Bloody stools: What does it mean? 4 causes and home remedies

Bloody stools, blood in stool, or fresh blood in stool is a condition that worries many people, especially when blood appears suddenly after defecation. Blood can be related to common issues like hemorrhoids or anal fissures, but it can also be a sign of a gastrointestinal disease that needs early examination. Therefore, self-treating symptoms without identifying the cause can lead to the problem being overlooked.

In this article, Tiptory helps you understand what causes bloody stools, when it might be a minor issue, and when medical attention is needed. Experts also provide appropriate handling methods for each cause, helping you proactively protect your health instead of just temporarily stopping the bleeding.

Part 1: Identifying the cause of bloody stools based on stool color

Note 1: Distinguishing black stool due to gastrointestinal bleeding

Checking stool color when there is blood in the stool

• Pay attention if the stool is black, tarry, especially if it's sticky, shiny, or has a very foul odor. This could be a sign of gastrointestinal bleeding and requires medical evaluation.

• Black stool due to gastrointestinal bleeding is called melena. This condition usually occurs when blood originates from the esophagus, stomach, or upper small intestine. As it passes through the digestive tract, the blood is digested and turns black.

• Some potential causes of bloody stools with black stool include stomach ulcers, gastritis, esophageal damage or tear, vascular abnormalities, esophageal or gastric varices, and reduced or lost blood supply to a part of the intestine.

• Foreign objects or lesions in the digestive tract can also cause bleeding. Therefore, do not rely solely on stool color to self-diagnose the cause.

Remembering stool characteristics to help the doctor with diagnosis

1. Observe the color, consistency, and shape of the stool before flushing if you suspect blood.

2. Note the time when black stool or bloody stools first appeared, how often it occurred, and the amount of blood observed.

3. Inform your doctor if black stool is accompanied by abdominal pain, dizziness, fatigue, shortness of breath, vomiting blood, or lightheadedness. These could be signs requiring urgent evaluation.

4. Not all cases of black stool should be mistaken for gastrointestinal bleeding. Some foods, iron supplements, or medications can change stool color. However, if the cause is unclear, especially if the stool appears tarry, it should be evaluated by a healthcare professional.

Don't just try to treat the symptoms

• Blood in stool can have many different causes, and treatment depends on the location and cause of the bleeding.

• If you experience fresh blood in stool, abnormal black stool, or recurrent bleeding, identifying the cause is more important than self-medicating to stop the bleeding.

• By accurately providing stool characteristics and accompanying symptoms, you can help your doctor quickly pinpoint the cause and choose appropriate examination methods.

Note 2: Red stool is often caused by lower gastrointestinal bleeding

Recognizing red-colored stool

• If the stool is bright red or has clear red blood, this condition is called hematochezia. This is often a sign of blood originating from the lower part of the digestive tract, such as the colon, rectum, or anus.

• Bloody stools, especially fresh blood in stool, can appear as blood coating the outside of the stool, dripping after defecation, or appearing on toilet paper.

• The color of the blood and how it appears can provide useful information, but it is not sufficient to precisely determine the cause. The patient still needs to be evaluated based on accompanying symptoms and medical history.

Potential causes of blood in stool

• Hemorrhoids or anal fissures: These are common causes, especially when bright red blood appears after straining or passing hard stools.

• Polyps or gastrointestinal cancer: Some lesions in the colon or small intestine can cause bleeding, sometimes without obvious pain.

• Inflammatory bowel disease: Inflammatory bowel diseases such as ulcerative colitis or Crohn's disease can cause bloody stools, often accompanied by diarrhea, abdominal pain, or tenesmus.

• Diverticulitis: Small pouches formed in the colon wall can become inflamed and bleed.

• Intestinal infections: Some infections can cause bloody diarrhea, abdominal pain, and fever.

• Injury or foreign body: Trauma and foreign bodies in the lower digestive tract can also cause bleeding.

• Vascular abnormalities: Vascular disorders or reduced blood supply to the intestines can lead to bleeding.

When to see a doctor

1. If fresh blood in stool recurs or the amount of blood is significant, you should see a doctor to find the cause instead of self-treating.

2. If bleeding is accompanied by severe abdominal pain, dizziness, fainting, severe weakness, rapid heartbeat, or cold skin, emergency care is needed as it may be related to significant blood loss.

3. If blood in stool is prolonged or accompanied by changes in bowel habits, unexplained weight loss, or anemia, an early gastrointestinal examination should be performed.

Do not assume bright red blood is always due to hemorrhoids

• Hemorrhoids are a common cause, but bloody stools can also be related to many other medical conditions.

• Therefore, blood color is only a guiding sign. To treat correctly, the doctor needs to determine the location and cause of the bleeding before choosing an appropriate method.

Note 3: Not all red stool is blood

Checking if stool color might be from food or medication

• Not all cases of red or black stool mean bloody stools. Some foods, medications, and supplements can change stool color, making it easy to mistake for fresh blood in stool.

• Abnormal stool color after eating certain foods usually does not come with other signs of bleeding. However, relying solely on visual observation is not always accurate in determining the cause.

Some causes that can change stool color

• Black stool: Can be related to black licorice, iron pills, bismuth-containing medications like Pepto-Bismol, beets, or blueberries. Meanwhile, tarry black stool, especially if it has an unusual odor, could be a sign of gastrointestinal bleeding and needs to be checked.

• Red stool: Beets and tomatoes can make stool red or dark red, easily mistaken for blood in stool.

• Medications and foods: If stool color changes immediately after using a medication or eating dark-colored food, remember this information to discuss with your doctor.

What to do if you're not sure if it's blood

1. Note down the foods, medications, or supplements you have used in the past few days.

2. Observe whether the abnormal color continues to appear after stopping the food that might have caused the discoloration.

3. If you still suspect bloody stools, especially if the condition recurs or is accompanied by abdominal pain, dizziness, fatigue, or changes in bowel habits, you should see a doctor.

4. When necessary, the doctor can test a stool sample to determine if there is actually blood. This is a more reliable method than just observing stool color at home.

Do not self-diagnose based solely on stool color

• Blood in stool can be due to benign causes but can also be related to medical conditions requiring treatment. Conversely, red or black stool can sometimes just be the result of food or medication.

• Therefore, if you cannot determine the cause, especially when fresh blood in stool recurs, it is safer to have a healthcare professional evaluate it rather than self-diagnose.

Note 4: Check medications that can cause gastrointestinal bleeding

Reviewing current medications

• Some medications can increase the risk of gastrointestinal bleeding, especially when taken in high doses, for extended periods, or in combination with other medications that increase bleeding risk.

• If you are experiencing bloody stools and using these medications, do not stop taking them on your own. Discuss with your doctor to assess the risk and determine if medication adjustment is needed.

Anticoagulants and antiplatelet drugs

• Aspirin, warfarin, and clopidogrel can increase the risk of bleeding. These medications are often used to prevent or treat issues related to blood clot formation.

• If blood in stool, black stool, or other abnormal bleeding signs appear while taking these medications, you must inform your doctor.

Non-steroidal anti-inflammatory drugs (NSAIDs)

• Some NSAIDs like ibuprofen and naproxen can damage the gastrointestinal lining and increase the risk of ulcers or bleeding, especially with prolonged use or in individuals with risk factors.

• If you are taking NSAIDs and experience fresh blood in stool, black stool, or unusual abdominal pain, you should be evaluated by a healthcare professional.

What to do if you suspect medication-related bleeding

1. Record the medication name, dosage, start date, and frequency of use.

2. Fully inform your doctor of all medications you are taking, including prescription drugs, over-the-counter drugs, and supplements.

3. Do not stop aspirin, warfarin, clopidogrel, or other anticoagulants on your own, as sudden discontinuation can increase the risk of blood clot formation in some individuals.

4. If bloody stools are heavy, stool is tarry black, you are vomiting blood, dizzy, fainting, or severely weak, emergency care or urgent medical evaluation is needed.

Medications can change management approaches

• When the cause of blood in stool is related to medication, the doctor may consider adjusting the medication, dosage, or choosing a different treatment option based on the cause of the bleeding and underlying medical conditions.

• Therefore, instead of stopping medication yourself when you see fresh blood in stool, let the doctor assess both the benefits of the medication and the risk of bleeding to choose a safe course of action.

Part 2: When to see a doctor for bloody stools?

Note 1: Provide sufficient information during examination

Clearly describe the bleeding condition

• When experiencing bloody stools or blood in stool, try to remember the amount of blood and how it appeared. For example, whether the blood was only on the toilet paper, coating the outside of the stool, or mixed in with the stool.

• If possible, tell the doctor if the blood is bright red, dark red, or if the stool is tarry black. These characteristics can help pinpoint the location of bleeding in the digestive tract.

Indicate the onset and progression

1. When did the fresh blood in stool start?

2. Did the bleeding occur once or repeatedly?

3. Has the amount of blood gradually increased or appeared more frequently?

4. Were there any preceding factors, such as constipation, straining during defecation, or prolonged diarrhea?

Report potential injury or foreign body

• Inform your doctor if you have recently experienced trauma to the abdominal or anal area.

• If you have accidentally swallowed or had a foreign object stuck, especially if accompanied by unusual symptoms afterward, you need to provide this information for the doctor to assess the risk of digestive tract damage.

Clearly state accompanying symptoms

• Inform your doctor if bloody stools are accompanied by abdominal pain, nausea, vomiting, fever, or diarrhea.

• These symptoms can help the doctor differentiate between various causes, such as infections, inflammatory bowel disease, or other issues in the digestive system.

Provide information about weight and health changes

• If you have experienced unintentional weight loss, clearly tell your doctor, especially if this occurs with prolonged blood in stool or changes in bowel habits.

• Providing information about current illnesses, medications being used, and recent health changes also helps ensure a more accurate diagnosis.

Prepare information before the visit

1. Record the time of blood appearance and the number of occurrences.

2. Describe the color, amount of blood, and characteristics of the stool.

3. List accompanying symptoms such as abdominal pain, fever, vomiting, or diarrhea.

4. Record current medications and any recent changes in diet or health.

5. If blood in stool recurs, bring this information with you to the appointment so the doctor has a comprehensive basis for evaluation.

Note 2: Rectal examination helps find the cause of bleeding

Doctor may need to perform a rectal exam

• When you seek medical attention for bloody stools, your doctor may perform a digital rectal exam to check the anal and rectal area.

• This is a common examination step when evaluating blood in stool and helps the doctor find abnormalities that may be related to bleeding.

How a rectal exam is performed

1. The doctor will explain the procedure and guide you into an appropriate position.

2. The doctor will wear gloves and use lubricant to gently insert one finger into the rectum.

3. The doctor checks for abnormalities such as lumps, lesions, pain, or signs that may be related to fresh blood in stool.

4. The procedure usually takes a short time. You may feel a slight discomfort or a urge to defecate, but generally it does not cause significant pain.

Discuss if you feel anxious

• Feeling embarrassed during an anal examination is completely understandable, but the information obtained can help the doctor pinpoint the cause of bloody stools.

• If you feel pain or excessive discomfort during the examination, immediately inform your doctor so adjustments can be made.

• Depending on the symptoms and examination results, the doctor may order additional tests or other examination methods to determine the cause of the bleeding.

Note 3: Tests help find the cause of bleeding

Doctor may order additional tests

• If you have bloody stools and the initial examination results are insufficient to determine the cause, your doctor may request additional tests based on the suspected location of bleeding and accompanying symptoms.

• Not all patients will need to undergo all the tests listed below. The doctor will choose the appropriate method for each case.

Blood test

• Blood tests can help assess anemia and provide further information on the extent of blood loss.

• The results can also help doctors evaluate overall health before other procedures.

Angiography

• Doctors may use contrast agents combined with X-ray imaging to visualize blood vessels and locate the source of bleeding in some appropriate cases.

• This method may be considered when fresh rectal bleeding is suspected to be related to vascular abnormalities or ongoing bleeding.

Gastrointestinal imaging tests

• Several imaging methods can help visualize the structure and walls of the gastrointestinal tract.

• Multi-phase CT enterography can provide more detailed images of the bowel wall and related abnormalities.

• In some cases, doctors may use oral contrast agents to aid in visualizing the gastrointestinal tract on X-ray images.

Colonoscopy

• Colonoscopy uses a flexible tube with a camera to directly visualize the inside of the colon.

• This method can help find causes of bloody stools such as polyps, inflammation, mucosal lesions, or other abnormalities.

• When necessary, the doctor can take tissue samples or treat certain lesions during the endoscopy.

Esophagogastroduodenoscopy (EGD)

• Upper gastrointestinal endoscopy, also known as EGD, uses an endoscope inserted through the mouth to examine the esophagus, stomach, and duodenum.

• This method is particularly useful when the doctor suspects the bleeding source is in the upper part of the gastrointestinal tract, such as when there are tarry, black stools.

Capsule endoscopy

• The patient swallows a small capsule with a camera. The capsule travels through the digestive tract and records images of the inside.

• This can be an option for observing the small intestine, an area difficult to access with conventional endoscopic methods.

Balloon-assisted enteroscopy

• This technique uses a specialized endoscopic system to access difficult-to-visualize segments of the small intestine.

• Doctors may use this method when trying to find the cause of bloody stools when previous tests have not identified the bleeding site.

Endoscopic ultrasound

• Endoscopic ultrasound combines an ultrasound probe with an endoscope to create more detailed images of the gastrointestinal wall and nearby structures.

• High-frequency sound waves are used to create images, helping doctors evaluate certain lesions that may be difficult to detect with conventional endoscopy.

Endoscopic retrograde cholangiopancreatography (ERCP)

• ERCP combines endoscopy and X-rays to examine the bile ducts and pancreatic duct, and can also assist in treating some problems related to these organs.

• This is not a routine test for all cases of bloody stools, but is only performed when the doctor suspects a relevant condition in the bile ducts or pancreas.

Choosing tests based on suspected cause

1. The doctor first evaluates the color of the blood, the amount of blood, accompanying symptoms, and physical examination results.

2. Then, the probable bleeding site in the gastrointestinal tract is determined.

3. Based on this information, the doctor selects the appropriate test or endoscopic procedure.

4. If fresh rectal bleeding recurs or the cause is unclear, a combination of methods may be needed to accurately pinpoint the bleeding source.

Do not self-select tests

• Each method has its own purpose, advantages, and limitations. Therefore, when experiencing bloody stools, patients should not self-request or self-select tests based solely on blood color.

• Accurately identifying the bleeding site and cause is a crucial step for the doctor to provide appropriate treatment, rather than just treating temporary symptoms.

Part 3: Effective and safe ways to treat bloody stools

Method 1: Some mild causes may resolve on their own

Monitoring and proper care for mild causes

• Some cases of bloody stools may improve with time for the body to recover, but it is important to identify or have the cause assessed by a doctor before only monitoring at home.

• If bleeding is prolonged, recurrent, or occurs in large amounts, self-care should not continue, and a medical examination is needed to find the cause.

Hemorrhoids can improve with proper care

• Hemorrhoids can cause fresh red blood when passing stool, along with itching, pain, or discomfort around the anus.

• Avoiding straining and limiting prolonged sitting on the toilet can help reduce pressure on the anal area.

• Eating enough fiber and drinking enough water helps soften stool, thereby reducing the need to strain during bowel movements.

Anal fissures need time to heal

• An anal fissure is a small tear in the skin around the anus, often causing pain during bowel movements and possibly fresh rectal bleeding.

• Many cases can heal within a few weeks if constipation is avoided and further injury to the anal area is prevented.

• If pain or bleeding is prolonged, a medical examination is needed to identify the cause and appropriate treatment.

Gastrointestinal infections require attention to rehydration

• Some cases of viral or bacterial gastroenteritis may improve on their own.

• When experiencing diarrhea, especially if accompanied by bloody stools, it is crucial to replenish fluids and electrolytes to prevent dehydration.

• Do not self-medicate with anti-diarrheal drugs in all cases, especially when diarrhea is bloody or accompanied by fever, without consulting a healthcare professional.

Increase fiber to reduce straining during bowel movements

• A low-fiber diet can make stool hard, causing you to strain more and increasing the risk of irritation or injury to the anal area.

• Adding fiber from green vegetables, fruits, legumes, and whole grains can help soften stool and make it easier to pass.

• Increase fiber gradually and drink enough water to allow the digestive system time to adapt.

Monitor for abnormal signs

1. If mild bloody stools are identified as being due to a benign cause, prioritize softening stool and avoiding straining.

2. Monitor the amount of blood and frequency of occurrence in subsequent bowel movements.

3. If bloody stools increase, persist, or recur, a medical examination is recommended to find the cause.

4. If bleeding is accompanied by dizziness, fainting, weakness, severe abdominal pain, or tarry, black stools, urgent medical evaluation is needed.

Do not consider all cases of bleeding as minor issues

• Hemorrhoids and anal fissures are common causes, but fresh rectal bleeding can also be associated with many other conditions.

• Therefore, allowing a mild condition to resolve on its own is only appropriate when the cause has been assessed and there are no warning signs.

Method 2: Treat infection as directed by a doctor

Antibiotics when appropriate cause

• Some cases of gastrointestinal infection require antibiotic treatment, but not all cases of bloody stools need this medication.

• For diverticulitis, the doctor may prescribe antibiotics depending on the severity of the disease, overall condition, and risk of complications.

• Antibiotics help control bacteria associated with inflammation or infection in small pouches formed on the colon wall.

Do not self-medicate with antibiotics for bloody stools

• Bloody stools can be caused by hemorrhoids, anal fissures, inflammatory bowel disease, polyps, infection, or many other reasons. Using antibiotics for the wrong cause may not help and can increase the risk of side effects or antibiotic resistance.

• Only use antibiotics as prescribed and instructed by a doctor, and take them at the correct dose and for the specified duration.

Diet may be adjusted during the acute phase

• In some cases of acute diverticulitis, the doctor may recommend a liquid or low-fiber diet for a short period, depending on symptoms and tolerance.

• The goal is to reduce the burden on the digestive system during the acute phase, then gradually return to an appropriate diet as the condition improves.

• Do not prolong fasting simply because of fresh rectal bleeding. Nutritional needs and appropriate food intake depend on the cause and severity of the disease.

Monitor progress after treatment

1. Take medication as directed and follow up if the doctor requests.

2. Monitor for abdominal pain, fever, diarrhea, and the amount of blood in stools.

3. If bloody stools increase, severe abdominal pain, high fever, frequent vomiting, dizziness, or weakness occurs, prompt medical evaluation is needed.

4. If fresh rectal bleeding continues to recur even after infection symptoms have subsided, consult the doctor to find another cause.

Treatment must be based on the cause

• Antibiotics are only one part of treating some infectious diseases. With bloody stools, the most important step is still to identify the source of bleeding and the underlying cause.

• Do not consider antibiotics as a general solution for all cases of bleeding during bowel movements.

Method 3: Endoscopy can help stop gastrointestinal bleeding

Treat bleeding lesions via endoscopy

• When bloody stools are caused by ulcers, abnormal blood vessels, or tissue lesions in the digestive tract, doctors can use interventional endoscopic techniques to control the source of bleeding.

• The chosen method depends on the location, extent of bleeding, and characteristics of the lesion.

Use heat to stop bleeding

• Thermal probes via endoscopy use heat to coagulate and control bleeding blood vessels.

• This technique can be used in some cases of bleeding due to gastrointestinal ulcers.

Use cryotherapy to treat abnormal blood vessels

• Endoscopic cryotherapy uses very low temperatures to affect abnormal blood vessels causing bleeding.

• The doctor will consider this method based on the location and characteristics of the lesion.

Use endoscopic clips

• Endoscopic clips can be placed directly on the lesion or bleeding blood vessel to close and control the source of hemorrhage.

• This is one of the mechanical hemostasis techniques used in the treatment of gastrointestinal bleeding.

Injecting sealant to occlude blood vessels

• In some appropriate cases, the doctor may inject medical glue via endoscopy to seal a bleeding blood vessel.

• This technique requires a specialized doctor and is performed in a medical environment with full facilities for hemorrhage control.

The doctor will choose the appropriate method

1. Identify the location and cause of fresh rectal bleeding or gastrointestinal bleeding.

2. Evaluate the size, location, and extent of bleeding of the lesion.

3. Select the appropriate endoscopic hemostasis method, which may involve one technique or a combination of techniques.

4. Monitor after intervention to detect recurrent bleeding early.

Not all cases of bloody stools require endoscopic intervention

• Therapeutic endoscopy is primarily used when a lesion requiring intervention is identified. If bloody stools are due to other causes, the doctor may choose an entirely different treatment method.

• Therefore, one should not determine the treatment method solely based on blood color or symptoms. Correct diagnosis of the cause is the foundation for safe and effective bleeding control.

Method 4: When does bleeding require surgery?

Surgery is considered for severe or recurrent bleeding

• Not all cases of bloody stools require surgery. This is often an option when the cause of bleeding is severe, recurrent, or cannot be controlled with medication and other interventions.

• The doctor will assess the extent of blood loss, the cause, the location of the lesion, and the overall health condition before deciding whether surgery is needed.

Anal fistula may require surgery

• An anal fistula is an abnormal communication that forms between the anal canal or rectum and the skin around the anus.

• This condition can occur after an perianal abscess ruptures and usually does not heal completely on its own.

• Depending on the location and extent of the fistula, the doctor may choose an appropriate surgical method to treat the fistula and reduce the risk of recurrence.

Recurrent diverticulitis may require intervention

• Recurrent diverticulitis can cause abdominal pain, bowel disorders, and in some cases, gastrointestinal bleeding.

• If the disease recurs multiple times or complications arise, the doctor may consider surgical removal of the affected colon segment.

• The decision for surgery should be based on individual cases rather than solely on the number of disease recurrences.

Intestinal polyps may need to be removed

• Colon polyps are small growths of tissue on the colon lining. Most polyps are not cancerous, but some types have the potential to develop into cancer over time.

• Many polyps can be detected and removed during a colonoscopy, without necessarily requiring open surgery.

• Removing polyps helps prevent some long-term risks and can resolve the source of bleeding in appropriate cases.

When urgent medical evaluation is needed

1. If there is fresh rectal bleeding in large amounts or continuous bleeding, immediate medical evaluation is required.

2. If bleeding is accompanied by dizziness, fainting, rapid heartbeat, weakness, or clammy skin, it may be a sign of significant blood loss.

3. If bloody stools recur, do not simply wait for them to resolve on their own, but seek the cause.

4. Surgery is only performed when the benefits outweigh the risks and less invasive treatment methods are unsuitable or ineffective.

Treatment needs to proceed from cause to method

• Bloody stools are a symptom, not a separate disease. Therefore, the treatment approach can vary greatly between hemorrhoids, polyps, diverticulitis, anal fissures, and other conditions.

Method 5: Acid-reducing medications can support treatment

Consult a doctor if bleeding is related to ulcers or gastritis

• If bloody stools or black stools are identified as being related to stomach ulcers or gastritis, the doctor may consider acid-reducing medications to support the treatment of mucosal damage.

• The two most commonly used groups of medications are histamine H2 receptor blockers and proton pump inhibitors (PPIs) such as omeprazole.

• The choice of medication, dosage, and treatment duration depends on the cause of the ulcer or inflammation, the extent of the damage, and other medications the patient is currently taking.

Omeprazole helps reduce the amount of acid in the stomach

• Omeprazole belongs to the PPI group, which reduces stomach acid production.

• When acid levels are reduced, the gastric and duodenal lining can heal better, and the risk of further damage causing bleeding is reduced.

• However, omeprazole is not a treatment for all causes of bloody stools.

H2 blockers may also be used in some cases

• H2 blockers reduce acid secretion by acting on histamine H2 receptors in stomach cells.

• Doctors may consider this group of medications depending on the cause, severity of the disease, and treatment response.

Do not self-medicate to mask bleeding symptoms

1. If there is fresh blood in the stool, the cause needs to be identified before self-medicating with acid reducers.

2. If there are black stools, abdominal pain, vomiting blood, or signs of blood loss, medical evaluation is needed instead of just using acid reducers at home.

3. Inform the doctor about all medications being taken to avoid drug interactions and choose the appropriate treatment option.

4. If the doctor prescribes medication, take it at the correct dose and for the prescribed duration, and follow up as needed.

Treating the underlying cause remains the priority

• Acid-reducing medications can play an important role when bleeding is related to ulcers or gastritis, but bloody stools can also originate from the colon, rectum, anus, or other causes.

• Therefore, if bloody stools are prolonged or recurrent, one should not rely solely on acid-reducing medications but rather find the correct source of bleeding for appropriate treatment.

Method 6: Iron supplementation for bleeding-induced anemia

Check for anemia if blood loss is prolonged

• Heavy or prolonged bloody stools can cause the body to lose iron and lead to anemia, especially when bleeding recurs.

• Symptoms may include fatigue, dizziness, lightheadedness, weakness, pale skin, or shortness of breath with exertion.

• If these symptoms appear along with bloody stools, it is advisable to see a doctor and have blood tests to determine if anemia is present.

Iron supplementation when indicated

• If tests confirm iron deficiency anemia, the doctor may prescribe iron supplements to replenish lost iron and help the body produce red blood cells.

• Do not self-medicate with iron just because you see fresh blood in your stool. Anemia has many causes, and iron supplementation should be based on test results and a doctor's evaluation.

• Iron does not address the underlying cause of bleeding. If blood loss continues, it is important to find and treat the source of bleeding.

Monitor treatment response

1. Undergo blood tests as indicated to assess the status of anemia and iron stores.

2. If prescribed iron, use it at the correct dose and for the duration instructed by the doctor.

3. Report any side effects such as nausea, abdominal pain, constipation, or dark stools.

4. Follow up as scheduled to assess the anemia and determine if the cause of bleeding has been controlled.

When to seek early medical attention

• If there is heavy bloody stool, continuous bleeding, or accompanying severe dizziness, fainting, weakness, shortness of breath, or rapid heart rate, urgent medical evaluation is needed.

• If bloody stools recur, even if the amount of blood is small, it should not be ignored, as prolonged blood loss can subtly lead to anemia.

Prioritize treating both blood loss and the underlying cause

• Iron supplementation only addresses the consequence of iron deficiency anemia; it does not replace finding the cause of fresh blood in the stool.

• Effective treatment requires simultaneously controlling the source of bleeding and restoring iron levels when the body is truly deficient.

Method 7: Colorectal cancer treatment by stage

Treatment should be based on tumor location and stage

• If bloody stools are determined to be related to colorectal cancer or bowel cancer, the treatment plan needs to be developed based on the tumor location, disease stage, cancer cell characteristics, and overall health.

• Not all cases of bloody stools are cancer. However, if bleeding is prolonged or recurrent, especially if accompanied by changes in bowel habits, unintentional weight loss, or anemia, an examination is needed to rule out serious causes.

Surgical removal of the tumor

• Surgery can be the primary treatment for many localized colorectal cancer cases.

• The doctor may remove the tumor along with a portion of the surrounding tissue or bowel segment, then reconnect the digestive tract when appropriate.

• In some cases, surgery is also used to alleviate symptoms or manage disease complications.

Chemotherapy

• Chemotherapy uses anti-cancer drugs to kill or control cancer cells.

• Depending on the stage, chemotherapy can be used before surgery, after surgery, or for treating advanced disease.

• The choice of drugs and regimen depends on the specific characteristics of the tumor.

Radiation therapy

• Radiation therapy uses high-energy radiation to kill or control cancer cells in the treated area.

• Radiation therapy is used more frequently in some cases of rectal cancer, especially when there is a need to reduce the risk of local recurrence in the pelvis.

• Not all patients with bowel cancer need radiation therapy.

Cancer treatment drugs

• Some patients may be treated with targeted therapy drugs or immunotherapy drugs, depending on the biological characteristics and molecular tests of the tumor.

• These methods can be used alone or in combination with other methods when appropriate.

Treatment according to the specialist's plan

1. Precisely identify the location and type of cancer.

2. Assess the disease stage using necessary tests.

3. Check certain molecular characteristics of the tumor when needed to select appropriate medications.

4. Develop a regimen that may combine surgery, chemotherapy, radiation therapy, targeted therapy, or immunotherapy.

5. Regular follow-up to assess treatment response and risk of recurrence.

Do not delay if there are warning signs

• Fresh blood in the stool does not necessarily mean cancer, but one should also not assume the cause is only hemorrhoids.

• If bloody stools recur, accompanied by changes in bowel habits, unintentional weight loss, prolonged abdominal pain, or anemia, seek medical attention to find the cause.

• If cancer is detected, earlier treatment and at the correct stage allow doctors more options for disease control.

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15. American Gastroenterological Association. Clinical Practice Guidelines on the Medical Management of Colonic Diverticulitis. Gastroenterology. Bethesda, MD: American Gastroenterological Association.

Content edited by: Lesley Collins Tran.

Information consulted and verified by expert: Sophia Miller.