Blood in the stool (the ‘poo’) or ‘rectal bleeding’ is a common reason people see a Gastroenterologist. There are many possible causes which can be benign and others which are more serious.
The type of symptoms, in particular colour, depends on the location of bleeding within the GI tract.
Bleeding from the colon or large bowel results in the passage of bright red or maroon coloured blood.
Bleeding from higher in the GI tract (stomach or small bowel) usually results in the passage of black bowel motions (melaena). This occurs because the blood is partially digested as it passes through the intestines.
Bleeding that occurs very slowly and over a long period of time may also not be noticeable. This gradual blood loss can lead to low iron levels and anaemia. This can lead to symptoms such a fatigue and feeling short of breath at low levels of exercise.
There are many causes of bleeding from the GI tract.
Bleeding from the lower bowel (fresh blood) can be caused by:
– anal fissures
– bowel cancer
– diverticular disease (diverticulosis)
– abnormal bloods vessels (angioectasia)
– Ulcers / inflammation
Bleeding from the upper / middle GI tract (black bowel motions) include:
– stomach ulcers
– polyps / stomach cancer
– abnormal blood vessels (angioectasia)
Depending on the suspected location of the bleeding, a gastroscopy (looking into the stomach) or colonoscopy (looking into the large bowel / colon) is usually the best way to diagnose the cause.
If the suspected bleeding is in the small bowel, a ‘pillcam’ is often needed. This involves swallowing a pill with a tiny camera inside which takes pictures as it travels through the small intestine.
The treatment for gastrointestinal bleeding depends upon the exact cause. In the case of red or maroon bleeding from the bowel it is important that serious causes be ruled out before the bleeding is blamed on haemorrhoids.
There are many methods that can be used during endoscopy to treat digestive tract bleeding. These include:
– Burning of bleeding vessels with lasers (argon) or the Gold probe
– Using procoagulant powder (Haemospray)
– Clips / endoscopic suturing
– Banding devices for varices and haemorrhoids
– Injection of adrenaline or specialized viscous materials
– Remove polyps with snare devices
You may be asked to stop certain medications that contribute to bleeding such as anti-inflammatory medications eg. ibuprofen and naproxen.
If iron deficiency or anaemia occurs, an iron infusion is often used to boost your iron stores and readily enable your body to produce more blood.
Dietary intake of iron is also critical in maintaining adequate body levels so you may be recommended to increase your intake of iron rich food or supplement with an iron tablet.