Hematochezia
Key points
- Bloody stools often indicate an injury or disorder in the digestive tract.
- Blood in the stool can originate from anywhere along your digestive tract, from mouth to anus.
- Call your doctor if you notice blood or changes in the color of your stool.
- Your doctor will take a medical history and perform a physical examination, focusing on your abdomen and rectum.
Alternative names
Stools - bloody; Bloody or tarry stools; Melena; Stools - black or tarry
Definition
Bloody stools often indicate an injury or disorder in the digestive tract. Your doctor may use the term "melena" to describe black, tarry, and foul-smelling stools or "hematochezia" to describe red or maroon-colored stools.
Considerations
Blood in the stool can originate from anywhere along your digestive tract, from mouth to anus. It may be present in such small amounts that you cannot actually see it, but is only detectable by a fecal occult blood test. When there IS enough blood to change the appearance of your stools, the doctor will typically want to know the exact color to try to estimate the site of bleeding. To make a definite diagnosis, however, endoscopy or special x-ray studies are needed.
A black stool usually means that the blood is coming from the upper part of the gastrointestinal (GI) tract. This includes the esophagus, stomach, or first part of the small intestine. Blood will typically appear like tar after it has been exposed to the body's digestive juices. Stomach ulcers caused by ibuprofen, naproxen, or aspirin are common causes of upper GI bleeding.
Maroon-colored stools or bright red blood usually suggest that the blood is coming from the lower part of the GI tract (large bowel or rectum). Hemorrhoids and diverticulitis (inflammation of an abnormal pouch in the colon called a diverticulum) are the most common causes of lower GI bleeding. However, sometimes massive or rapid bleeding in the stomach causes bright red stools.
Consuming black licorice, lead, iron pills, bismuth medicines like Pepto-Bismol, or blueberries can also cause black stools. Beets and tomatoes can sometimes make stools appear reddish. In these cases, your doctor can test the stool with a chemical to rule out the presence of blood.
Brisk bleeding in the esophagus or stomach (such as peptic ulcer disease), can also cause you to vomit blood.
Common Causes
Upper GI tract (usually black stools):
- Bleeding stomach or duodenal ulcer
- Gastritis
- Esophageal varices
- Mallory-Weiss tear (a tear in the esophagus from violent vomiting)
- Trauma or foreign body
- Bowel ischemia (a lack of proper blood flow to the intestines)
- Vascular malformation
Lower GI tract (usually maroon or bright red, bloody stools):
Written and revised by
David Cohen, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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