Blood in the stool with diarrhea

introduction

Blood in the stool is a frightening discovery for many. However, the cause is usually harmless.
The most common cause of blood in stool is hemorrhoids. However, since serious illnesses can also lead to blood in the stool, a doctor should always be examined. The blood in the stool can be dark or light. Light blood comes from the lower part of the intestine. Dark blood has already clotted and is coming from the upper sections. The causes for this are usually more serious.

Causes of blood in the stool with diarrhea

The causes of blood in the stool can be very diverse. Many think of the worst first, colon cancer. However, in many cases, more harmless things are the triggers.
There are various bacterial pathogens, such as Clostridium difficile, that can lead to bloody diarrhea. Most often, however, hemorrhoids lead to blood in the stool. There may also be injuries to the mucous membrane that were caused, for example, as part of a previous constipation and are reopened by the diarrhea.
Inflammatory bowel disease can also be the cause in people of young adulthood. Bloody diarrhea is typical of ulcerative colitis. In ulcerative colitis, the lining of the large intestine becomes inflamed. It runs in phases and is characterized by symptom-free phases and phases with symptoms.
Dark blood in the stool suggests bleeding in the upper gastrointestinal tract, e.g. a stomach ulcer. In any case, if blood is found in the stool, a doctor should be consulted.

also read: Pseudomembranous colitis

To find out more about diarrhea, please visit our page on the subject Diarrheal diseases

Antibiotics as a cause of blood in the stool

Taking antibiotics can irritate the bacterial flora of the colon. The antibiotic attacks some bacterial strains more than others, creating an imbalance. In this way, bacteria that cause diarrhea can gain the upper hand.
As a rule, this bacterial strain is the Clostridium difficile. This causes watery diarrhea, cramping abdominal pain, and fever. In severe cases, blood can also be found in the stool. So-called antibiotic-associated diarrhea mainly affects the elderly and people who have had to take several antibiotics.

Read more about this: Antibiotic-associated diarrhea

Concomitant symptoms

The bloody diarrhea is often accompanied by abdominal pain and cramps. If the bloody diarrhea is due to an infection in the gastrointestinal tract, fever and general fatigue may also occur. As a rule, the diarrhea occurs 2-10 days after antibiotic therapy and is characteristically malodorous.

With ulcerative colitis, a chronic inflammatory bowel disease, abdominal pain also occurs. The diarrhea is bloody and slimy.
Ulcerative colitis can also manifest outside of the intestine. Inflammation of the eyes and joints and skin changes can occur. Colon cancer has few symptoms in its early stages. Only in the further course do further complaints arise. Often this leads to constipation, between which diarrhea with blood loss can occur. Furthermore, it can lead to unwanted defecation with flatulence. In the advanced stage, there is also a noticeable loss of weight and a decline in performance.

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Blood in your stool and stomach pain

In addition to diarrhea, abdominal pain often occurs.
Cramp-like pelvic pain is typical of viral or bacterial diarrhea and usually occurs with antibiotic-induced diarrhea. In ulcerative colitis, in addition to the very frequent diarrhea, abdominal pain also occurs. Tenesmen are typical here. This is a painful urge to defecate. The pain in ulcerative colitis is localized in the left lower abdomen. The pain often occurs (intensified) during or after a bowel movement.
Bloody diarrhea with abdominal pain is not typical for colon cancer. But here, too, the localization of the tumor can cause pain or impair the digestion.

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Blood in the stool with cramps

Diarrhea is often accompanied by uncomfortable abdominal cramps.
Abdominal cramps are particularly typical in diarrhea due to viral or bacterial infections. Abdominal cramps also traditionally occur with food intolerances. The cramps can often be relieved with warmth or easily digestible teas.

Therapy for blood in the stool with diarrhea

Regardless of the cause, care should be taken to ensure sufficient fluids in the case of diarrhea - especially in small children and the elderly - as a lot of fluid is lost through bowel movements.
In addition, many electrolytes (salts) are also lost through this. Further therapy depends on the cause. In antibiotic-induced diarrhea, a specific antibiotic is used to fight the bacterium Clostridium difficile. This is mostly metronidazole. Vancomycin is given in severe cases. After successful therapy, the intestinal flora can be built up with the help of diet or prebiotics. Prebiotics are substances that linger in the intestine for a long time and are supposed to stimulate the build-up of health-promoting bacteria.

In cases in which Clostridium difficile diarrhea that does not respond to therapy repeatedly occurs, a stool transplant can also be considered for therapy. Various anti-inflammatory drugs are used in ulcerative colitis. In mild cases aminosalicylates are administered, in severe cases cortisone as well. After successful treatment of the diarrhea, aminosalicylates will continue to be administered prophylactically. In the few cases in which colon cancer causes the symptoms, the tumor is surgically removed. Depending on the stage, the therapy must be supplemented by chemotherapy and radiation.

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Diagnosis of blood in the stool

First there is a detailed discussion with the doctor about the existing complaints.
Further complaints can be decisive for the diagnosis and determine the further diagnostic examinations. The conversation with the doctor is followed by a brief physical examination. In some cases, this will be followed by a colonoscopy for further clarification. It is important for diagnosing chronic inflammatory bowel diseases or cancer. If necessary, a small tissue sample is taken during the colonoscopy, which is then examined.If antibiotic-induced diarrhea is suspected, a colonoscopy should not be performed, but a pathogen detection.

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Duration and forecast

The prognosis is usually quite good. Hemorrhoids are not dangerous. Antibiotic-induced diarrhea also usually has a good prognosis. Only in rare cases the diarrhea cannot be treated by the antibiotic and the fight against the bacterium Clostridium difficile can then take a very long time.

Ulcerative colitis is an incurable disease. How well the disease can be contained by the medication varies greatly. In severe cases, ulcerative colitis cannot be treated by the medication and those affected suffer from severe and frequent diarrhea. With such a high level of suffering, the colon can be surgically removed for therapy. This drastically reduces the number of diarrhea. If colon cancer is discovered at an early stage, the chance of survival is around 90%. In advanced stages, however, the chances of recovery drop drastically.

Also read: Surgery for ulcerative colitis