Stool Bloody

WHEN TO SEE YOUR DOCTOR

* See your doctor any time you see blood in your stool.

What Your Symptom Is Telling You

If you had red pepper in your salad last night, there's a slight chance that it made the treacherous journey through your digestive system and emerged as red as ever.

But generally speaking, when you see something red in your stools, you don't need a medical degree to know what it is.

"If you see something that looks like blood in your stool, with rare exceptions, it's blood," says Samuel Labow, M.D., president of the American Society of Colon and Rectal Surgeons and a private practitioner in Great Neck, New York.

Perhaps the most common causes of blood in your stool or in your toilet bowl are hemorrhoids or an anal fissure, says Nicholas J. Talley, M.D., associate professor of medicine at the Mayo Clinic Medical School in Rochester, Minnesota. A hemorrhoid is a puffy little bit of tissue that's left its proper spot inside the rectum and protruded out where it's not supposed to be. Even just a little overambitious wiping or straining can make it bleed. Anal fissures are cracks in the skin surrounding the anus?also from straining.

In both cases, the blood is added to the stool on its way out. When blood is actually in the stool, a number of things could be responsible. If you're taking large amounts of aspirin or some other nonsteroidal anti-inflammatories for relief from arthritis, you may notice some blood in your stool, says Barry Jaffin, M.D., a specialist in gastrointestinal motility disorders and a clinical instructor in the Department of Gastroenterology at Mount Sinai Hospital in New York City. Many of these medications can irritate the stomach and small intestine and even cause ulcers, which may be painless, but can sometimes be bloody, he says.

Inflammatory bowel disease?a digestive disorder with no known cause?can also cause bloody stool. This condition is often accompanied by pain, says Dr. Jaffin.

Although less likely, bloody stool may also mean that you've developed a polyp or even a cancerous tumor in your colon. "Most of the small polyps don't show any signs at all, but when they get to a certain size, they bleed," says Dr. Labow. "If they are far enough up inside your colon, the blood will be on the surface of the stool and possibly mixed in the stool."

Diverticulosis can be another cause of bloody stool, although there's little doubt when you're suffering from it. Like a bulge in the side of a tire, diverticulosis is a weak spot in the colon wall that can sometimes bleed, says Dr. Labow. When it does, the bleeding isn't something that you can ignore, he says. "You don't go to the bathroom and see a little bit of blood on the tissue, or a couple of drops of blood in the toilet bowl and say, 'Oh, that's my diverticulosis.' Diverticulosis by its nature will usually give you very, very significant bleeding. It's a hemorrhage," says Dr. Labow.

Symptom Relief

If you had a bloody nose, you might stuff it with cotton gauze. If you cut your finger, an adhesive bandage would probably be in order. Your first line of defense against bloody stool: a phone call to your doctor.

"It's vital that you get bloody stool checked as soon as possible," says Dr. Talley.

Here are a few things you should be aware of.

Wash it down. One of the easiest ways to end the straining that can cause the hemorrhoids or anal fissures that sometimes result in bloody stool is by drinking more fluids. In fact, drinking between six and ten eight-ounce glasses of fluids?like juice or water?a day will actually help prevent constipation, says Dr. Jaffin. (For more tips on putting an end to constipation, see page 105.)

Alter your medications. If you're taking aspirin or some other anti-inflammatory painkiller for arthritis, you should discuss you medications with your doctor.

Expect tests. Once you say okay to a gut check, you doctor will probably perform a sigmoidoscopy. During this office procedure, your doctor will use the magic of fiber optics to look inside your colon for whatever might be causing the problem, says Dr. Jaffin.