Blood in your stool: it’s not always hemorrhoids

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Colorectal cancer — also referred to as colon cancer — is the third-most diagnosed cancer in men and women in the U.S. There are certain symptoms that should not be ignored, such as blood in the stool.

Dr. Erick Alayo, a gastroenterologist affiliated with Sharp Chula Vista Medical Center, helps understand the reality about this concept with these five frequently asked questions:

1. How do I know if there is blood in my stool?
It is very important to observe any colors that stand out in your stool to identify any issues and inform your doctor. The stool color may vary: a red or maroon color is most concerning as it may reveal a problem with the lower part of the digestive tract such as hemorrhoids, whereas a dark, blackish color might reveal an ulcer or other problem with the upper digestive tract.

2. How is blood in stool assessed?
The best way to assess stool blood is by conducting a colonoscopy. This process allows the doctor and patient to really observe the colon's interior. The colonoscopy allows accurate diagnosis and a specific treatment. A colonoscopy to prevent colon cancer should be conducted at 50 years old unless there is family history of colon cancer.

3. Are there certain foods that are causing blood in stool?
Many people think that spicy peppers and other foods cause blood in stool. This is partially true. Eating foods that cause strain or that are low in fiber — such as carbohydrates and flours — can produce constipation. This strain can lead to hemorrhoids, which can in turn create stool blood.

4. If it's not hemorrhoids, what else can it be?
Seeing blood in the stool should not be taken lightly. Other reasons for seeing stool blood can include polyps, tumors, ulcers and colitis, among other concerns. Other symptoms associated with seeing blood in the stool can be abdominal pain, vomiting, weakness, difficulty breathing, diarrhea, palpitations and weight loss. If these symptoms are not addressed promptly, these conditions could lead to colon cancer.

5. How can stool blood be prevented or eliminated?
Stool blood can be prevented by adding more vegetable fiber to your diet, for example, salads, leafy greens and green vegetables, such as spinach and broccoli. A colonoscopy or anoscopy can confirm hemorrhoids. Once confirmed, these can be eliminated by rubber band ligation, the most commonly used procedure in the U.S. In this procedure, a small elastic band is placed around the base of a hemorrhoid to cut off the circulation of blood to the hemorrhoid and cause it to die. Another option would be a surgical procedure, called a hemorrhoidectomy. This is conducted for large, persistent and internal hemorrhoids that may return after a successful rubber band ligation.

Learn more about colon cancer prevention and treatment.