22/07/2020

Hematochezia: Blood in Stool

Advice About Bright Red Blood in Stool

Blood is supposed to stay in your body. Seeing blood in your bowel movement is very frightening. It is an indication that something is not working right, but it is not always a herald of colon cancer. Rectal bleeding has many causes, but only one of them is colon cancer.

When You Note Blood in the Stool - The best action you can take now, to advocate for yourself, is to pay attention to this symptom and be prepared to discuss it with your doctor. Ask yourself these questions:
  • Was the blood in the stool, toilet bowl or on the toilet paper?
  • Was the blood bright red or dark red?
  • Approximately how much blood did you see? (Keep in mind, a drop of blood in a toilet bowl will turn all of the water red.)
  • Did you have to strain to pass the bowel movement?
  • How frequently do you have bowel movements?
  • Do you have other symptoms?
  • When was your last colon screening exam or colonoscopy?
  • Do you have a history of polyps or a family history of polyps?
Causes of Blood in the Stool:
  • Hemorrhoids
  • Inflammatory Conditions
  • Colon Polyps
  • Constipation
  • Bowel Infections
  • Colon Cancer

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Rectal Bleeding: Symptoms & Signs

Blood in the stool can be bright red, maroon in color, black and tarry, or occult (not visible to the naked eye). Causes of blood in the stool range from harmless, annoying conditions of the gastrointestinal tract such as hemorrhoids and anal tears (anal fissures) from straining against hard stools with constipation to serious conditions such as cancer. Blood in the stool should be evaluated by a health care professional.

Rectal bleeding (known medically as hematochezia) refers to passage of bright red blood from the anus, often mixed with stool and/or blood clots. Most rectal bleeding comes from the colon, rectum, or anus and can be associated with diarrhea. The color of the blood during rectal bleeding often depends on the location of the bleeding in the gastrointestinal tract. Generally, the closer the bleeding site is to the anus, the blood will be a brighter red. Thus, bleeding from the anus, rectum, and the sigmoid colon tend to be bright red, whereas bleeding from the transverse colon and the right colon (transverse and right colon are several feet away from the anus) tend to be dark red or maroon colored.

In some patients, bleeding can be black and "tarry" (sticky) and foul smelling. The black, smelly, and tarry stool is called melena. Melena occurs when the blood is in the colon long enough for the bacteria in the colon to break it down into chemicals (hematin) that are black. Therefore, melena usually signifies bleeding is from the upper gastrointestinal tract (for example, bleeding from ulcers in the stomach or the duodenum or from the small intestine) because the blood usually is in the gastrointestinal tract for a longer period of time before it exits the body. Sometimes melena may occur with bleeding from the right colon. On the other hand, blood from the sigmoid colon and the rectum usually does not stay in the colon long enough for the bacteria to turn it black. Rarely, massive bleeding from the right colon, from the small intestine, or from ulcers of the stomach or duodenum can cause rapid transit of the blood through the gastrointestinal tract and result in bright red rectal bleeding. In these situations, the blood is moving through the colon so rapidly that there is not enough time for the bacteria to turn the blood black.

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Blood in Stool

Blood in the stool can be frightening, whether you discover it while wiping after a bowel movement or from a test ordered by your health care provider. While blood in stool can signal a serious problem, it doesn't always. Here's what you need to know about the possible causes of bloody stools and what you -- and your doctor -- should do if you discover a problem.

Causes of Blood in Stool - Blood in stool means there is bleeding somewhere in your digestive tract. Sometimes the amount of blood is so small that it can only be detected by a fecal occult test (which checks for hidden blood in the stool). At other times it may visible on toilet tissue or in the toilet after a bowel movement as bright red blood. Bleeding that happens higher up in the digestive tract may make stool appear black and tarry.

Possible causes of blood in stool include:
  • Diverticular disease - Diverticula are small pouches that project from the colon wall. Usually diverticula don't cause problems, but sometimes they can bleed or become infected.
  • Anal fissure - A small cut or tear in the tissue lining the anus similar to the cracks that occur in chapped lips or a paper cut. Fissures are often caused by passing a large, hard stool and can be painful.
  • Colitis - Inflammation of the colon. Among the more common causes are infections or inflammatory bowel disease.
  • Angiodysplasia - A condition in which fragile, abnormal blood vessels lead to bleeding.
  • Peptic ulcers - An open sore in the lining of the stomach or duodenum, the upper end of the small intestine. Many peptic ulcers are caused by infection with a bacterium called Helicobacter pylori (H. pylori). Long-term use or high doses of anti-inflammatory drugs such as aspirin, ibuprofen, and naproxen can also cause ulcers.
  • Polyps or cancer - Polyps are benign growths that can grow, bleed, and could become cancerous. Colorectal cancer is the fourth most common cancer in the U.S. It often causes bleeding that is not noticeable with the naked eye.
  • Esophageal problems - Varicose veins of the esophagus or tears in the esophagus can lead to severe blood loss.

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Blood in the stool (rectal bleeding)

Seeing blood in the toilet, on the outside of your stool, or with wiping after a bowel movement is common. Fortunately, most of the causes of such rectal bleeding are not life-threatening; common causes include hemorrhoids and anal fissures. However, the only way to be certain of the cause is to be evaluated by a healthcare provider. This topic will review when to seek help for blood in the stool, the most common causes of blood in the stool, and tests that may be recommended. (See "Approach to minimal bright red blood per rectum in adults".)

WHEN TO SEEK HELP - Most people with minor rectal bleeding do not have colon cancer or another serious condition. However, it is not possible to know the cause of rectal bleeding without an examination. Thus, ANYONE who notices rectal bleeding should talk to their healthcare provider to determine if an examination is needed. (See 'Rectal bleeding tests' below.)

RECTAL BLEEDING CAUSES - Seeing a small amount of blood after wiping, on the outside of your stool, or in the toilet is most commonly caused by hemorrhoids or an anal fissure:
  • Hemorrhoids — Hemorrhoids are swollen blood vessels in the rectum or anus that can be painful, itchy, and can sometimes bleed (figure 1). Painless rectal bleeding with a bowel movement is a common symptom of hemorrhoids. Bright red blood typically coats the stool or blood may drip into the toilet or stain toilet paper. (See "Patient education: Hemorrhoids Beyond the Basics)".
  • Anal fissure — An anal fissure is a tear in the lining of the anus, the opening where feces are excreted. Anal fissures can cause bleeding and a sensation of tearing, ripping, or burning during or after a bowel movement. (See "Patient education: Anal fissure Beyond the Basics)".
  • Other causes of rectal bleeding — There are many other causes of rectal bleeding, including colon cancer, colon polyps, colitis, and diverticulosis. (See "Etiology of lower gastrointestinal bleeding in adults" and "Approach to acute lower gastrointestinal bleeding in adults".)
In addition, bleeding from higher in the digestive tract, such as the stomach, can produce black, tarry bowel movements because stomach acid turns blood black. Bismuth (such as in Pepto Bismol) and iron supplements can also make the stool appear black. Passing blood from the rectum that is dark red or includes clots usually indicates bleeding from higher in the colon than anal fissures or hemorrhoids would produce.

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Hematochezia

Hematochezia is the passage of fresh blood through the anus, usually in or with stools (contrast with melena). The term is from Greek αἷμα ("blood") and χέζειν ("to defaecate"). Hematochezia is commonly associated with lower gastrointestinal bleeding, but may also occur from a brisk upper gastrointestinal bleed. The difference between hematochezia and rectorrhagia is that, in the latter, rectal bleeding is not associated with defecation; instead, it is associated with expulsion of fresh bright red blood without stools. The phrase bright red blood per rectum (BRBPR) is associated with hematochezia and rectorrhagia.

Signs and symptoms - Hematochezia from upper gastrointestinal, small bowel, or colonic sources can present with moderate to large volume bleeding, whereas patients with rectal or anal outlet bleeding usually present with ‘drops’ or ‘streaks’ on the stool or toilet paper

Causes:
  • In adults, most common causes are hemorrhoids and diverticulosis, both of which are relatively benign; however, it can also be caused by colorectal cancer, which is potentially fatal. In a newborn infant, haematochezia may be the result of swallowed maternal blood at the time of delivery but can also be an initial symptom of necrotizing enterocolitis, a serious condition affecting premature infants. In babies, hematochezia in conjunction with abdominal pain is associated with intussusception. In adolescents and young adults, inflammatory bowel disease, particularly ulcerative colitis, is a serious cause of hematochezia that must be considered and excluded.
  • Hematochezia can be due to upper gastrointestinal bleeding. However, as the blood from such a bleed is usually chemically modified by action of acid and enzymes, it presents more commonly as black "tarry" feces known as melena. Haematochezia from an upper gastrointestinal source is an ominous sign, as it suggests a very significant bleed which is more likely to be life-threatening.
  • Eating beetroot can cause harmless red-colored feces (beeturia) because of insufficient metabolism of a red pigment, and is a differential sign that may be mistaken as hematochezia.
  • Consumption of dragon fruit (pitaya) or blackberries may also cause red or black discoloration of the stool and sometimes the urine (pseudohematuria). This too, is a differential sign that is sometimes mistaken for hematochezia.
  • In infants, the Apt test can be used to distinguish fetal hemoglobin from maternal blood.

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Hematuria: Blood in urine

Hematuria is the presence of red blood cells in the urine. If there are enough red cells, the urine can become bright red, pink or cola colored. Often, however, the urine appears completely normal because there is not enough blood to cause a color change. In this case, the condition is called "microscopic" hematuria. There are many possible causes of hematuria, including:
  • Urinary tract infection — Hematuria can be caused by an infection in any part of the urinary tract, most commonly the bladder (cystitis) or the kidney (pyelonephritis).
  • Kidney stones
  • Tumors in the kidney or bladder
  • Exercise — Exercise hematuria is a harmless condition that produces blood in the urine after strenuous exercise. It is more common in males than females.
  • Trauma — Traumatic injury to any part of the urinary tract — from the kidneys to the urethral opening (the connection between the bladder and the outside world) — can cause hematuria.
  • Drugs — Hematuria can be caused by medications, such as blood thinners, including heparin, warfarin (Coumadin) or aspirin-type medications, penicillins, sulfa-containing drugs and cyclophosphamide (Cytoxan).
  • Glomerulonephritis — Glomerulonephritis is a family of illnesses that are characterized by inflammation of the glomeruli, the filtering units of the kidneys. Glomerulonephritis is a rare complication of certain viral and bacterial infections (including strep throat). It can also occur in people with certain auto-immune diseases, systemic lupus erythematosus (lupus or SLE) and vasculitis. Sometimes there is no identifiable cause.
  • Bleeding disorders — This includes conditions such as hemophilia and von Willebrand's disease.

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Nocturia: Excessive Urination at Night

Nocturia is a condition that causes you to wake up during the night to pee. This condition is also called nocturnal urinary frequency — having to pee more often at night. Nocturia becomes more common as people age (usually older than 60) and occurs in all genders and sexes, sometimes for different reasons. It can be common for people to wake up once during the night to pee, but peeing more frequently may be a sign of an underlying condition or problem.

When a person pees too much during the daytime, but can limit the amount of trips to the bathroom at night, it’s referred to as frequent urination. Nocturia is strictly using the bathroom multiple times after bedtime and before you wake up in the morning. Whether it’s happening due to an underlying medical condition or something else, it can leave you feeling tired because your regular sleep cycle is disrupted.

How common is nocturia? Nocturia is a common condition affecting more than 50% of adults after age 50. It’s more common in men and people assigned male at birth (AMAB) after age 50. Before 50, nocturia is more common in women and people assigned female at birth (AFAB). It affects up to 1 in 3 people over the age of 30.


Pneumaturia: Gas in urine

What Is Pneumaturia? Having small bubbles in your urine is called pneumaturia. It isn’t a diagnosis on its own but can be a symptom of certain health conditions. Common source causes for pneumaturia include urinary tract infections (UTIs) and passageways between the colon and the bladder (called fistula) that don’t belong.

If you have pneumaturia, you’ll feel gas or a bubbling sensation interrupting your urine stream. Your urine may appear to be full of small air bubbles. This is different than urine that looks foamy, which is usually an indicator of too much protein in your urine. Since pneumaturia is a symptom of other conditions and not a condition all by itself, you may want to look out for other symptoms that sometimes come along with it, such as:
  • burning sensation while urinating
  • difficulty urinating
  • feeling the need to “go” all the time
  • discolored urine
All of these symptoms could indicate an infection in your urinary tract. Common causes:
  • One common cause of pneumaturia is infectious bacteria. Pneumaturia can indicate a UTI, as the bacteria create bubbles in your urine stream.
  • Another common cause is a fistula. This is a passage between organs in your body that doesn’t belong there. A fistula between your bowel and your bladder can bring bubbles into your urine stream. This fistula can be an outcome of diverticulitis.
  • Less often, deep sea divers will have pneumaturia after a period of time underwater.
  • Sometimes pneumaturia is a symptom of Crohn’s disease.


Diabetes: Early Signs & Symptoms

Diabetes mellitus refers to a group of diseases that affect how the body uses blood sugar (glucose). Glucose is an important source of energy for the cells that make up the muscles and tissues. It's also the brain's main source of fuel. The main cause of diabetes varies by type. But no matter what type of diabetes you have, it can lead to excess sugar in the blood. Too much sugar in the blood can lead to serious health problems.

Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes and gestational diabetes. Prediabetes happens when blood sugar levels are higher than normal. But the blood sugar levels aren't high enough to be called diabetes. And prediabetes can lead to diabetes unless steps are taken to prevent it. Gestational diabetes happens during pregnancy. But it may go away after the baby is born. Diabetes symptoms depend on how high your blood sugar is. Some people, especially if they have prediabetes, gestational diabetes or type 2 diabetes, may not have symptoms. In type 1 diabetes, symptoms tend to come on quickly and be more severe.

Some of the symptoms of type 1 diabetes and type 2 diabetes are:
  • Feeling more thirsty than usual.
  • Urinating often.
  • Losing weight without trying.
  • Presence of ketones in the urine. Ketones are a byproduct of the breakdown of muscle and fat that happens when there's not enough available insulin.
  • Feeling tired and weak.
  • Feeling irritable or having other mood changes.
  • Having blurry vision.
  • Having slow-healing sores.
  • Getting a lot of infections, such as gum, skin and vaginal infections.


Constipation and Urinary Incontinence
Bloating and cramps are two common symptoms of constipation

Being constipated means your bowel movements are tough or happen less often than normal. You might be constipated if you have less than three bowel movements per week.

Constipation is very common. Around 2.5 million people visit their doctor each year in the U.S. because they are constipated. It's usually not serious, and home remedies can get you back on track. How often should you poop? The normal length of time between bowel movements varies from person to person. Some people have them three times a day. Others have them just a few times a week.

But going longer than 3 days without one is usually too long. After 3 days, your stool gets harder and more difficult to pass. Constipation Symptoms You may have:
  • Few or no bowel movements
  • Trouble having a bowel movement (straining to go)
  • Hard or small stools
  • A feeling that everything didn’t come out
  • Belly bloating
  • A feeling like your rectum is blocked
  • A stomachache or cramps


Acupressure Points for Constipation

Acupressure can help in relieving constipation symptoms such as abdominal pain, bloating and gas by applying pressure to specific points on the body. The following are the commonly used acupressure points to relieve constipation that you can do on your own. Instead of pressing with your fingers, you can also use acupressure stick:
  • Tianshu (ST25) - Tianshu can improve digestion. You can place three fingers parallel and alongside the centre of the belly button. Tianshu is located at the edge of the last finger, away from the belly button. Use your thumb or forefinger and apply pressure or you can do circular motion with finger.
  • Guanyuan (CV4) - Guanyuan is used for relieving abdominal pain and diarrhea. It is located at 3 inches below your belly button. Use your thumb or forefinger and apply pressure or you can do circular motion with finger.
  • Zhigou (TE6) - Zhigou is an effective pressure point for relieving chronic constipation. It is located at 3 inches up the back of your arm from the crease of your wrist. Use your thumb and apply pressure or you can do circular motion with thumb. This procedure should have been repeated for the other wrist.
  • Zusanli (ST36) - Zusanli can strengthen the digestive system. It is located on the outer calf, about four finger widths under the knee bone. Use your thumb or forefinger and apply pressure. This procedure should have been repeated for the other foot.


15 signs your stomach is functioning badly




A queasy feeling in the pit of your stomach, dreading even the idea of food, and having to constantly run to the washroom; these are all unpleasant symptoms of stomach issues. There are all sorts of reasons why you may have a poorly functioning stomach. Sometimes, it’s from food poisoning or a gastro bug going around; however, if your stomach is chronically upset, it might be a sign of a bigger problem. If you are experiencing any of these 15 signs that your stomach is functioning badly, be sure to make an appointment with your healthcare provider:
  • Frequent and chronic diarrhea
  • Blood in your stool
  • Severe cramps after eating
  • Chronic constipation
  • Frequent heartburn
  • Difficulty swallowing
  • Loss of appetite
  • Unexplained weight loss
  • Sudden intense abdominal pain
  • Feeling full after eating a small portion
  • Swollen abdomen
  • Anemia
  • Fatigue and weakness
  • Frequent vomiting
  • Skin issues


What your poop tells you about your health
5 Things Your Poop Can Tell You About Your Health

Having a bowel movement is a critical part of digesting the food we eat. Stool formed by the large intestine is the body's way of getting rid of waste.

While you should talk to your doctor about any concerns, changes in poop color and consistency could show what is happening inside your digestive system:
  • Rocks and Pebbles - Poop that is hard and shaped like tiny rocks or pebbles is likely just a sign of constipation. You can still be considered constipated even if you are able to pass a small amount of stool. The large intestine helps to concentrate waste by absorbing water. If muscle contractions in the large intestine are not working properly, waste left in the colon becomes even more concentrated, resulting in harder stool.
  • Color Changes - A change in stool color is one of the most common concerns patients ask about. The foods you eat and the kind of bacteria living in your colon can both cause such changes, and added food colorings are frequent culprits. This is one reason why patients preparing for a colonoscopy are instructed to avoid food and beverages with certain added colors the day before. Doctors note that when they perform a colonoscopy, they can actually tell what color the beverage was that the patient drank during their preparation for the procedure. Most changes in the color of stool are not cause for concern. The exception is poop that appears black or bloody, which could signal other problems with the digestive system.
  • Black and Tarry - The most common cause of black and tarry poop is taking iron supplements or a medication containing bismuth, such as Pepto-Bismol. However, it could mean you're losing blood somewhere in your gastrointestinal tract, such as in the stomach or small intestine.
  • Oily or Greasy Stools - If you have poop that appears oily, has a greasy consistency and is difficult to flush, it could be a signal that your body is not able to properly digest fat. The consistency changes could be caused by an infection, nutrients not being digested due to celiac disease or a problem with the pancreas, such as pancreatic cancer or pancreatitis.
  • Pencil Thin - Stool that is only occasionally very thin is not a cause for concern. It is likely due to muscle contractions in the large intestine as it helps to concentrate waste. If there is a sudden and consistent change in your stool always being thin, it could mean there is a blockage in your colon, and you should see your doctor.