Bloody or tarry stools

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Lower digestive anatomy

Stools - bloody; Hematochezia; Melena; Stools - black or tarry

Call your doctor immediately if you notice blood or changes in the color of your stool. Even if you think that hemorrhoids are causing the blood in your stool, your doctor should examine you to make sure that there is no other, more serious cause present.

In children, a small amount of blood in the stool is usually not serious. The most common causes are constipation and milk allergies. However, it is still worth reporting to your doctor, even if no evaluation is needed.

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Your doctor will take a medical history and perform a physical examination, focusing on your abdomen and rectum.

The following questions may be included in the history to better understand the possible causes of your bloody or dark stools:

• Are you taking blood thinners (aspirin, warfarin, clopidogrel, Aggrenox) or NSAIDs (ibuprofen, naproxen)?
• Have you had any trauma to the abdomen or rectum, or have you swallowed a foreign object accidentally?
• Have you eaten black licorice, lead, Pepto-Bismol, or blueberries?
• Have you had more than one episode of blood in your stool? Is every stool this way?
• Have you lost any weight recently?
• Is there blood on the toilet paper only?
• What color is the stool?
• When did it develop?
• What other symptoms are present -- abdominal pain, vomiting blood, bloating, excessive gas, diarrhea, or fever?

Treatment depends on the cause and severity of the bleeding. For serious bleeding, you may be admitted to a hospital for monitoring and evaluation. If there is massive bleeding, you will be monitored in an intensive care unit. Emergency treatment may include a blood transfusion.

The following diagnostic tests may be performed:

• Angiography
• Barium studies
• Bleeding scan (nuclear medicine)
• Blood studies, including a complete blood count ( CBC) and differential, serum chemistries, clotting studies
• Colonoscopy
• Esophagogastroduodenoscopy or EGD
• Stool culture
• Tests for the presence of Helicobacter pylori infection
• X-rays of the abdomen

TREATMENT

If you have passed a lot of blood, you may need emergency treatment, which can include:

• Blood transfusions
• Fluids through a vein
• Interventional radiography embolization (a procedure to block the blood vessels that may be bleeding)
• Medications to decrease stomach acid
• Possible surgery if bleeding does not stop

Review Date: 01/07/2011
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).