Blood in Stool: What Constitutes Hematochezia? - Gastroenterology and Hepatology

The definition of blood in stool (hematochezia) refers to the presence of red or maroon-colored blood in the feces, which can indicate bleeding in the lower gastrointestinal tract?

Hello, doctor: What is the general definition of blood in stool (hematochezia)? Does it refer to visibly seeing blood mixed with the stool in the toilet? Sometimes, after a bowel movement, the stool in the toilet appears normal, but when wiping, especially after several wipes, I occasionally see one or two small drops of blood.
Is this considered blood in stool, or is it more likely that the tissue is irritating the anal area? Thank you.

Xiao Jie, 40~49 year old female. Ask Date: 2019/08/19

Dr. Chen Shidian reply Gastroenterology and Hepatology

It can be considered mild rectal bleeding; it is recommended to avoid constipation, wash the anal area with water after bowel movements, and seek medical attention if necessary.

Reply Date: 2019/08/19

More Info

Hematochezia is a medical term that refers to the passage of fresh blood through the anus, typically in or with stools. It is important to differentiate between hematochezia and other forms of blood in the stool, such as melena, which refers to black, tarry stools that indicate bleeding from the upper gastrointestinal tract.
In general, hematochezia is characterized by the presence of bright red blood, which can be mixed with or separate from the stool. This can occur for various reasons, including hemorrhoids, anal fissures, diverticular disease, inflammatory bowel disease (IBD), or colorectal cancer. The blood may be visible in the toilet bowl, on the surface of the stool, or on toilet paper after wiping.

In your case, if you notice small drops of blood on the toilet paper after wiping, it could be due to several factors. One possibility is that the blood is coming from a minor injury to the anal area, such as a small tear or fissure, which can occur with straining during bowel movements or from passing hard stools. This is often accompanied by pain or discomfort during bowel movements.
However, if the blood is bright red and appears consistently, even in small amounts, it is advisable to consult a healthcare professional for further evaluation. While occasional small amounts of blood may not be a cause for alarm, persistent or recurrent bleeding should be investigated to rule out any underlying conditions.

It is also essential to consider other symptoms that may accompany the bleeding, such as changes in bowel habits, abdominal pain, weight loss, or changes in appetite. These could provide additional clues to the underlying cause of the bleeding.

In summary, hematochezia refers to the passage of fresh blood in stools, and while small amounts of blood on toilet paper may not always indicate a serious issue, it is crucial to monitor the situation. If you experience ongoing bleeding or have concerns about your symptoms, seeking medical advice is the best course of action. A healthcare provider may recommend diagnostic tests, such as a colonoscopy, to determine the source of the bleeding and provide appropriate treatment.

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