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Ibs and bloody stools. Causes of IBS and Rectal Bleeding: A Comprehensive Guide

by alexxlab

Can IBS cause bloody stools? What are the symptoms of IBS and rectal bleeding? When should you worry about rectal bleeding? Get the answers to these questions and more in this informative article.

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Can IBS Cause Bloody Stools?

IBS can be a concerning and life-disrupting digestive issue. Many who have been diagnosed with IBS have a wide range of bowel-related symptoms such as bloating, cramping, abdominal pain, constipation, and diarrhoea. In many cases, the diagnosis of IBS is reached once other digestive problems have been excluded, such as coeliac disease, lactose intolerance, inflammatory bowel diseases, bowel cancer, and ovarian cancer. However, over time IBS symptoms can change, and if blood is visible in the stool, further investigations may be required to ensure no changes have taken place in the bowel.

IBS and Blood in Stool: Should You Be Worried?

Due to the nature of IBS, symptoms can change over time, with factors such as stress, medication, and diet playing a role. Rectal bleeding can be common in those with IBS-C, the type of IBS with constipation. It’s often caused by small tears in the anus due to fecal impaction, which is the increased load of feces in the rectum that places pressure on the lining, leading to injury. This would commonly be seen as bright red blood on the toilet paper. However, if there is a sudden change in IBS symptoms and persistent blood in the stool lasting for several days, this would require further investigation from a doctor or gastroenterologist to rule out anything else, particularly colon cancer, which has better treatment outcomes if diagnosed at an early stage.

When Should You Worry About Rectal Bleeding?

If symptoms of IBS change suddenly, particularly the frequency of bowel movements and increased pain, and are accompanied by an increase in the amount of blood, further examination would generally be advised. The shade and volume of the blood can also indicate the degree of concern. Typically, if the individual is constipated and the blood that is present is bright red and in small amounts, this is likely due to a small tear in the anus or haemorrhoids. However, if the blood appears darker, like “coffee grounds,” this may indicate a bleed higher up within the digestive tract and could require further investigation to rule out conditions such as colon cancer.

IBS and Rectal Bleeding: Understanding the Connection

While in severe cases of IBS, there may be blood, it is not a commonly experienced symptom. IBS may be caused by infections in the digestive tract or as the consequence of viral or bacterial gastroenteritis. In the acute period of these infections, bloody diarrhoea is not uncommon, but this would generally resolve once the infection has been cleared. In some individuals, general symptoms of IBS may remain and be termed post-infectious IBS (PI-IBS), but even following the infection, blood would not be a common occurrence.

IBS, Blood, and Mucus: What’s the Link?

The digestive tract has a thin layer of protective mucus covering its surface, which may shed on a daily basis and should not be visible in the stool. However, when the lining of the digestive tract becomes inflamed or irritated, mucus production is increased to protect it. This higher amount of mucus can often be visible in the stool of those with IBS and would be pale or white in colour. However, if there is a sudden increase in the amount of mucus produced alongside an increase in pain and the presence of blood, further investigation would often be suggested to investigate other causes such as colon cancer.

Bloating and Blood in Stool: Investigating the Connection

Bloating is one of the most common digestive symptoms and is present across a wide range of gut conditions, including IBS, SIBO, inflammatory bowel disease, coeliac disease, ovarian cancer, and colon cancer. Due to its association with these other conditions, if bloating persists or worsens, further investigation can often be important to rule out any other underlying conditions. This would be particularly important if the bloating is accompanied by the presence of blood in the stool.

IBS and Rectal Pressure: Exploring the Relationship

In addition to the presence of blood in the stool, individuals with IBS may also experience rectal pressure, which can be a concerning symptom. This rectal pressure is often associated with the constipation-predominant type of IBS (IBS-C) and can be caused by the increased load of feces in the rectum, leading to a feeling of fullness or discomfort. If this rectal pressure is accompanied by the presence of blood, it is important to seek medical attention to ensure no other underlying conditions are present.

IBS and Rectal Bleeding Causes

Can IBS cause bloody stools?

IBS and blood in stool, should I be worried?

When should you worry about rectal bleeding?

IBS and Rectal Bleeding

IBS blood in stool and mucus

Bloating and blood in stool

IBS blood when wiping

IBS rectal pressure

Can IBS cause bloody stools?

IBS can be a concerning and life disrupting digestive issue.

Many who have been diagnosed with IBS have a wide range of bowel related symptoms such as:

  • Bloating
  • Cramping
  • Abdominal pain
  • Constipation
  • Diarrhoea

In many cases, the diagnosis of IBS is reached once other digestive problems have been excluded.  

This would often include examinations and tests for:

  • Coeliac disease
  • Lactose intolerance
  • Inflammatory bowel diseases
  • Bowel cancer/colon cancer
  • Ovarian cancer

However, over time IBS symptoms can change and if blood is visible in the stool further investigations may be required to ensure not changes have taken place in the bowel. (1)

IBS and blood in stool, should I be worried?

Due to the nature of IBS, symptoms can change over time, with factors such as stress, medication and diet playing a role.

Rectal bleeding can be common in those with IBS-C, the type of IBS with constipation.   It’s often caused by small tears in the anus due to fecal impaction.  This is the increased load of feces (poo) in the rectum that places pressure on the lining that can then lead to injury.

This would commonly be seen in the stool a bright red blood due to the fact that it is reasonably fresh.  Typically, this would be noticed in small amounts on toilet paper.
However, if there is a sudden change in IBS symptoms and persistent blood in the stool lasting for several days, this would require further investigation from a doctor or gastroenterologist to rule anything else out.  In particular colon cancer which has better treatment outcomes if diagnosed at an early stage. (2)

When should you worry about rectal bleeding?

If symptoms of IBS change suddenly, particularly the frequency of bowel movements and increased pain and is accompanied by an increase amount of blood, further examination would generally be advised.

The shade and volume of the blood can also indicate the degree of concern.

Typically, if the individual is constipated and the blood that is present is bright red and in small amounts this is likely due to a small tear in the anus of haemorrhoids.

The appearance of blood in the stool can also take another form which may be harder to spot.

It is generally accepted that the further the blood travels through the colon, the darker it appears.  This means that can blood can appear in the stool in what can be described as “coffee grounds” and would take the appearance of dark spots in the stool which can indicate a bleed higher up within the digestive tract.

This may also lead to a stool that is generally darker in colour.

While this may indicate the need for further examination to rule out colon cancer.  Other causes of this are a tear, inflammation or certain medications.
NSAIDs (non-steroidal anti-inflammatory) medication such as Ibuprofen, in particular may contribute to irritation that can result in a bleed. (3)

IBS and Rectal Bleeding

While in severe cases of IBS, there may be blood, it is not a commonly experienced symptom.

IBS may be causes by infections in the digestive tract or as the consequence of viral of bacterial gastroenteritis.  In the acute period of these infections, bloody diarrhoea is not uncommon.  This would generally revolve once the infection has been cleared.
In some individuals, general symptoms of IBS may remain and be termed post infectious IBS (PI-IBS) however, even following the infection, blood would not be common. (4)

IBS blood in stool and mucus

The digestive tract has a thin layer of protective mucus covering its surface.  This may shed on a daily basis should not be visible in the stool.

However, when the lining of the digestive tract becomes inflamed or irritated, mucus production is increased to protect it.

This higher amount of mucus can often be visible in the stool of those with IBS and would be pale or white in colour.   
However, if there is a sudden increase in the amount of mucus produced alongside an increase in pain and the presence of blood, further investigation would often be suggested to investigate other causes such as colon cancer. (5)

Bloating and blood in stool

Bloating is one of the most common digestive symptoms and is present across a wide ride of gut conditions. 

These include:

  • IBS
  • SIBO
  • Inflammatory bowel disease
  • Coeliac disease
  • Ovarian cancer 
  • Colon cancer 

Due to its association with these other conditions, if bloating persist or worsens, further investigation can often be important to rule out any other conditions.
This would be particularly true if blood is present in the stool. (6)

IBS blood when wiping

Bright red blood that appears on toilet paper can often be a sign of a tear in the lining of the rectum.  Often the results of constipation or haemorrhoids.  

Dietary approaches to improving bowel movements can often ensure adequate fibre intake as well as maintaining optimal hydration.  
These 2 key factors to support bowel motility be help reduce fecal impaction reduce the strain placed on the bowel wall. (7)

IBS rectal pressure

This increase in rectal pressure in the bowel will not only be putting additional strain on the bowel wall but it may lead to changes in the balance on the beneficial bacteria in the colon.

This may be associated with an increase in methane producing organisms, who can then contribute to a further reduction in bowel motility and disruption within in the colon. (8)

References

  1. https://www.ncbi.nlm.nih.gov/books/NBK534810/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1266237/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1239576/
  4. https://www.fairview.org/patient-education/89211
  5. https://www. ncbi.nlm.nih.gov/pmc/articles/PMC3758667/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3264926/
  7. https://www.ncbi.nlm.nih.gov/books/NBK563143/
  8. https://www.ncbi.nlm.nih.gov/books/NBK563143/

Gastroenterology Specialties, P.C. & Lincoln Endoscopy Understanding Minor Rectal Bleeding

What are the possible causes of minor rectal bleeding?

  1. Hemorrhoids
  2. Anal fissures
  3. Proctitis (inflammation of the rectum)
  4. Polyps
  5. Colon or anal cancer
  6. Rectal ulcers

Understanding Minor Rectal Bleeding

Minor rectal bleeding refers to the passage of a few drops of bright red (fresh) blood from the rectum, which may appear on the stool, on the toilet paper or in the toilet bowl. This brochure addresses minor rectal bleeding that occurs from time to time. Continuous passage of significantly greater amounts of blood from the rectum or stools that appear black, tarry or maroon in color can be caused by other diseases that will not be discussed here. Call your doctor immediately if these more serious conditions occur. Because there are several possible causes for minor rectal bleeding, a complete evaluation and early diagnosis by your doctor is very important. Rectal bleeding, whether it is minor or not, can be a symptom of colon cancer, a type of cancer that can be cured if detected early.

What are hemorrhoids?

Hemorrhoids (also called piles) are swollen blood vessels in the anus and rectum that become engorged from increased pressure, similar to what occurs in varicose veins in the legs. Hemorrhoids can either be internal (inside the anus) or external (under the skin around the anus). Hemorrhoids are the most common cause of minor rectal bleeding, and are typically not associated with pain. Bleeding from hemorrhoids is usually associated with bowel movements, or it may also stain the toilet paper with blood. The exact cause of bleeding from hemorrhoids is not known, but it often seems to be related to constipation, diarrhea, sitting or standing for long periods, obesity heavy lifting and pregnancy. Symptoms from hemorrhoids may run in some families. Hemorrhoids are also more common as we get older. Fortunately, this very common condition does not lead to cancer.

How are hemorrhoids treated?

Medical treatment of hemorrhoids includes treatment of any underlying constipation, taking warm baths and applying an over-the-counter cream or suppository that may contain hydrocortisone. If medical treatment fails there are a number of ways to reduce the size or eliminate internal hemorrhoids. Each method varies in its success rate, risks and recovery time. Your doctor will discuss these options with you. Rubber band ligation is the most common outpatient procedure for hemorrhoids in the United States. It involves placing rubber bands around the base of an internal hemorrhoid to cut off its blood supply. This causes the hemorrhoid to shrink, and in a few days both the hemorrhoid and the rubber band fall off during a bowel movement. Possible complications include pain, bleeding and infection. After band ligation, your doctor may prescribe medications, including pain medication and stool softeners, before sending you home. Contact your doctor immediately if you notice severe pain, fever or significant rectal bleeding. Laser or infrared coagulation and sclerotherapy (injection of medicine directly into the hemorrhoids) are also officebased treatment procedures, although they are less common. Surgery to remove hemorrhoids may be required in severe cases or if symptoms persist despite rubber band ligation, coagulation or sclerotherapy.

What are anal fissures?

Tears that occur in the lining of the anus are called anal fissures. This condition is most commonly caused by constipation and passing hard stools, although it may also result from diarrhea or inflammation in the anus. In addition to causing bleeding from the rectum, anal fissures may also cause a lot of pain during and immediately after bowel movements. Most fissures are treated successfully with simple remedies such as fiber supplements, stool softeners (if constipation is the cause) and warm baths. Your doctor may also prescribe a cream to soothe the inflamed area. Other options for fissures that do not heal with medication include treatment to relax the muscles around the anus (sphincters) or surgery.

What is proctitis?

Proctitis refers to inflammation of the lining of the rectum. It can be caused by previous radiation therapy for various cancers, medications, infections or a limited form of inflammatory bowel disease (IBD). It may cause the sensation that you didn’t completely empty your bowels after a bowel movement, and may give you the frequent urge to have a bowel movement. Other symptoms include passing mucus through the rectum, rectal bleeding and pain in the area of the anus and rectum. Treatment for proctitis depends on the cause. Your doctor will discuss the appropriate course of action with you.

What are colon polyps?

Polyps are benign growths within the lining of the large bowel. Although most do not cause symptoms, some polyps located in the lower colon and rectum may cause minor bleeding. It is important to remove these polyps because some of them may later turn into colon cancer if left alone.

What is colon cancer?

Colon cancer refers to cancer that starts in the large intestine. It can affect both men and women of all ethnic backgrounds and is the second most common cause of cancer deaths in the United States. Fortunately, it is generally a slow-growing cancer that can be cured if detected early. Most colon cancers develop from colon polyps over a period of several years. Therefore, removing colon polyps reduces the risk for colon cancer. Anal cancer is more rare but curable when diagnosed early.

What are rectal ulcers?

Solitary rectal ulcer syndrome is an uncommon condition that can affect both men and women, and is associated with long-standing constipation and prolonged straining during bowel movement. In this condition, an area in the rectum (typically in the form of a single ulcer) leads to passing blood and mucus from the rectum. Treatment involves fiber supplements to relieve constipation. For those with significant symptoms, surgery may be required.

How is minor rectal bleeding evaluated?

Your doctor may examine the anus visually to look for anal fissures, cancer, or external hemorrhoids, or the doctor may perform an internal examination with a gloved, lubricated finger to feel for abnormalities in the lower rectum and anal canal.

If indicated, your doctor may also perform a procedure called colonoscopy. In this procedure, a flexible, lighted tube about the thickness of your finger is inserted into the anus to examine the entire colon. Sedative medications are typically given for colonoscopy to make you sleepy and decrease any discomfort.

As an alternative, to evaluate your bleeding your doctor may recommend a flexible sigmoidoscopy, which uses a shorter tube with a camera to examine the lower colon. To examine only the lower rectum and anal canal, an anoscope may be used. This very short (3 to 4 inch) tube is especially useful when your doctor suspects hemorrhoids, anal cancer, or anal fissures.

What can I do to prevent further rectal bleeding?

This depends on the cause of the rectal bleeding. You should talk to your doctor about specific management options.

Important Reminder:
This information is intended only to provide general guidance. It does not provide definitive medical advice. It is very important that you consult your doctor about your specific condition.

Ischemic heart disease (IHD) – causes, forms, symptoms, signs, diagnosis, treatment, prevention

Causes

Classification

Symptoms

Complications

Diagnosis

Treatment

Prognosis and prevention

Coronary heart disease (CHD) is a disease in which a significant decrease or cessation of blood circulation and nutrition of the heart muscle, called the myocardium, is diagnosed. It happens acute and chronic.

The main manifestation of IHD is pain in the region of the heart, which is called an angina attack. If the patient does not pay attention to this and continues to ignore the symptoms, myocardial infarction occurs with its complete necrosis.

According to WHO, this is one of the most common diseases in the world. It is because of coronary artery disease that people aged 40 years and older most often die. The likelihood of the onset of the disease increases with age, and if nothing is done for prevention, then at 55–60 years the risk of dying from a myocardial infarction will become very high.

Causes and triggers

Ischemic heart disease appears for various reasons. First of all, it is atherosclerosis of large vessels supplying the myocardium with blood. There are also some factors that greatly increase the likelihood of developing the disease. They can roughly be divided into two broad categories.

The first completely depend on the person, on the kind of life he leads. They are:

  • smoking;
  • elevated blood cholesterol levels;
  • hypertension or diabetes;
  • obesity;
  • lack of adequate physical activity every day;
  • maintaining a sedentary or lying lifestyle;
  • food with a lot of animal fats;
  • constant consumption of high-calorie foods;
  • stress.

All of these risk factors for coronary heart disease can be eliminated or corrected.

However, there are others that cannot be changed:

  • age;
  • belonging to the male sex;
  • IHD or heart attack in relatives – affects the genetic predisposition.

In addition, the risk of coronary heart disease in women increases significantly when menopause and menopause are reached. The fact is that the sex hormones produced by the ovaries reliably protect the heart and blood vessels, so this pathology is much less common in women.

It must be remembered that if several of these factors are combined, especially from a variable group, then the risk of a heart attack at 45–50 years of age increases several times.

Classification

Ischemic heart disease is a fairly well-studied pathology for which a classification has been developed. It will depend on the form in which the disease manifests itself.

In total, it is customary to include 9 diseases with completely different manifestations here:

  • myocardial infarction of any kind;
  • primary cardiac arrest, which occurs instantly due to ventricular fibrillation – this is called sudden coronary death;
  • thrombosis in the coronary arteries, but without infarction;
  • angina;
  • consequences of a heart attack that was transferred in the past;
  • ischemic cardiomyopathy with circulatory disorders;
  • myocardial ischemia, which does not manifest itself in any way and is called painless;
  • failure of the heart rhythm, conduction;
  • atherosclerosis of the coronary arteries, leading to circulatory disorders.

Although coronary artery disease manifests itself in several of these forms, it is usually associated with angina pectoris, since it occurs more often than others. It is stable when, under the same loads, an attack of pain of the same strength occurs, vasospastic, which occurs against the background of rest or a small load, as well as microvascular, which rarely develops and occurs with vasospasm.

It should also be noted the functional class of angina pectoris, where the first allows you to perform almost any daily activities, and the pain appears only after intense and prolonged exercise, and the fourth sometimes does not even allow you to stand up or move from bed to chair.

Symptoms

Symptoms of coronary heart disease depend on the form in which it manifests itself.

In the event of sudden cardiac death, there are only 3 minutes to save a person’s life. Further, critical changes begin in the brain due to circulatory arrest, and biological death occurs.

Angina pectoris is the most common symptom of CAD. It presents with numerous symptoms. These are paroxysmal pains and a feeling of discomfort at the location of the heart, nausea, vomiting, a strong fear of death. Pain is given to the right side of the body. Sometimes the localization of pain is different – it can appear in the stomach or on the left side of the body. There are times when there are no symptoms at all.

Signs of coronary heart disease include a heart attack. Then the patient will complain of pain that does not go away either at rest or after taking Nitroglycerin. As a rule, it is very sharp, located behind the sternum. There is anxiety, overexcitation, fear for one’s life.

The danger of the disease is that not all patients with coronary artery disease have at least some symptoms. Often a person does not even know that he has a violation of myocardial circulation, and this explains the sudden onset of a heart attack.

Ischemic heart disease in men is also different in that it is often in a neglected state. Not all of them go to the doctor in a timely manner or undergo annual medical examinations and visit a cardiologist. For some, pain in the heart becomes so familiar and mundane that they simply do not pay attention to it.

Complications

The disease is dangerous for its complications and a high risk of sudden death. Often, patients with this diagnosis are diagnosed with arrhythmias and problems with cardiac conduction. If the disease is not treated and becomes chronic, diffuse cardiosclerosis, changes in the myocardium, ischemic cardiomyopathy, and chronic heart failure may develop.

Diagnostics

IHD is diagnosed and treated by a cardiologist. Timely detection of the disease helps to prevent the likelihood of sudden death, to prevent the development of many complications. But the diagnosis of “ischemic heart disease” is required to be confirmed by tests and other studies.

If a person is suspected to have coronary artery disease, he is prescribed general blood tests, urine tests, a glucose test, determination of the level of glycated hemoglobin, blood for creatinine and other biochemical parameters, lipid fractions.

Diagnosis of coronary heart disease is necessarily carried out with an ECG, myocardial scintigraphy, selective coronary angiography, ultrasound is also done.

Treatment

The treatment program for coronary heart disease includes taking medications, changing the diet, and correcting life and habits. A person should receive dosed loads, and also often walk in the fresh air.

Nitroglycerin is used to eliminate spasms of blood vessels and reduce pain, Bisoprolol and Metoprolol improve blood circulation, calcium antagonists prevent damage to heart cells. Also, the treatment program should include drugs that prevent the development of blood clots. Most often, these drugs are based on acetylsalicylic acid.

Statins are used to lower blood cholesterol, and normalization of nutrition and diet with the cessation of eating foods containing a lot of fat is also indicated.

Clinical recommendations for ischemic heart disease also include surgical treatment, which helps to restore blood circulation. This is usually stenting or coronary artery bypass grafting.

Prognosis and prevention

With IHD, it is impossible to give an unambiguous prognosis. It is directly related to the form of pathology, the severity of symptoms and the neglect of the disease.

Prevention of coronary heart disease should start at an early age. Physical activity is necessary, you should not smoke and drink alcohol, you need to eliminate stressful situations, eat right. You should monitor blood pressure, prevent the development of obesity, take walks every day, visit a cardiologist once a year and undergo prescribed tests.

The author of the article:

Andrey Alexandrovich Berezin

cardiologist

work experience 13 years

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