Stools, bloody

Considerations:
Blood, as seen in the stool, can originate anywhere along the intestinal tract. A black stool usually means that the blood is coming from the upper part of the tract. At least 2 Tablespoons (or 60 milliliters) of blood must have been lost in order to make the stool black. Maroon-colored stools suggest that the blood is coming from the middle portion of the intestinal tract, and bright red from the large bowel or rectum. See also GI bleeding .

The ingestion of black licorice, lead, Pepto-Bismol, or blueberries can all cause black stools or false melena. Stools should be tested for the presence of hidden blood.

Some of the conditions that cause bloody stools can also cause vomiting blood .

Common Causes:
GI bleeding is the most serious source of bloody stools. The color can help to pinpoint the location of the bleeding.

Black color:

Maroon color

Bright red color:

Note: There may be other causes of bloody stools. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for bloody stools, occurring alone or in combination with other problems.

Home Care:
Immediate medical management under the doctor's direction is required.

Call Your Healthcare Provider If:

  • any evidence of GI bleeding occurs.
  • there is any change in the color of the stool. Don't rely on visual impressions; always test it or have it tested. Home kits can be purchased at the drugstore, or you can send a specimen to the doctor.
  • there is blood in the stool. DO NOT take it lightly. Make an appointment to see the doctor right away.



What to Expect:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting bloody or dark stools in detail may include:

  • quality
    • Is there blood on the toilet paper only?
    • Is there bright red blood in the stool (hematochezia)?
    • Is there maroon colored stool?
    • Are there black or tarry bowel movements (melena)?

  • time pattern
    • When did it develop?
    • Is every stool this way?
    • Has there been more than one episode (repeated)?

  • aggravating and related factors
    • Does bloody stool occur with menstruation?
    • Have you ingested black licorice, lead, Pepto-Bismol, or blueberries?
    • Have you eaten a lot of meat lately?

  • other

The physical examination will probably include emphasis on the abdominal and rectal regions. If there is evidence of hypovolemic shock , vital signs (temperature, pulse , rate of breathing, blood pressure ) will be monitored and the patient observed closely; emergency treatment may be necessary.

Diagnostic tests that may be performed include:

After seeing your health care provider:
If a diagnosis was made by your health care provider related to bloody or dark stools, you may want to note that diagnosis in your personal medical record.