colon cancer, on the other hand, is silent–at least during the early stages. It can sometimes perforate, giving symptoms very similar to diverticulitis.
Black feces
Sometimes, blood is not red but black. How is it possible? That’s the color it gets after gastric juices digest it and after it travels through your whole intestines. Consequently, the bleeding usually comes from a higher segment, like the stomach.
Dark blood may indicate gastric ulcers, painful sores in the stomach that bleed and cause discomfort after eating. They also bleed, and blood has to travel through the whole digestive tract, getting digested and mixed with food.
Colon cancer can also give dark stools when it grows on the right side of your colon. In that case, blood will have to travel through the whole 55 inches of the colon, with plenty of time to get degraded.
A word of caution: some foods can cause black stools. For instance, if you eat rice with black squid ink, your stool may appear black for up to three days.
No blood at all
Finally, I need to mention the last option: invisible blood. That’s blood you cannot see, but it can be detected through tests like a Fecal occult blood test (FOBT).
We use FOBT for screening. People over a certain age (around 50) need to run this test on their feces. If the test is positive, it means there is occult blood, and you will need further studies to find out whether it’s cancer or something else.
Takeaway
Bleeding down there is very common. It may be caused by a trivial condition like hemorrhoids or a serious one, like colon cancer. You can see where the blood comes from by checking its appearance. However, if you need clarification on your problem, ask your doctor.
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