Hematochezia is the appearance of fresh blood in the stool (feces). Hematochezia is usually caused by bleeding in the lower digestive tract. However, some cases of hematochezia can be caused by upper gastrointestinal bleeding.
Hematochezia, especially in the elderly, needs to be treated properly because of the risk of dangerous complications, such as anemia, shock, and even death.
Symptoms of Haematochezia
The main symptom of hematochezia is red, fresh blood that comes out with the stool. In addition to bleeding during bowel movements, some other symptoms that can accompany hematochezia are:
- Stomach ache
- Changes in bowel patterns
- Weight loss
- Symptoms of anemia due to blood loss, such as weakness, irregular heartbeat, and fainting.
If the blood that comes out a lot and fast, the sufferer can go into shock to death. Symptoms of shock to watch out for are:
- Heart beat
- A cold sweat
- Reduced frequency of urination
- Decreased consciousness.
Causes of Hematochezia
Gastrointestinal bleeding that causes hematochezia usually occurs in the large intestine (colon). There are various diseases that can cause this bleeding, including:
- Injuries to the anus or anal fissure
- Colon cancer
- Ulcerative Colitis
- Crohn's disease
- Benign tumors of the digestive tract
- Intestinal polyps
- Inflammation of the end of the large intestine or rectum (proctitis).
Diagnosis of Haematochezia
To confirm the occurrence of hematochezia, the doctor will ask about the symptoms that appear and perform a physical examination. After that, the doctor will also ask the patient to take a stool sample to be examined in the laboratory.
The doctor may also ask the patient to undergo other tests to determine the cause of the hematochezia. The tests include:
- blood test, to determine the number of blood cells, check the speed of blood clotting, and liver function.
- Kolonoscopy, to see the condition of the large intestine with the help of a thin tube-shaped instrument with a camera, which is inserted through the rectum.
- Biopsi, namely taking tissue samples for later examination in the laboratory.
- X-ray photo, to see the condition of the digestive tract with the help of x-rays, which sometimes also uses a special solution as a dye (contrast fluid).
- Angiography, to see damage to the blood vessels with the help of x-rays or magnetic waves, using a contrast fluid that is injected into the blood vessels.
- Radionuclide scan. The working principle of this procedure is similar to that, except that the contrast fluid in this procedure will be replaced with radioactive material.
- Laparotomy.This procedure is performed by dissecting the abdomen to examine the cause of the hematochezia.
The main goal of treating hematochezia is to stop bleeding, that is, by treating the disease or condition that caused it. If the cause is treated, hematochezia may stop on its own.
Methods of treatment of hematochezia consist of:
- Endoscopy. Through an endoscope (eg a colonoscopy), the gastroenterologist will stop bleeding in the digestive tract by heating, covering it with special glue, or by injecting medication at the bleeding site.
- Angiographic embolization. This treatment is done by injecting special particles in the damaged blood vessels, to block the flow.
- Band ligation. This treatment is done by placing a special rubber on the area of the broken blood vessel to stop the bleeding.
Hematochezia patients are advised not to take non-steroidal anti-inflammatory drugs, such as diclofenac, to speed healing.
Hematochezia with rapid and profuse bleeding needs to be treated immediately to avoid complications. Complications due to hematochezia can include anemia, shock, and even death.
Prevention of Haematochezia
Hematochezia can be prevented by doing the following:
- Eat high-fiber foods to prevent constipation, because there is a risk of hemorrhoids and diverticulitis.
- Quit smoking.
- Limiting the habit of drinking alcohol.
- Do not take drugs, especially non-steroidal anti-inflammatory drugs, without consulting a doctor first.