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Bloody diarrhea - causes and therapy
Blood in the stool can be bright red as well as dark red, solid or liquid, sometimes there are only drops on the feces, then it stains it again. If the blood is light red, so fresh, it probably comes from the intestine, while dark and clotted blood comes from the upper sections of the digestive tract.
contents
- causes
- diagnosis
- treatment
- hemorrhoids
- Are problems with the hemorrhoids embarrassing?
- Follow-up of enlarged hemorrhoids
- Rubber band and operation
- Cause: Crohn's disease
- Cause: Ulcerative colitis
- constipation
- Occasional constipation
- Chronic constipation
- When is a colonoscopy recommended??
- When is a colonoscopy inevitable?
causes
Blood in the stool is usually harmless: the cause is then hemorrhoids or cracks in the skin of the rectum. More problematic are intestinal polyps, which may develop into colon cancer or infections of the intestine, a diaphragmatic rupture or varicose veins in the esophagus.
Bloody diarrhea: The causes can be harmless but also serious. Image: vchalup - fotolia Gastrointestinal infections, anal fissures and blood disorders are further triggers for blood in the stool.
If your diarrhea has traces of blood and you do not know the cause, you should always see a doctor to clarify the origin, especially if the symptoms are more common.
diagnosis
The doctor first finds out where the blood originates from. Then he asks how often the patient has to go to the toilet, whether the diarrhea occurred earlier, what they ate, whether they hurt themselves, etc. Also important is the question of whether people have lost weight in recent months, without to change their diet, whether they had to vomit, dizziness like nausea. Are there basic diseases?
The doctor scans the abdomen like rectum and uses a stethoscope, he examines the blood levels, and in case of suspicion is on a gastric or colonoscopy.
treatment
The treatment depends on the disease. If the patient suffers from a broken stomach ulcer, burst varicose veins, or sudden internal bleeding, the doctor stops the bleeding first.
Hemorrhoids are less dramatic. The patient uses ointments and suppositories. Only with extreme hemorrhoids does the physician obliterate them. Polyps remove specialists with endoscopy Colorectal cancer can be treated with chemo- and radiation therapies as well as with surgery.
hemorrhoids
Hemorrhoids are tissue cushions in the outermost intestinal tract. Popularly, when someone suffers from bloody stools, we say "he has hemorrhoids". But this is wrong: The hemorrhoidal braid is no harm, but just as important as subcutaneous or almond. It protects the intestine outwards.
We do not suffer from "almonds" but from "tonsillitis". So when we "suffer from hemorrhoids", we suffer from these hemorrhoids enlarging.
When we release feces, the sphincter relaxes, and the blood drains away from the hemorrhoidal tissue. After that it flows back into the hemorrhoids, they swell up and close the anus.
But the blood vessels in the hemorrhoid pad can "leach out". For example, if we press hard to get the feces out, the upholstery will increase.
Often we do not notice it at all, and the hemorrhoids regenerate by themselves. However, if we notice it, it itches us in the inner area of the anus, and we feel pressure there. In addition, we have blood in the faeces, but also within the anus.
Problems with the hemorrhoids may be associated with other causes of blood in the chair. For example, with severe constipation both the hemorrhoids may enlarge, as can tears in the skin of the end-arm, and anal fissures.
Not only constipation, but also the opposite, namely severe diarrhea, can overload the hemorrhoids.
There is a widespread belief that people with severe obesity suffer from hemorrhoids complaints. This is not just a prejudice: heavy obesity creates a permanent pressure on the abdomen - and this in turn pushes the hemorrhoids.
However, it is hardly known that chronic coughing also presses on the hemorrhoids and can also lead to blood in the stool.
Less common is a genetic weakness of the connective tissue. Because the hemorrhoids are also part of this connective tissue, they fail to effectively occlude the anus outlet and can not fully swell up and down as their job would.
Are problems with the hemorrhoids embarrassing?
Enlarged hemorrhoids are among the "intimate complaints" that many people are reluctant to talk about - they often conceal the problem even from their doctors. This is a mistake.
First, these symptoms are not indicative of poor personal hygiene - it is not an infection with bacteria or viruses, especially those who do not wash their buttocks properly.
Second, hemorrhoids can be effectively treated, eliminating itching, pressure, and bleeding.
Third, and most importantly, alleged hemorrhoid complaints are sometimes serious illnesses, in the worst case a sign of colorectal cancer - and it can be fatal.
Follow-up of enlarged hemorrhoids
But there is another reason to consult a doctor if you have problems with the hemorrhoids. This sometimes results in follow-up problems that can be extremely unpleasant.
If the hemorrhoids slip out of the anus, they sometimes become trapped. Blood clots form, a thrombosis develops, and bleeding, a strong swelling and pain.
Such slipped-out hemorrhoids are easily confused with thrombosis at the anus margin. These perianal venous thromboses develop, however, in the veins on the anus margin. They also lead to bleeding, the blood is dark. Pregnant and childbearing women are particularly affected. Most of these thromboses heal completely again.
Those who suffer for a long time from severely bleeding hemorrhoids sometimes develop anemia.
Rubber band and operation
In case of heavy bleeding of the hemorrhoids a medical procedure is recommended. In this method, the physician rubs a rubber ring over the enlarged tissue. No blood flows in anymore, and it dies.
If the bleeding is very severe and persists, surgery is required. The doctors cut out the enlarged tissue. A local anesthesia is usually sufficient, but a general anesthetic is sometimes appropriate.
In the stapler operation, the doctor uses a stapler. This removes a ring of enlarged (and superfluous) tissue on the outer; rectum and joins the wound edges with staples. This surgery takes less time than the classic methods, it causes less pain and heals earlier.
Cause: Crohn's disease
Crohn's disease is manifested by:
1) Regular diarrhea. These are slimy, but usually without blood. Ulcerative colitis, however, is almost always accompanied by bloody stools.
2) Abdominal pain occurring in relapses, usually in the right lower abdomen. There is a risk here of confusing the disease with an inflamed cecum. Ulcerative colitis also causes abdominal pain, but these occur convulsively and immediately before bowel movements.
A serious intestinal disease of varying severity is Chron's disease. Image: Bilderzwerg-fotolia 3) weight loss and mild fever. This is not a must.
As with all serious illnesses, panic is just as bad a guide as carelessness. Those who suffer from severe diarrhea lasting more than three days, with mild fever and severe abdominal pain, should include alternative explanations.
The following questions help:
1) Have I overstimulated my intestine in recent days?
For example, did I drink a lot of coffee, eat large amounts of sugar or sugar substitutes, for example in the form of energy drinks, gummy bears, chocolate? Did I drink a lot of alcohol and / or smoked a lot of cigarettes? I have consumed a lot of animal fats - belly meat when grilling, roast goose or knuckle of pork?
2) Have I not fed enough fiber to my intestines, so no fruits and vegetables, no legumes like beans or chickpeas eaten, or no linseeds, pumpkin seeds, etc.?
3) Did the diarrhea begin after a meal? There may be an intolerance or food poisoning?
4) Am I just coming back from a trip? Is it possibly a travel diarrhea? This lasts for two to five days, coli bacteria or viruses are the cause.
At the latest, if there is blood in the diarrhea, violent abdominal pain to come and those affected fever, they should go to the doctor on the same day.
Crohn's disease affects all layers of the intestinal wall - but not all sections of the intestine are equally inflamed. The exact cause is still unknown, but those affected show a lack of endogenous antibiotics; Therefore, many researchers suspect a defective immune response on a genetic basis, which may be activated by an infection.
The antibiotics are missing, and therefore the intestinal mucosa can not defend harmful bacteria sufficiently. These bacteria then trigger the inflammation.
Crohn's disease primarily attacks the last part of the colon, but also affects every other part of the intestine, from the mouth to the anus. Everywhere there are inflammations - when they heal, they leave scars that can narrow the intestine.
In the severe course of the disease, nutrients are only insufficiently processed by the intestine. Then weight loss and blood loss is the result. The risk of developing colon cancer is increasing.
Cause: Ulcerative colitis
Ulcerative colitis affects the upper layers of the mucosa on the intestinal wall. There are easily bleeding ulcers. The disease usually starts in the rectum, spreads in the colon and migrates towards the cecum.
Inflammatory bowel disease ulcerative colitis - Image: bilderzwerg - fotolia In every fourth affected inflammation affects the entire colon. Most sufferers suffer from episodes of the illness, between which there are longer phases without complaints.
However, every tenth person knows no periods without complaints. In every twentieth, the inflammation takes on an extreme form: very heavy watery diarrhea, high fever and, associated with that, a high loss of water lead to circulatory shock - ulcerative colitis can even lead to death in these people.
In the acute phases sufferers suffer from diarrhea, the feces mixes with blood and mucus and torments the patients up to 30 times a day. Each time they plague themselves with abdominal cramps, which are extremely painful. Sometimes fever is added.
Rarely, the symptoms also show up outside the intestine, as inflammation in joints, the eyes and on the skin.
If only the rectum affected, as slimy as bloody diarrhea is considered the safest feature.
Dangerous complications of this disease are possible paralysis of the intestine. If the inflammations severely damage the intestinal wall, the muscles there relax, the intestine can not transport the supplied food and expands.
High fever occurs and inflammation of the peritoneum threatens. If the doctors do not operate right now, it's time for a bowel break - and it can cost a lifetime.
In addition, the risk of colon cancer is greatly increased: A chronic ulcerative colitis often degenerates after ten years.
constipation
Much less dangerous than chronic intestinal inflammation is chronic constipation - constipation. This affects every fifth person in Germany.
The bowel movement hurts, and seizures cause abdominal cramps. If they were in the toilet, they still feel that their bowels are not empty. The hard feces often cause hemorrhoids and cracks at the end of the bowels. These cracks are not only unpleasant, but they can also lead to blood in the stool.
Often constipation is accompanied by severe flatulence. Not only are they unpleasant, they can also become a social problem. Although they can sometimes be suppressed, nevertheless embarrassing situations are the rule: Sometimes the persons concerned leave air, if they are currently in the S-Bahn, in the elevator or at a conference.
At the same time it disturbs the everyday life in a high degree, constantly leaving the room to look for an undisturbed place.
Occasional constipation
Occasional constipation is not a concern. Every person is affected by it sometime. The most common cause is unfamiliar nutrition. If, for example, the intestine clogs on a journey into southern climes, a light laxative helps; some tropical travelers swear by strong coffee. Such blockages usually disappear when our intestines have adjusted to the new diet or when we take familiar habits again.
Such (temporary) constipation can also have psychological causes - as the legacy of our evolution. Defecation in a perceived as threatening situation makes living things in nature vulnerable. Anyone who sits down in hostile terrain to do his job, defenseless for this time and is a found food for predators and an easy victim for human opponents.
For example, some people have problems with bowel movements in unfamiliar surroundings, school leavers who are doing their social year as well as students who move into the first flat. For example, in a young man who moved into a student house in the first semester, the bowel movement failed for almost two weeks. When he visited his parents, everything was back to normal.
Chronic constipation
In case of chronic constipation, the doctor is asked to clarify if a serious illness is present.
Most of the reason for chronic constipation but "only" in the wrong diet - associated with lack of exercise. If the intestinal muscles work too slowly, the food stays longer in the intestine, but the intestinal porridge lacks the liquid and constipation occurs.
In particular, this inertia causes greasy and sweet foods. Lack of physical training also has an effect, because trained abdominal muscles support digestion.
Chronic constipation can promote bloody diarrhea. Image: Adiano - fotolia Digestion in particular promote dried fruit, legumes and flaxseed. Its action supports fluid, especially water and herbal teas. It causes the fibers to swell and thus increases the volume of the stool, which then leaves the intestine more easily. Against chronic constipation helps to change the diet in the long term.
When is a colonoscopy recommended??
A colonoscopy is important for the above-mentioned reasons, when there is no known cause of blood in the stool, the stool turns blackish, without the stomach hurts, if a primary tumor is present, if there is a suspicion of chronic or non-chronic intestinal diseases.
But even if pain occurs in the middle and lower abdomen, if someone is suffering from severe obesity and moves little when iron deficiency is present, and in case of severe flatulence over a long time, a colonoscopy is recommended.
When is a colonoscopy inevitable?
Absolutely for colonoscopy should sufferers whose chair is deformed, as "band noodle", "coffee bean" or "pencils", severe diarrhea following constipation, already had a colon cancer, indurations in the abdomen can be felt, the person suffering from a chronic bowel disease. (Dr. Utz Anhalt)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)
Additional Information:
- www.leitlinien.net - Crohn's disease: guideline for the diagnosis and treatment of Crohn's disease.
- www.dccv.de - Website of the German Crohn's Disease and Colitis Ulcerosa Association e. V.
- The Cancer Registry Data Center at the Robert Koch Institute informs about the frequency and spread of cancer diseases: www.krebsdaten.de
- The Cancer Information Service answers any questions about colon cancer by calling 0800-4203040 or emailing [email protected]