After gastrointestinal bleeding is discharged through the intestine, the feces contain blood or whole blood stool, which can be bright red, dark red or tar-like. The color of bloody stool depends on the bleeding site, the amount of bleeding and the time that blood stays in the digestive tract. Lower digestive tract (small intestine, colon, rectum, anus) bleeding, stool is often bright red or dark red. Upper digestive tract (esophagus, stomach, duodenum) bleeding, stool is often tar-like.
(1) etiology
Blood in stool is generally divided into bloody stool, tar stool and occult blood stool. Common reasons are described below.
1 Blood usually comes from the lower end of ileum, colon, rectum and anus, and the stool is bright red or dark red, which can be mixed with mucus and pus. Common diseases are hemorrhoids and anal fissure bleeding. Hemorrhoid hematochezia is ejected during defecation or drops blood after defecation; Anal fissure has less bloody stool, but anal pain is more severe. Rectal polyp bleeding, stool blood volume is not large, blood adheres to the surface of stool, and sometimes stool becomes thin and strip-shaped or imprinted. Dysentery blood is purulent bloody stool with frequent defecation and left lower abdominal pain.
Tarry stool is black stool. Upper gastrointestinal bleeding does not vomit, and blood stays in the intestine for a long time. Hemoglobin in the blood combines with sulfide in the intestine to form ferrous sulfide, which makes the stool black and shiny, like asphalt. The appearance of tarry stool indicates that the amount of bleeding has reached more than 60 ml. However, it should be noted that some foods and drugs can make the stool black, which can be identified by fecal occult blood test.
3 occult blood stool, a small amount of gastrointestinal bleeding does not cause the color change of stool, and it is called occult blood stool when the fecal occult blood test is positive. All diseases that cause gastrointestinal bleeding can cause occult bloody stools, such as gastric ulcer and gastric cancer.
(2) Rescue measures
The rescue measures are basically the same as vomiting blood. Stay in bed quietly, reduce activities, observe the amount of bleeding, use hemostatic drugs appropriately, and send them to the hospital for rescue in case of syncope and shock.
Is hematochezia an internal hemorrhoid?
Bloody stool is a typical symptom of internal hemorrhoids, especially early internal hemorrhoids, but it cannot be considered as internal hemorrhoids. Bloody stool is a common symptom, and many diseases can cause bloody stool in clinic.
① Various enteritis: due to inflammation, the integrity of intestinal mucosa is destroyed, and dark purple blood and secretions are mixed in stool, accompanied by various unique symptoms of enteritis.
② Anus papillitis and its hypertrophy: On dental floss, the surface is covered with anal epithelium, with occasional bleeding.
③ Anal fissure: severe pain during defecation and blood dripping after defecation.
④ Rectal cancer: frequent bleeding and many secretions are the most likely to be misdiagnosed and missed. Fingertips can be stained with blood during hand examination, and hard lesions with different shapes, rough surfaces and uneven edges can be touched. Pathological biopsy is needed to confirm the diagnosis. Bleeding from this disease can also lead to anemia.
⑤ Rectal adenoma or choriocarcinoma: The disease often bleeds. Every time I have a bowel movement, there is bloodshot blood in my stool, and occasionally there is a lot of bleeding. However, the tumor is long and pedicled. Anoscopy showed that the tumor was red and pedicled. (turn