Hematochezia is a condition when there is fresh blood in the feces or feces . Hematochezia generally occurs due to bleeding in the lower digestive tract , such as from hemorrhoids or colon cancer .

Hematochezia is different from melena . In patients with hematochezia, the blood that comes out is fresh red. Whereas in sufferers of melena, the blood that comes out is black. This happens because the bleeding that occurs in the lower digestive tract is located not far from the anus.

Hematochezia does not always signal a serious condition. However, this condition still needs to get proper treatment because of the risk of causing dangerous complications, such as anemia, shock, and even death.

Causes of Hematochezia

Hematochezia is generally caused by bleeding in the lower digestive tract, such as the colon and rectum. Some conditions that can cause bleeding in the digestive tract are:

  • Hemorrhoids
  • Sores to the anus (anal fissures )
  • Colon cancer
  • Ulcerative colitis
  • Colon polyps
  • Benign tumors in the colon or rectum
  • Crohn's disease
  • Inflammation of the lining of the rectum ( proctitis )
  • Diverticulitis

Apart from the conditions above, there are several other conditions that can cause hematochezia in infants or children, namely:

  • Inflammation of the colon or small intestine in infants ( necrotizing enterocolitis )
  • Twisted intestines
  • Intussusception
  • Intestinal ischemia
  • Cow's milk allergy
  • A bulge at the bottom of the small intestine ( Meckel's diverticulum )

Risk factors for hematochezia

A number of factors that can increase a person's risk of developing hematochezia are:

  • Old age (elderly)
  • Family history of gastrointestinal disorders
  • Excessive consumption of alcoholic beverages
  • Constipation or constipation
  • Bloated

Symptoms of Hematochezia

Symptoms of hematochezia can vary, depending on the cause. However, the main symptom of hematochezia is fresh bright red blood that comes out with the stool.

Apart from blood coming out during bowel movements, there are several other symptoms that can accompany hematochezia, namely:

  • Stomach ache
  • Fever
  • Diarrhea
  • Change in bowel pattern
  • Weight loss

When to see a doctor

Check with your doctor if you experience symptoms of hematochezia, especially if it persists for more than 2 days and is accompanied by severe stomach pain. Also check with your doctor if the hematochezia is accompanied by a change in bowel pattern and weight loss.

If the blood that comes out a lot and fast, the patient can experience shock to death. Immediately go to the emergency room if the following complaints appear:

  • Heart beat
  • A cold sweat
  • Loss of consciousness
  • Hard to breathe
  • Pale and cold skin
  • Small amount of urine

Diagnosis of Hematochezia

To ensure the occurrence of hematochezia, the doctor will conduct a question and answer regarding the symptoms that appear, as well as the patient's and family's medical history. After that, the doctor will do a physical examination, especially in the anus.

Next, the doctor will ask the patient to undergo a stool examination, to detect blood in the stool. If the examination results detect blood in the stool, the doctor will carry out further tests to find out the cause, such as:

  • Blood tests , to determine the number of blood cells, check the speed of the blood clotting process, and check the function of the liver
  • Colonoscopy , to see the condition of the large intestine by inserting a camera tube through the anus
  • Biopsy, to take tissue samples for examination in the laboratory
  • X-rays, to see the condition of the digestive tract with the help of X-rays or using a barium solution
  • Angiography , to see damage to the blood vessels by injecting a contrast liquid into the blood vessels
  • Radionuclide scan, to see damage to the blood vessels by injecting radioactive material into the blood vessels
  • Laparotomy, to see the source of bleeding by means of open surgery on the stomach

Hematochezia Treatment

Hematochezia treatment aims to stop bleeding, treat anemia due to bleeding, and prevent bleeding from happening again.

To stop bleeding, doctors can perform the following procedures:

  • Endoscopy, such as colonoscopy, to stop bleeding in the digestive tract by heating or injecting medication into the bleeding area
  • Angiographic embolization , to close the flow of damaged blood vessels by injecting special particles in these blood vessels
  • Band ligation , to stop bleeding by placing a special rubber in the area of ​​the broken blood vessel

If the patient has a lack of blood or anemia, the doctor will provide replacement fluids in the form of infusions and blood transfusions.

Meanwhile, to prevent recurrent bleeding, doctors can address the conditions underlying the occurrence of hematochezia. For example, doctors may perform hemorrhoidectomy operations on hemorrhoids patients, or give TNF ( tumor necrosis factor ) inhibitor drugs such as infliximab, on ulcerative colitis patients.

In addition to the above treatments, doctors can also advise patients to make the following efforts to speed up the healing process:

  • Do not take non-steroidal anti-inflammatory drugs , such as diclofenac and aspirin
  • Doing a seated soak, namely by soaking the buttocks in a container filled with warm water
  • Eat foods high in fiber, such as vegetables and fruit

Hematochezia complications

If not treated immediately, hematochezia can cause serious complications that can be fatal, namely shock. Hematochezia can also cause anemia , which can make sufferers feel symptoms such as weakness, irregular heartbeat, and headaches.

Prevention of Hematochezia

The risk of hematochezia can be reduced by making the following efforts:

  • Eat foods with high fiber content, to prevent constipation ( constipation )
  • Limit consumption of alcoholic beverages
  • Do not smoke
  • Drink enough water every day, at least 8-10 glasses
  • Cleaning the anus every day
  • Do not strain too hard when defecating
  • Avoid sitting too long on the toilet
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