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From doctors' experience, one of the most frightening symptoms for patients is bleeding. Nose bleeding, coughing blood or blood in stool bring them very often to the emergency room, even if there is no reason for panic. There are many possible causes of finding blood in stool or on the toilet paper and they can be benign as well as serious, but blood in stool is always a sign of bleeding from some part of gastrointestinal tract (GIT). Here are some of the most common causes of bloody stool.

Bleeding from Upper Portions of GIT

Upper GIT consists of esophagus, stomach, and duodenum - first part of small intestine. Bleeding from this area often produces black or tarry stool called melena because of hemoglobin from blood being digested by enzymes. The most common cause of melena is bleeding from peptic ulcers in stomach or duodenum. Patients who take anticoagulant therapy have greater risk of bleeding from GIT, so if melena appears in these patients, blood analyses should be ran in order to adjust anticoagulant therapy. Esophageal varices - dilated blood vessels in esophageal wall, often appear in patients with liver damage, and they can cause massive hemorrhage with melena but also with high amount of red blood in stool. Malign tumors of stomach and chronic gastritis are other common causes of melena. There are usually other symptoms that accompany upper GIT bleeding and ease the diagnosis, such as nausea, blood vomiting, low blood pressure, and anemia.

Black feces or melena is considered a medical emergency and it should be subjected to diagnostic procedures as soon as possible.

There are usually other symptoms that accompany upper GIT bleeding, such as nausea, blood vomiting, low blood pressure, and anemia.

Bleeding from Lower Portions of GIT

While upper GIT bleeding causes melena, bleeding from intestines, especially from colon and rectum, usually produces red blood in stool which is called hematochezia. Bleeding from rectum is called rectorrhagia. The most common cause of hematochezia - fresh blood in stool or on the toilet paper is actually benign and it is the bleeding from hemorrhoidal blood vessels located in anal canal. This is associated with pain while defecating and sitting and irritation in anal region which can be very uncomfortable. Good hygiene, local cremes, and losing weight are usually enough to subside the symptoms, but in some more severe cases surgery is needed in order to stop the bleeding. Anal fissures are small tears of skin in the anal canal and are presented with similar symptoms.

More severe causes of hematochezia include diverticulosis, colorectal cancer, and inflammatory bowel diseases such as ulcerative colitis and Crohn's disease. Some intestinal infections caused by Salmonella and E.Coli can also produce bloody stool which is associated with diarrhea, high temperature, and other signs of infection.

Dragon fruit, pitaya, beetroot, and many other foods can falsely cause feces to be blood-like.

To summarize, blood in stool doesn't need to look red. Instead, it can be black or take different nuances of red color. You should refer to your doctor any case of bloody or tarry stool with all the other symptoms in order to achieve proper diagnosis.

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