In order to understand well how to treat yourself in the case of bloody stools, it is important to establish the possible causes. Blood in the stool can be caused by a number of problems, such as infections, autoimmune diseases, and abnormal growths. It is also important to note that there are two types of bloody stools, melaena and hematochezia, so you need to identify which one you have before seeking a cure.
Steps
Part 1 of 3: Getting Medical Assistance for Bloody Stool
Step 1. Realize that the cure for bloody stools depends solely on the cause
There is no universal treatment to cure bloody stools - the cure depends solely on the cause of the bleeding.
- However, there are general treatments that apply to almost all causes, such as surgery, drug treatment, and others.
- If possible, your doctor will try to treat the disorder with drug therapy before considering surgery.
Step 2. Take antibiotics to eliminate infectious agents
First, antibiotics can be prescribed when the presence of blood in the stool is caused by infectious agents, such as Campylobacter and Shigella.
- Fluoroquinolones and Bactrim are the first therapeutic choices if there is a sure diagnosis for the disorder, accompanied by diarrhea. These medicines are also given postoperatively to prevent further complications, such as intra-hospital infections and sepsis.
- Depending on the infectious agent, and based on the patient's antibiogram results, some therapies include Macrolides, Penicillin, Fluoroquinolones.
Step 3. Use a proton pump inhibitor to treat bleeding caused by peptic ulcers
Proton pump inhibitors, such as omeprazole, are given to patients with peptic ulcer to try to stabilize stomach acid production and prevent bleeding.
- Omeprazole can be administered orally, in 20 mg daily tablets. Although not administered intravenously, this drug is recommended where oral intake is not possible.
- The use of non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, should be discontinued when taking these drugs, due to their effects on the gastric mucosa.
Step 4. Take octreotide to control bleeding from esophageal varices
This somatostatin analog has been shown to help control bleeding from esophageal varices.
- It is administered subcutaneously (100 micrograms three times a day), or intramuscularly (a dose of 20 mg once a month).
- Combined with beta inhibitors and antibiotics, this drug has shown positive effects in preventing frequent bleeding.
Step 5. Undergo surgery
Several types of surgeries are performed to treat bloody stools caused by peptic ulcer, Mallory-Weiss tear, esophageal varices, and even lower digestive problems.
- When treating pathologies of the upper digestive system, endoscopic therapy is used. An endoscope is an instrument used to inspect the esophagus and stomach and, if necessary, can be used as a therapeutic procedure.
- Banding is one of the techniques used to treat esophageal varices and hemorrhoids. Applying the bandage to infected blood vessels with elastic bands causes them to close and be eliminated by the body.
- Managing pathologies located in the lower digestive tract is a bit more serious (it involves cancer, ulcerative colitis, and diverticulosis, if symptomatic), and may require more demanding surgery. Depending on the location from which blood enters the stool, colon resection is used.
- There are many types of resection, such as partial colectomy, low anterior resection (removal of the sigmoid and superior rectum), and others.
Part 2 of 3: Identifying the Melena
Step 1. Understand what is meant by melena
Melena consists of black, tarry and foul-smelling stools that contain blood from almost all areas of the digestive system, but usually from the upper part, namely the esophagus, stomach and small intestine.
- The appearance of this blood is due to the fact that it has mixed with the contents of the digestive system, such as enzymes and bacteria. The presence of this type of content indicates that the blood has been present in the digestive system for at least 14 hours, or 3 to 5 days.
- This evidence is practically a pathognomonic symptom of peptic ulcer, and every physician should immediately consider this pathology when a patient complains of the presence of black stool.
Step 2. Understand the possible causes of melena
There are several possible causes for melena, such as:
- Peptic ulcer: this is one of the main pathologies that cause the presence of blood in the stool. In fact, 30-60% of patients who have bleeding in the upper digestive system suffer from a peptic ulcer. In addition, this pathology requires urgent surgery and targeted therapy to avoid further complications.
- Mallory-Weiss tear: this pathology consists of lacerations at the junction between the esophagus and the stomach, and is found in chronic alcoholics, after episodes of severe vomiting.
- Esophageal varices: includes bleeding of almost a third of the gastrointestinal tract; this pathology is characterized by the rupture of the veins located near the esophagus.
- Cancer: Cancer of the upper gastrointestinal tract can also cause bloody stools, along with damage to the mucous membrane (gastritis), but keep in mind that melaena is not the most important symptom.
Part 3 of 3: Identifying Hematochezia
Step 1. Understand what is meant by hematochezia
Hematochezia is the passage of venous and arterial blood in the stool. This indicates that the source of the bleeding is near the rectum, mainly in the colon.
- This blood usually comes from damaged blood vessels which are used to nourish the proximal structures of the lower intestine.
- One of the main causes of hematochezia is hemorrhoids, and fresh blood in the stool is typically found in people with this condition.
Step 2. Understand the causes of hematochezia
There are several possible causes for hematochezia, such as:
- Hemorrhoids: Hemorrhoids usually appear after age 50, and are the leading cause of lower gastrointestinal bleeding. This condition is usually self-limiting, but can cause severe pain and must be managed.
- Diverticulosis: A diverticulum is a kind of pouch that forms inside the intestine. A common symptom of this condition is abrupt and sometimes massive bleeding, which causes a strong presence of blood in the stool. In almost 80% of patients the bleeding stops spontaneously. But for patients whose bleeding persists, therapy is needed.
- Infectious causes: Some strains of E. Coli (enterohemorrhagic), Shigella, Campylobacter, and some other bacteria can cause bloody stools, along with diarrhea. Infections of these bacteria usually manifest with symptoms of malaise such as fever, increased white blood cells, abdominal pain, and more.
- Ulcerative colitis: This disease affects the colon and is characterized by bouts of diarrhea with bloody stools, along with a plethora of symptoms such as abdominal pain, cramps and tenesmus. This disease is associated with other systemic diseases, such as liver disease, and pathologies of the musculoskeletal system.
- Colon cancer: Colon cancer is a diagnostic possibility that must be investigated whenever blood is found in the stool, regardless of the obvious potential causes (such as hemorrhoids).
