Blood in the stools is a frightening sight for many people, and one that gives immediate cause for concern. It is important to realise, however, that whilst this symptom may indicate a serious illness, in many cases it is caused by a harmless or easily treatable problem. The most important thing is not to ignore it, but to see a doctor to identify the exact causes.
Blood in the stools can take various forms: it may be bright red, fresh blood (haematochezia), which usually originates from the lower bowel, or dark, digested, tarry stools (melena), which indicates bleeding in the upper digestive tract. There may also be hidden, or occult, bleeding, which is not visible to the naked eye but can be detected by laboratory tests.
In this article, we provide a detailed overview of the possible causes of blood in the stools, the diagnostic procedures and, most importantly, the prevention strategies and latest scientific findings that will help us reduce the risks more effectively by 2025. Our aim is to help you maintain your health by providing up-to-date and easy-to-understand information. The Endomedix Gastroenterology Centre Our specialists are committed to using the very latest diagnostic and therapeutic procedures.
The most common causes of blood in the stools
There are numerous possible causes of blood in the stools, ranging from quite trivial problems to serious illnesses. The location and nature of the bleeding can reveal a great deal about the underlying cause.
Causes of lower gastrointestinal bleeding (fresh, red blood)
These are the most common reasons why blood is bright red and appears on toilet paper or on the surface of the stool.
- Haemorrhoids: This is the most common cause. It involves the dilation of the veins around the rectum, which can bleed when passing stools or straining.
- Anal fissure: A small tear in the mucous membrane of the anus, caused by hard stools or straining. It is typically accompanied by sharp pain and a small amount of bright red blood.
- Diverticulosis: Small pouches (diverticula) that form in the wall of the large bowel may become inflamed or rupture, which can cause sudden, painless but significant bleeding.
- Polyps and tumours: Polyps (benign growths) or malignant tumours (colorectal cancer) growing in the large intestine and rectum can also cause bleeding. This bleeding may be obvious, but often occurs only in a hidden form.
- Inflammatory bowel diseases (IBD): Crohn’s disease and ulcerative colitis are chronic inflammatory conditions that can be accompanied by diarrhoea, abdominal pain and bloody stools.
Causes of upper gastrointestinal bleeding (dark, tarry stools)
In such cases, the blood comes from the stomach or the upper part of the small intestine, and turns black during digestion.
- Stomach and duodenal ulcers: Ulcers that form on the lining of the stomach or duodenum, often caused by infection with the bacterium _Helicobacter pylori_ or the excessive use of non-steroidal anti-inflammatory drugs (NSAIDs).
- Oesophageal varices: In cases of advanced liver disease, the veins in the oesophagus may become dilated and, if they rupture, can cause life-threatening bleeding.
- Mallory-Weiss syndrome: A tear in the mucous membrane of the lower oesophagus caused by severe vomiting or retching.
Modern diagnostic tools
Accurately identifying the cause of blood in the stools is essential for appropriate treatment. The Endomedix Gastroenterology Centre uses state-of-the-art diagnostic procedures to identify the source of the bleeding.
- Physical examination and medical history: The doctor first asks the patient in detail about their symptoms, the nature of their stools, any previous illnesses and their medication history. A visual examination of the anus and surrounding area, together with a digital rectal examination (DRE), can in itself reveal the presence of haemorrhoids or a fissure.
- Faecal occult blood test: It is used to detect hidden blood that is not visible to the naked eye. Modern immunochemical tests (FIT) are extremely sensitive and specific in detecting blood originating from the large intestine.
- Endoscopic examinations: These are the most important procedures for determining the exact location of the source of the bleeding.
- Colonoscopy (colonoscopy of the colon): It is used to examine the entire large bowel and the final section of the small bowel. It also allows for the removal of polyps and the taking of tissue samples. In the event of a positive faecal occult blood test, this is the primary examination recommended.
- Gastroscopy (gastroscopy of the stomach): It is suitable for examining the oesophagus, stomach and duodenum. It is essential to carry out this examination if melena or upper gastrointestinal bleeding is suspected.
- Capsule endoscopy: A capsule containing a small, swallowable camera can be used to examine even those parts of the small intestine that are difficult to reach, if gastroscopy and colonoscopy have failed to identify the source of the bleeding.
- Imaging techniques: If endoscopy is inconclusive or cannot be performed, CT angiography may also be used; this is capable of detecting active bleeding at a rate of at least 0.3–0.5 ml per minute.
Prevention strategies in 2025: The latest scientific findings
Prevention is always better than cure. Lifestyle, diet and regular screening are key to reducing the risk of conditions that can lead to blood in the stools.
1. Lifestyle and dietary recommendations
By following the advice below, you can significantly reduce the risk of developing haemorrhoids, anal fissures and diverticulosis.
- A diet rich in fibre: Eat plenty of vegetables, fruit, whole grains and pulses. An adequate intake of fibre (25–30 grams a day) softens the stools, makes bowel movements easier and reduces straining.
- Drink plenty of fluids: Drink at least 2–2.5 litres of water or other sugar-free fluids every day. This is essential for the fibre to work properly and to soften the stools.
- Regular physical activity: Physical activity stimulates bowel function and helps prevent constipation. Even a 30-minute walk a day can make a big difference.
- Respecting the urge to have a bowel movement: Do not hold in your stools! If you feel the urge, go to the toilet, as holding them in leads to stools becoming harder and constipation.
2. The responsible use of medicines
Certain medicines may irritate the digestive system and cause bleeding.
- Non-steroidal anti-inflammatory drugs (NSAIDs): Medicines such as aspirin, ibuprofen or diclofenac can damage the stomach lining and cause ulcers. Always consult your doctor before taking them, particularly if regular use is required. Your doctor may recommend a stomach-protecting medicine (e.g. a proton pump inhibitor, or PPI) to reduce the risks.
- Anticoagulants: Anticoagulants and antiplatelet agents increase the risk of bleeding. If you are taking such medication and notice blood in your stools, inform your doctor immediately. Gastric protection therapy is also often recommended alongside these medicines.
3. Treatment of _Helicobacter pylori_ infection
This bacterium is the main cause of gastric and duodenal ulcers. Early detection of the infection and treatment with antibiotics (eradication) drastically reduces the risk of ulcer disease and associated bleeding. Diagnosis can be made using a breath test, a stool test or a tissue sample taken during an endoscopy.
4. The importance of colorectal cancer screening
Bowel cancer is one of the most common forms of cancer, but if detected at an early stage, it has a good chance of being cured. The aim of screening is to detect precancerous conditions (polyps) and early-stage tumours in good time.
- Who is it recommended for, and when? Regular screening is recommended for asymptomatic individuals at average risk from the age of 45–50. Current guidelines recommend starting screening earlier, at the age of 45, due to the rising number of cases even among younger age groups.
- Screening methods: The most common method is the faecal occult blood test (FIT); if the result is positive, a colonoscopy is required. A colonoscopy is the „gold standard” method, as it not only diagnoses the condition but also allows for therapeutic intervention through the removal of polyps.
From Endomedix Gastroenterology Centre It places particular emphasis on colorectal cancer screening, helping patients with prevention through pain-free examinations carried out under anaesthesia.
Treatment options
Treatment always depends on the underlying cause.
- Conservative treatment: In the case of haemorrhoids and fissures, the lifestyle changes mentioned above, sitz baths and special suppositories and creams can provide relief.
- Drug therapy: In cases of peptic ulcer disease, proton pump inhibitors (PPIs) and _H. pylori_ eradication therapy are the solution. In cases of inflammatory bowel disease, specialised anti-inflammatory, immunosuppressive or biological therapies are required.
- Endoscopic procedures: In the event of active bleeding, the source of the bleeding can be treated endoscopically. Various techniques are available, such as haemostatic injections, thermal coagulation (electrocoagulation) or the placement of mechanical clips. Colonic polyps are also removed endoscopically (polypectomy).
- Surgical intervention: Surgery may be necessary in cases of severe bleeding that cannot be controlled endoscopically, cancer, or inflammatory bowel disease that does not respond to drug treatment.
When should we see a doctor?
Although blood in the stools is often harmless, It should never be taken lightly. A medical consultation is recommended in all cases. Seek immediate medical attention or call an ambulance if you experience any of the following:
- Heavy, continuous bleeding.
- Dizziness, weakness, a feeling of faintness.
- Severe abdominal pain, fever.
- Vomiting, particularly if it is bloody or coffee-ground-like.
Remember, early diagnosis can save lives! Serious conditions such as bowel cancer can remain symptom-free for a long time, and hidden bleeding may be the only early sign.
The Path to Prevention
Blood in the stools can be a cause for serious concern, but it is also an important signal from our body that must not be ignored. Modern medicine now has extremely effective diagnostic and therapeutic tools at its disposal for identifying and treating the underlying causes.
Prevention, however, is just as important. A balanced diet rich in fibre, drinking plenty of fluids, regular exercise and the responsible use of medication all help to maintain the health of our digestive system. In addition, do not forget about the regular bowel cancer screening recommended for those aged 45 and over, which is one of the most effective means of prevention.
If you notice any symptoms, or simply want to do more for your health, please feel free to contact the Endomedix Gastroenterology Centre specialists. With the help of our experienced doctors and state-of-the-art technology, we are here to provide you with personalised advice and examinations.
