Most people expect a bloody stool to appear red, but in fact, they usually appear very dark - almost black - and have a sticky, tar-like consistency. Sometimes, blood will appear dark or bright red. The color depends on where the bleeding is occurring, When bleeding is near the rectum, the blood will be more like the reddish color associated with bleeding; when bleeding is occurring “further up” the gastrointestinal tract, it tends to darken by the time it’s expelled in the stool.
Blood in the stool can be a sign of a serious medical issue, and it should never be ignored. Dark stools indicate bleeding is occurring somewhere high in the GI tract as a result of issues like ulcers or erosions and irritation due to inflammatory bowel disease, polyps or tumors. Brighter red is more commonly associated with problems in or near the rectum, including rectal tumors and hemorrhoids. Tiny cuts or fissures can also cause bleeding, as can a painful condition called diverticulitis that occurs when tiny pouches form in the intestine and become irritated and inflamed.
Diagnosis begins with a physical exam and a review of symptoms, as well as a review of the patient’s medical history to look for possible risk factors for bowel and GI disorders and diseases. Blood tests and still samples may also be ordered, and diagnostic imaging like x-rays, MRIs or ultrasounds may be ordered as well. Many patients will have minimally-invasive diagnostic exams using long, flexible scopes to examine the inside of a portion of the GI tract. These exams are typically performed while the patient is sedated so there’s no discomfort. Depending on the cause of the bleeding, some minor procedures may be performed at the same time with special instruments designed to be used through the scope. More serious issues like cancerous tumors usually require traditional surgical techniques using larger incisions to remove the tumors, and some other bowel diseases may also require traditional surgery to remove a damaged portion of the bowel.
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