Is Blood in Stool an Emergency?

Blood in the stool is usually not a cause for concern, but you should see a doctor if you also have changes in your bowel movements, weakness, and tiredness. Emergency symptoms include fever, severe abdominal pain or cramping, bloody diarrhea that comes on suddenly, lightheadedness or fainting, dizziness, sweating, cold/clammy skin, fast heart rate, passing more than one cup of blood, and others.

Blood in the stool often comes from the lower intestine (colon), rectum, or anus and may be noticed when you see blood in the toilet or on toilet paper after wiping following a bowel movement.

When Should I Be Concerned About Blood in My Stool?

Blood in the stool often is not an emergency but you should tell your doctor if it occurs. See a doctor if you have blood in the stool along with: 

• Changes in frequency or consistency bowel movements
• Weakness 
• Tiredness

Blood in stool may be an emergency if it is accompanied by: 

• Fever
• Severe abdominal pain or cramping
• Bloody diarrhea that comes on suddenly
• Lightheadedness or fainting
• Dizziness
• Sweating 
• Cold, clammy skin
• Fast heart rate 
• Passing more than one cup of blood
• Urinating less than usual
• Nausea and/or vomiting (especially vomiting blood or vomit that looks like “coffee grounds”)
• Confusion
• Vision problems

Call 911 and get to a hospital’s emergency department if you have blood in the stool and any of the symptoms above. These could be signs of a severe infection or even shock, which are medical emergencies. 

The cause of blood in the stool is diagnosed with a patient history and physical exam that usually involves a rectal examination. 

Other rests to help diagnose the cause of blood in the stool include 

• Anoscopy to inspect the anal canal and lower rectum: this is usually an office procedure that does not require sedation
• Colonoscopy to examine the entire colon
• Sigmoidoscopy to examine the rectum and most of the lower large intestine
• Esophagogastroduodenoscopy
• Wireless capsule endoscopy 
• Double-balloon enteroscopy
• Push enteroscopy
• Radionuclide scans
• Angiography
• Blood tests
  • Complete blood cell (CBC) count
  • Coagulation profile
  • Electrolyte levels

There are many potential causes of blood in the stool, and treatment depends on the cause. 

• Hemorrhoids
  • Fiber supplements
  • Laxatives 
  • Warm sitz baths 
  • Topical treatments: pain-relieving creams and hydrocortisone rectal suppositories 
  • Surgery for severe cases
• Anal fissure 
  • Fiber therapy
  • Laxatives 
  • Topical nifedipine and topical nitroglycerin 
  • Botulinum toxin 
  • Surgery for cases that persist despite other treatments
• Precancerous polyps 
  • Surgical removal of polyps (polypectomy)
• Colorectal cancer 
  • Chemotherapy
  • Radiation therapy
  • Surgery to remove the part of the colon or rectum that has cancer
• Colitis 
• Diet changes
  • Avoid medications that worsen symptoms such as nonsteroidal anti-inflammatory drugs (NSAIDS)
  • Topical medications applied directly to the rectum including 5-ASA (aminosalicylic acid or mesalamine)
  • Topical or oral steroid medications 
  • Oral 5-ASA 
  • Biologics
  • Intravenous steroids for severe cases
  • Other medications: tofacitinib or cyclosporine