Bloody stools: Should I worry about them?

Dear Reader,

There are lots of different medical conditions that can cause blood to appear in a person's stool. They range from the very minor to the very serious, and may include:

• Anal fissures, which are small cracks or tears around the anus that can be caused by large and/or forceful bowel movements or anal sex (including insertion of fingers, sex toys, etc.);
• Hemorrhoids (a.k.a. piles), which are enlarged veins in the lower part of the rectum or anus;
• Infection or disease in the GI (gastrointestinal) tract such as bacterial infections, stomach ulcers, or inflammatory bowel disease (IBD);
• Tumors or cancer of the GI tract such as polyps or colon cancer.

Only a health care provider can determine whether the blood in your stool is from straining too hard, or from a more serious and/or long-term medical problem. People who experience blood in their stool are urged to seek medical advice to rule out any serious problems. If you’re a Columbia student, you can schedule an appointment with Medical Services on the Morningside campus via Open Communicator or by calling 212-854-2284. If you’re a student at the Medical Center campus, try reaching out to Student Health at 212-305-3400 for further information.

Before your appointment, it’s good to consider and observe a few things which you can then report to your health care provider. First, how much blood is there? Whether there is a small or large quantity of blood present, it could be cause for worry. A large quantity of blood (say enough to color the water in the toilet pinkish-red or show up as visible clots) can be a sign of a life threatening bleed in the GI tract, which requires emergency medical treatment. Small amounts of blood may not necessarily mean a small problem, though — for example, one of the early signs of colon cancer is the presence of minute amounts of hidden (or occult) blood in stools — so any amount of blood in the stool needs to be followed up with a call to your health care provider. Second (or #2), what color is your stool? Bleeding in the GI tract can produce stools that are maroon colored or black and tar-like. However, some foods and medicines can also cause black or tar-like stools (including blueberries, black licorice, and pink bismuth) or maroon ones (e.g., beets).

Best of luck figuring out the cause!

Take care,