What is Hematochezia?
Blood in Stool or Hematochezia refers to the condition where fresh blood passé through the anus, generally with or in the stools. Hematochezia is often associated with bleeding in the rectum or colon, which form the lower gastrointestinal region. However, the region is not restricted- and it may occur due to a brisk bleed in the upper gastrointestinal region. Hematochezia is commonly confused with rectorrhagia- but the difference between the two is that in the rectorrhagia, there is no relation between bleeding and defecation, rather fresh blood is expelled without any stool. The term BRBPR, which stands for bright red blood per rectum, is associated with both these conditions.
Hematochezia Causes :
The simple implication of blood in your stool is that bleeding is occurring in some part of your digestive tract. Singling out one cause of it can only be done via fecal tests and maybe a colonoscopy, but some of the most common causes of Hematochezia are as follows:
- Anal Fissure : A small tear or cut in the tissue lining of the anus, which is just like the cracks that occur on chapped lips, are known as anal fissures. Anal fissures can be caused by passing large and hard stools, and are very painful.
- Diverticular Disease : Diverticula refers to small pouches projecting from the wall of the colon. DIverticula is not known to cause problems as such, but they may bleed and become infected in certain cases.
- Angiodysplasia : Angiodysplasia refers to the condition in which abnormal and fragile blood vessels cause bleeding.
- Colitis : Colitis means inflammation in the colon. The common infections and causes of colitis include inflammatory bowel diseases and infections.
- Peptic Ulcers : A peptic ulcer refers to an open sore present in the duodenum or stomach lining. Most peptic ulcers are caused due to infection by the bacterium H. Pylori. It may also be caused due to high dosage or long-term use of aspirin, naproxen and ibuprofen among other anti-inflammatory medications.
- Cancer/Polyps : Polyps refer to benign growth that may grow further, bleed and even turn cancerous. Colorectal cancer ranks as the 4th most common type of cancer in the United States. Bleeding caused due to cancer is not generally noticeable by the naked eye.
Hematochezia Symptoms :
Passage of fresh red blood in or with stools is a symptom of Hematochezia. Other symptoms that occur during gastrointestinal bleeding may be:
- Body Weakness
- Diarrhea or constipation
- Abdominal distention
- Abdominal cramping
Hematochezia may be a sign of cancer as well, so it is advisable to keep a check for the following symptoms too:
- Unexplained and sudden weight loss
- Rectal Pain
- Sudden change in bowel movement frequency
- Ribbon-like or narrow stools
- Abdominal pain
The tests for Hematochezia include:
- Nasogastric Lavage : This test will tell your doctor if bleeding is taking place in the lower or upper digestive tract.
- EGD or Esophagogastroduodenoscopy or Upper GI Endoscopy : An endoscope is inserted from the mouth to the stomach via the esophagus. This is used to determine the source of the bleeding.
- Barium X-Ray : It uses a contrast material, known as barium, so that the digestive tract becomes visible in an X-ray.
- Radionuclide Scanning : A small quantity of a radioactive material is injected in a vein, and a special camera is used to track the blood flow to find locations of the bleeding.
- Enteroscopy : This is similar to EGD, but the patient has to swallow a capsule with a very tiny camera in it that transmits the video to a monitor.
The prognosis of Hematochezia depends on the underlying cause. Hematochezia caused due to Anal Fissures, Ulcers and Colitis is manageable and can be cured without the requirement of surgeries. This, however, may vary as per the extent and severity of Colitis and Ulcers. Your doctor may want to conduct a biopsy, if there are Polyps, to check whether they are cancerous or not. In cases of Colorectal Cancer, the survival rate is 75-92% for 2nd and 1st stage cancers. It drops to the 44-73% range for stage III cancer.
A few tips that will help you to prevent Hematochezia include:
- Application of creams that contain Vitamin A, D or cortisone
- Following a fiber-rich diet
- Drinking sufficient quantity of water each day
- Avoid sitting for long hours
- Take oral supplements for iron to prevent anemia
Hematochezia Home Remedies :
Prior to bowel movement, lubricating the anal canal will ease passing and minimize pain associated with passing stools. OTC creams, as mentioned in the prevention section, will also help to promote healing and provide relief. In place of toilet paper, use facial tissues. These contain moisturizing lotion coating, that will minimize resistance/friction to the affected area of your anus.
A special mention must be made with regards to the diet to be followed in case of Hematochezia. Avoid all processed and junk foods, and avoid meats as well. Increase your daily intake of fresh vegetables and fruits. Okra or Lady Finger is beneficial as it works like a natural lubricant for the anal cavity when you pass stools.
Hematochezia Treatment :
The treatment of Hematochezia is done as per the underlying condition. However, since the diagnosis of it may take time, it is important that the treatment start in time. If the underlying cause is hemorrhoids, then home remedies, including dietary changes and a hot sitz bath is all that may be needed. Patients that have diverticulitis will need medications that alleviate spasms in the abdomen, such as diclomine and hyoscymaine along with antibiotics. Surgery is required in cases where these medications do not work.
Patients that have colorectal cancer will receive treatment depending on the stage/progress of the cancer. In cases of early detection and no metastases, the prognosis is favorable. If the condition has worsened, then palliative care may be the only option. Chemotherapy may still be done for preventing any further metastasis. Surgery is done for removal of the polyps, but only as a palliative measure. Hematochezia, though dangerous in certain cases, is a manageable condition overall. In case you experience any symptoms, including even the slightest of blood from the anus, then seek the advice of your doctor as soon as you can for early detection and cure.