Causes Of Red Stool Or Maroon Stool

Any Blood In The Stool Should Always Be Investigated By A Doctor

Tomato Soup
Tomato soup can be both delicious and nutritious. But eating a significant amount of red foods could lead to stools that appear red. Image & copy; GMVozd / Getty Images

Having a red stool can give you a start, and immediately make you think it is blood, but there are a few reasons that a stool can be red that aren't due to blood. If you do think it could be blood, you should consult a physician immediately, but if you aren't sure, try to remember the foods you ate recently, especially any that are red or orange.

The medical term for the passage of visible blood in the stool is "hematochezia." The brighter color of the blood indicates that it may be coming from a source in the lower gastrointestinal tract (colon), rather than the higher gastrointestinal tract (esophagus, stomach, small intestine).

A physician should always investigate blood in the stool to rule out potentially serious conditions. If you are bleeding a lot and feel faint or have other symptoms such as severe abdominal pain, call 911.

When It's Not Actually Blood

Several different types of food with natural or artificial coloring may cause red colored stools, which looks like hematochezia, but it isn't. Some of the foods that can cause red stools include:

  • Red gelatin, popsicles, or Kool-Aid
  • Tomato juice or soup
  • Large amounts beets
  • Anything colored with red food coloring (red #40)

If you haven't eaten any of these foods, or other brightly colored foods, and are having red stools, contact your doctor right away to get it checked out. This is especially true if you've had more than one red stool and you aren't eating anything red.

Diagnosing True Hematochezia

The blood could be caused by several different conditions including hemorrhoids, anal fissures, colon polyps, diverticular bleeding, or inflammatory bowel disease (IBD).

The site of the bleeding must be determined before a diagnosis can be made and a treatment prescribed. To start to find out the cause of the bleeding, a patient history will be taken, which includes questions about changes in bowel habits (such as constipation or diarrhea) and the location of any pain.

A physician may order a fecal occult blood (FOBT) test to determine if there is blood in the stool. An FOBT is a simple test for a patient—it only requires that a stool sample is collected at home and dropped off at the physician’s office or a laboratory.

A physician may order other diagnostic tests to determine the cause and exact location of the bleeding. This could include x-rays, blood tests, colonoscopy, gastroscopy, stool culture, and barium studies. A doctor may also do a quick rectal exam, which is where a gloved, lubricated finger is inserted into the anus (it's very fast and shouldn't hurt).

Causes of Hematochezia

Hemorrhoids. Hemorrhoids are a common cause of bright red blood in the stool or on the toilet paper. A hemorrhoid is actually a form of varicose vein. The veins in and around the rectum and anus become swollen. Symptoms of hemorrhoids include anal itching, bleeding during bowel movements, pain, protrusion during bowel movements and sensitive lumps around the anus. To diagnose hemorrhoids, a physician will need to examine the anus and rectum and possibly perform a rectal exam.

Anal fissures. A fissure is a tear or ulcer in the lining of the anal canal. The anal canal is the last part of the rectum before the anus. Fissures can occur in anyone, but are more common in middle age or young adults. A fissure can be difficult to heal as it causes a spasm of the anal sphincter and aggravates itself. Symptoms of a fissure include an anal lump, bright red blood in the toilet bowl or on paper, painful bowel movements, and swollen skin tag. A fissure is typically diagnosed with a visual or a rectal exam. Fissures can be caused by constipation or by forcing a hard bowel movement through the anus, during childbirth, or ulceration of hemorrhoids.

Diverticular bleeding. A diverticulum is a small pouch in the colon that bulges out of a weakened spot in the colon wall. The condition of having diverticula in the colon is called diverticulosis and it affects about 10% percent of Americans over the age of 40 years. Although not common, diverticula may cause bleeding that appears the stool or the toilet. This bleeding may not require treatment unless it is continuous or severe.

Inflammatory bowel disease. Ulcerative colitis and Crohn's disease are incurable chronic diseases of the intestinal tract collectively known as inflammatory bowel disease (IBD). Intervals of active disease, or 'flares', and periods of remission characterize IBD. IBD may cause bleeding in the digestive tract that appears in the stool or the toilet. Several diagnostic tests are normally completed and studied by a digestive specialist before a diagnosis of IBD is made.

Colon polyps. A rarer cause of blood in the stool is a colon polyp. A polyp is a benign growth on the wall of the colon or rectum. Some colon cancers may develop from these benign polyps. Discovering polyps early through a sigmoidoscopy or a colonoscopy and having them removed may help prevent colon cancer. By the time a colon polyp is causing visible bleeding, cancer is often already present.

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