Blood in the stool

Introduction The blood discharged from the anus is bloody, whether it is blood or all blood, the color is bright red, dark red or tar-like, all called blood in the stool. Blood in the stool prompts gastrointestinal bleeding, especially in the colon and rectum. Blood in the stool with hematemesis is the manifestation of upper gastrointestinal bleeding. The color of the stool depends on the level of bleeding, the amount of bleeding and the time spent in the intestine. The upper gastrointestinal bleeding is mostly black stool. If the amount of bleeding is large and the discharge is fast, It can also be dark red or even bright red. Lower gastrointestinal bleeding is mostly bright red or dark red. If it stays in the intestine for a long time, it can also be turned into black stool. The tar-like black stool indicates that the amount of bleeding is above 60ml. Patients with blood in the stool can have no hematemesis, and those who vomit blood have more black stools. Blood in the stool can also be part of the manifestations of systemic diseases, and sometimes it can cause "bleeding of blood" by swallowing blood from outside the digestive tract.

Cause

Common causes of blood in the stool:

Lower gastrointestinal disease

(1) anal canal disease anal fissure and hemorrhoids.

(2) rectal disease anus, rectal injury, rectal polyps, rectal tumors, etc.

(3) Colonic and small bowel diseases, bacterial dysentery, amoebic dysentery, localized enteritis, intussusception, intestinal tuberculosis, enteric typhoid, ileal distal diverticulitis, melanin plaque-gastrointestinal polyposis, intestinal duplication, intestinal tract Tumor, small intestine tumor, mesenteric artery embolization, etc.

2. Upper gastrointestinal diseases, esophagus, stomach and duodenum, biliary diseases, etc.

3. Systemic and toxic diseases

(1) Hemorrhage, coagulopathy, blood disease, neonatal hemorrhagic disease, severe infection and DIC.

(2) Epidemic hemorrhagic fever of acute infectious diseases and parasitic diseases, typhoid fever, paratyphoid fever and typhus, leptospirosis, hookworm disease, schistosomiasis, sepsis, etc.

(3) poisoning or drug toxicity sepsis, bacterial food poisoning, poisonous plant poisoning, drug toxicity, chemical poisoning and so on.

(4) hereditary hemorrhagic telangiectasia

The above diseases cause intestinal inflammation and ulcers, intestinal blood circulation disorders, gastrointestinal mucosal damage or increased capillary permeability leading to blood in the stool.

an examination

Related inspection

Ultrasound examination of gastrointestinal diseases in anal examination

Laboratory examination

Visually observe the color of the stool, the amount of blood, whether it has mucus and pus and blood, and whether the blood mixes with the stool. Stool microscopy can detect pathological components of intestinal inflammation, parasite eggs and certain parasites (such as amoeba). Blood is convenient for microscopic examination without red blood cells, and occult blood tests should be performed.

Peripheral blood hemoglobin and red blood cell counts help to understand the extent of blood loss. Check out the coagulation function. Stool culture, schistosomiasis hatching, immunological tests such as serum ring egg sedimentation test and freeze-dried red blood cell indirect hemagglutination test, fat Dar's reaction and external Fischer reaction.

2. Special inspection

(1) Proctoscopy and sigmoidoscopy can directly understand the lesions, such as internal hemorrhoids, polyps, ulcers, tumors, etc., and can take the contents for microscopic examination and biopsy.

(2) Fiber colonoscopy can observe deep colon lesions.

(3) gastrointestinal barium meal perspective, photos and barium enema angiography for the diagnosis of gastrointestinal ulcers, diverticulum, polyps, tumors, etc.

(4) Selective celiac angiography and radionuclide scanning are helpful in the diagnosis of unexplained gastrointestinal bleeding.

Differential diagnosis

According to the medical history, physical examination and necessary auxiliary examination, the diagnosis can generally be confirmed.

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