Side Effect: Blood in Stool

What is Blood in Stool?

What does Blood in the Stool look like?

Blood in the stool can present as either melena or hematochezia.

• Melena refers to the passage of dark, tarry stools due to the presence of digested blood in the feces. It indicates bleeding in the upper digestive tract, such as the esophagus, stomach, or small intestine, where the blood is partially digested by gastric acid and enzymes and oxidized causing it to turn a dark color
• Hematochezia refers to the passage of bright red or maroon-colored blood from the rectum, indicating lower gastrointestinal bleeding. The blood may be mixed with the stool or appear in streaks separate from stool, and the amount of blood can range from a few drops to large amounts.

Who gets Blood in the Stool?

There are various causes of blood in the stool including hemorrhoids, anal fissures, diverticulitis, inflammatory bowel disease, colorectal cancer, and infections.

• Patients with cancer can develop melena if their tumors invade the upper digestive tract or if they undergo treatments that cause damage to the gastrointestinal lining, such as chemotherapy or radiation.
• Melena may also occur as a side effect of anticoagulant medications used to prevent blood clots, which can increase the risk of bleeding.
• Hematochezia can be a symptom of various medical conditions, including inflammatory bowel disease, diverticulitis, infections, and colorectal cancer. Patients with cancer, particularly those with colorectal cancer, can develop hematochezia due to tumor infiltration into the bowel wall or from treatment-related side effects, such as radiation to the bowel (also known as the intestines).
• Hemorrhoids may cause blood in the stool and can be the result of straining during bouts of constipation.
• Any amount or any type of blood (black and tarry, or bright red) should prompt a person to seek medical attention.

How to prevent Blood in Stool

Prevention of blood in the stool depends on the underlying cause. For example, maintaining a high-fiber diet and avoiding straining during bowel movements can prevent hemorrhoids and diverticulitis.

• To prevent melena in patients with cancer, it is important to monitor gastrointestinal health and address any underlying issues that may increase risk of bleeding. This may include avoiding nonsteroidal anti-inflammatory drugs (NSAIDs) to prevent damage to the intestinal lining, limiting alcohol consumption, and managing underlying conditions such as peptic ulcers or inflammatory bowel disease.
• Preventing hematochezia in patients with cancer involves managing the underlying cancer and its treatment-related complications, as well as identifying potential medication-related causes and limiting the use of these drugs when possible.

How to treat Blood in Stool

The treatment of blood in the stool in patients with cancer depends on the severity and stage of the cancer. Treatment options may include surgery, chemotherapy, radiation therapy, or a combination of these modalities.

• If melena or hematochezia develops in patients with cancer, prompt medical attention (sometimes an emergency department or urgent care visit) is necessary to determine the cause and provide appropriate treatment.
  
  
• Depending upon the amount of blood loss, red blood cell transfusions to replace lost blood may be needed. Additionally, procedures such as endoscopy or colonscopy may be needed to identify and treat the source of bleeding. Surgery may also be needed to remove tumors or repair damaged tissue.