What Medication Can Cause Blood In Stool – Hematochezia refers to the passage of fresh, bright red Blood in the stool and usually indicates lower gastrointestinal (GI) bleeding. The lower gastrointestinal tract is defined anatomically as the region distal to the ligament of Treitz, a thin band of tissue that connects and supports the end of the duodenum and the beginning of the jejunum. Hematochezia should not be confused with melena, which refers to the passage of black, resinous stool originating from the upper gastrointestinal tract proximal to the ligament of Treitz.
The causes of hematochezia in adults are usually inflammatory bowel disease (IBD), including ulcerative colitis; hemorrhoids; and bleeding from a diverticulum in the colon. In addition, peptic ulcer disease and esophageal varices are causes of upper gastrointestinal bleeding and can lead to hematochezia in severe cases.
What Medication Can Cause Blood In Stool
Ulcerative colitis is a subtype of inflammatory bowel disease that involves an autoimmune attack on the large intestine (ie, the large intestine), resulting in inflammation and ulceration of the lining. appears. Severe ulcerative colitis can cause hematochezia due to bleeding from the ulcer.
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Hemorrhoids are swollen veins in the lower part of the rectum that can be painless or painful depending on their internal or external location. They are usually caused by straining during bowel movements and are associated with obesity and pregnancy. When the walls of the blood vessels in hemorrhoids are stretched too thin as a result of increased pressure in the lower part of the rectum, hematochezia can occur, usually due to tension.
Diverticulosis is a condition where small pouches (i.e., diverticula) form and push out through the colon wall, which can cause bleeding. Genetics, as well as a high-fat, low-fiber diet, make a person more likely to develop diverticular pouches.
Peptic ulcer disease occurs when the protective lining of the stomach and duodenum is eroded by infection with Helicobacter pylori (H. pylori) bacteria or long-term use of non-steroidal anti-inflammatory drugs (NSAIDs). If the ulcer is severe, it can bleed rapidly and should be treated immediately because of the risk of hypovolemic shock.
Esophageal varices refer to the presence of dilated veins in the esophagus due to obstruction of flow through the portal vein, often caused by severe scarring of the liver. Blood pooling can lead to rupture of the esophageal vein, which manifests as massive blood loss and melena (i.e., black, tarry stools) or hematochezia.
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In the elderly, an arteriovenous malformation (AVM) can cause multiple, often minor, bleeding episodes. An AVM is a vascular lesion that can occur anywhere in the gastrointestinal tract, usually in the colon, and is associated with advanced age; chronic kidney disease; and certain types of heart disease, such as aortic stenosis. Less common causes of colonic bleeding in adults include cancer and ischemic colitis (ie, inflammation of the colon).
Causes of hematochezia in newborns include necrotizing enterocolitis and midgut volvulus. Necrotizing enterocolitis is tissue death due to reduced blood flow in certain parts of the large intestine, and swelling of the midgut occurs when the intestine twists during embryonic development.
Signs and symptoms of hematochezia include bright red blood in the stool, usually seen on the toilet or on toilet paper, and a feeling of pain or pressure in the rectum. In many cases, a person with hematochezia may be unaware of their hematochezia and may not report any symptoms. In other cases, depending on the cause and severity of the bleeding, people may experience abdominal pain, vomiting, diarrhea, weakness, difficulty breathing, palpitations, and even fainting (ie fainting). Prolonged hematochezia can cause excessive blood loss, resulting in anemia, palpitations, shortness of breath, and fainting. Excessive and rapid blood loss can also lead to hypovolemia and shock. In addition, bleeding associated with an underlying malignancy (ie, colon cancer) may lead to unintentional weight loss.
Hematochezia can be identified in the patient’s history if the patient seeks guidance because of passing blood in the stool or experiences symptoms such as fainting or dizziness. The doctor may ask questions to confirm the presence of bleeding, assess the amount and rate of blood loss, determine the source and potential causes, and determine the severity of the bleeding. Diagnosis involves a thorough physical examination followed by a more directed digital examination, in which a gloved, lubricated finger is inserted into the rectum to look for growths, rectal fissures, or hemorrhoids. inserted to detect unusual items. A clinician may order laboratory tests, including hemoglobin levels, to detect anemia. Upper endoscopy and colonoscopy may also be performed, procedures in which the clinician inserts a small tube with a camera through the esophagus and rectum, respectively. The procedures are usually performed under anesthesia and allow the clinician to see where the gastrointestinal bleeding is coming from. A computed tomography (CT) angiogram may be performed to look at the source of the blood loss, and if active bleeding is present, a red blood cell nuclear scan may be used to identify the source of the gastrointestinal bleeding. A nuclear red blood cell scan uses a small amount of radioactive material to label red blood cells (RBCs) so they can be seen and tracked throughout the body.
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Hematochezia is primarily treated by restoring the person’s blood volume to help prevent hypovolemia and shock, which are medical emergencies. The second step of treatment usually involves finding the source of the bleeding. Then, depending on the location and underlying cause, the clinician may use a combination of pharmacologic therapy, endoscopic cauterization (ie, a procedure that uses a heated probe to close the bleeding vessel), and surgery. In the case of hemorrhoids, a topical treatment or a suppository containing hydrocortisone can help reduce the pain. IBD can be treated with drugs that control inflammation, such as aminosalicylates (eg, balsalazide, mesalamine, olsalazine) or immunosuppressants (eg, azathioprine and mercaptopurine).
Diverticulosis is usually treated with supportive care, such as high-fiber diets, and may resolve on its own. Ischemic colitis can similarly go away on its own and can be treated with supportive care such as rest and intravenous fluids. If severe, antibiotics (eg, metronidazole, ciprofloxacin) may be used to reduce the risk of infection and necrosis.
AVM and colon cancer may require the use of more invasive approaches such as endoscopic cauterization and surgery, respectively. Necrotizing enterocolitis is usually treated with a feeding tube and surgery, depending on the severity. Finally, midgut volvulus can be reduced or twisted surgically.
Hematochezia refers to the passage of blood in the stool from the lower gastrointestinal tract. It is usually caused by inflammatory bowel disease, hemorrhoids, and diverticulosis in adults; arteriovenous malformation and colon cancer in adults; and necrotizing enterocolitis and midgut volvulus in neonates and children. A common symptom of hematochezia includes bright red blood seen in stool or on toilet paper after wiping. A person with hematochezia may also feel weak due to blood loss and have symptoms such as abdominal pain, vomiting, or diarrhea. Diagnosis is made by a trained clinician after a thorough interview and physical examination, sometimes followed by a colonoscopy, CT scan, and nuclear red blood cell scan. Treatment depends on the cause, but usually involves restoring lost blood volume, identifying the source of the bleeding, and stopping the bleeding. Medications and topical creams can be used to treat underlying causes of hematochezia, and more severe cases may require surgery.
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Diverticular disease. At the National Institute of Diabetes and Digestive and Kidney Diseases. Accessed 25 Feb 2022, https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis#:~:text=Diverticulosis%20is%20a%20condition%20bu,%20this taken from the call. 20case%20diverticular%20disease.
Ishikawa, S., Mukai, S., Hirata, Y., Kohata, A., Kai, A., Namba, Y., Okimoto, S., Fujisaki, S., Fukuda, S., Takahashi, M. Fukuda , T. and Ohdan, H. (2020). Rectal arteriovenous malformation treated with transcatheter arterial embolization. Gastroenterology Reports, 14(1): 7-14. DOI: 10.1159/000505090
Liu, J. J., & Saltzman, J. R. (2009). Endoscopic hemostasis treatment: how to do it? Canadian Journal of Gastroenterology, 23(7): 484. DOI: 10.1155/2009/857125
Walker, H. K., Hall, W. D., & Hurst, J. W. (Eds.). (1990). Clinical Methods: History, Physical, and Laboratory Examinations (3rd ed.). Butterworths. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK411/10 Common Causes of Blood in the Stool (Hematochezia) Blood in the stool can be an indicator of a more serious health condition. Learn about the most common reasons for finding blood in the stool.
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You may be surprised to find blood on the toilet or when wiping after a bowel movement. Or your doctor may find traces of blood in your stool after a routine medical exam. You may also notice a change in the color of your stool. Blood in the stool is commonly called hematochezia. This means you may have internal bleeding anywhere within your gastrointestinal (GI) tract.
The general location of the bleeding can affect the color of the stool. If the blood looks like bright red or dark red, it usually indicates bleeding in the rectum or colon (or elsewhere in the lower gastrointestinal tract). Black and tarry stools, on the other hand, usually indicate bleeding
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