Why is my blood so bright red
There’s Blood in My Poo, Is It Serious? | GutDr Q&A
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the question for this week's episode is
gut doctor i've noticed some bright red
blood in my stools is this just
hemorrhoids do i need to do anything
about it
that's a really good question let's dive
right into it
[Music]
this is a very important question from
our subscriber and one that i think
deserves a very considered response we
don't know the specifics of the case but
we can outline some general principles
for managing rectal bleeding in
answering this question our subscriber
mentions the passage of bright red blood
and that's important because there is a
medical term given to this it's called
hematochesia hermetice is very common
and it's thought it may affect around 10
percent of adults most cases aren't
reported but a good proportion are
concerned and do present to their local
doctor and that's a very good thing
because the first important point i want
to make is that hematochesia always
warrants further assessment and medical
advice
when you present for a medical
evaluation the first thing that will
happen is that you will be assessed for
just how sick you are this is very
similar to the approach taken in the
hematemesis video the vital signs will
be taken and if there are signs of shock
then appropriate measures will be taken
in hospital including blood tests
administering fluids and blood products
your overall health as a patient will be
assessed including whether there are any
major medical issues such as problems
affecting the heart lungs or kidneys and
what type of medications you're on
including the presence of any blood
thinners like warfarin
occasionally a very brisk bleed from the
upper gas intestinal tract that is
somewhere in the esophagus stomach or
first part of the small intestine can
result in fresh frank blood in the
stools if this is the case then a
similar approach to the management of
hematemesis should be taken and plans
should be made for an urgent gastrostomy
to assess and treat the upper
gastrointestinal source of bleeding
the second thing that will happen after
resuscitation if this is required is a
clinical assessment of where the
bleeding is coming from the medical
history is key here and as part of the
work up you'll be asked about how much
red blood has been passing how long the
bleeding has been happening how often it
is occurring and the color of blood
itself
additional questions asked include are
their blood streaks present upon wiping
with toilet paper because this may
suggest the presence of hemorrhoids or
an anal fissure which is a tear in the
lining of the anus
asking about the presence of abdominal
or pelvic pain is important because the
presence of pain may suggest an
inflammatory condition of the bowel such
as inflammatory bowel disease
intestinal ischemia which is where there
is a lack of blood supply to the
intestine or peptic ulcer disease
have you had a colonoscopy done recently
and were any polyps removed if so it's
possible this bleeding could be coming
from the pilot removal a change in bowel
habits unexplained weight loss and a
family history of bowel cancer can be
very relevant questions for your doctor
to ask especially if you're over the age
of 50.
a digital erectile examination is a
necessary examination because it can
provide very useful information for
example it can confirm the presence of
blood in stools and the color pain upon
digital insertion may suggest an anal
fissure as the cause of bleeding
external hemorrhoids may be found on
inspection and a very obvious rectal
mass may prompt concern about a rectal
tumor
the third part of the medical evaluation
is carrying out diagnostic tests to
confirm the source of the bleeding a
very important investigation here is a
colonoscopy which is a thin flexible
tube which is passed through the back
passage and goes all the way around to
the end of the colon or in some cases it
can go a bit further to the very end of
the small intestine most of the time a
colonoscopy will be able to confirm the
source but in some instances where
there's nothing found other tests may be
needed these include imaging studies or
a test called a capsule endoscopy where
a small camera is swallowed and takes
continuous photos inside the gut this
capsule looks for any sources in the
small bowel that could account for the
hematophysia the good news is that the
majority of cases of hematochesia are
due to benign causes such as hemorrhoids
the most common reason for a more
heavier bleed is from diverticular
disease and this refers to bleeding
that's coming from blood vessels of
pouches we call them diverticulae found
in the wall of the colon diverticular
disease is a condition that increases in
prevalence as you age fortunately with
diverticular disease and many other
causes of hematokesia the bleeding
spontaneously settles the vast majority
of the time
the final part of the medical evaluation
is to look at ways to prevent recurrent
bleeding in the case of hemorrhoids we
know that high dietary fiber has been
shown to reduce bleeding
if it's a blood vessel in the colon
that's causing bleeding we can treat
this directly with heat therapy or if
it's a tumor this can be operated on
treating an acute flare of inflammatory
bowel disease with medications can be
effective in stopping bleeding
so in summary and to go back to the
original question by our subscriber yes
if you do have bright red blood in the
stools you should certainly visit your
local doctor for an assessment
i trust this has been helpful
information for our subscriber and for
all of you viewing let me know your
comments and thoughts down below check
out more gut doctor videos over here and
please subscribe to this channel if you
haven't already thanks for watching and
i'll see you next time
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