When referring to human feces, blood in the stool looks different depending on how early it enters the gastrointestinal tract - and thus how much digestive action has been exposed - and how many there are. This term may refer either to melena, to its black appearance, usually derived from upper gastrointestinal bleeding; or to hematochezia, in red, usually derived from lower gastrointestinal bleeding. The evaluation of blood found in stool depends on its characteristics, in terms of color, quantity and other features, which can point to its source, however, more serious conditions may present with mixed images, or with bleeding forms found. in other parts of the treaty. The term "blood in the stool" is usually only used to describe the visible blood, and not the fecal occult blood, which is only found after physical examination and laboratory chemistry testing.
In infants, apt tests can be used to distinguish fetal hemoglobin from maternal blood based on differences in fetal hemoglobin composition compared with hemoglobin found in adults.
Video Blood in stool
Diagnosis dan patofisiologi diferensial
Blood in the stool can come from many sources. The causes range from harmless to very serious conditions. A common way to divide the causes of bleeding is based on the source of the bleeding. GI channels can be divided into top and bottom, with some causes of bleeding affecting the entire channel (up and down). Blood in the stool often appears different depending on the source. This difference can be helpful when diagnosing this condition. The rate of bleeding can also make the blood in the stool look different from ordinary cases.
Top GI channels
The upper GI tract is defined as an organ that is involved in digestion over the Treitz ligament and consists of the esophagus, stomach, and duodenum. Upper gastrointestinal bleeding is usually characterized by melena (black stool). Bright red blood can be seen with active and rapid bleeding.
Lower the digestive tract
Lower gastrointestinal bleeding will usually appear as hematochezia and may vary in degree of seriousness. Slow bleeding from the upturned part of the intestine can cause partial blood digestion and the appearance of melena in the stool.
Pathophysiology
Blood development in one's feces results from a variety of conditions, which can be divided into major categories of disease. These broad categories include cancer processes or abnormal intestinal wall structures, inflammatory diseases, infection-induced colitis or medications and vascular compromise.
Cancer (neoplasms)
- Colorectal cancer
- Stomach cancer
Changes in the intestinal wall
Motility
Intestinal wall is important for the movement of waste products through the digestive tract. Repeated attempts to defecate may cause tearing around the rectum exit (anal fissure)
- Constipation
Structure
This list of diagnoses includes a disease in which the intestinal wall is disrupted by the disease.
- Peptic ulcer disease - divided into duodenal or gastric ulcers, the most common common causes include:
- Non-steroidal anti-inflammatory drugs (NSAIDs) - the use of these drugs results in structural changes in the intestinal wall, namely ulcers, and potential blood in the stool.
- H. pylori These bacterial infections can erode the wall of the stomach or duodenum, causing structural changes in the stomach wall and bleeding in the stool.
- Chronic illness
Diverticulitis and diverticulosis are produced from the outgoing sac of the colonic mucosa, or intestinal wall, leading to weak bowel wall damage and increased susceptibility to bacterial infections in the gastrointestinal tract, resulting in a potentially vascular compromise. , bundles of bacteria in the perforation area (abscess), the formation of abnormal communication between other parts of the GI tract with a hole (fistula), or intestinal obstruction (obstruction). - Meckel's diverticulum is a congenital residual omphalo-mesenteric duct that connects the fetal yolk sac to the normal intestine closed and destroyed during the developmental process. If in part, or all of these channels remain a diverticulum or fistula may occur, leading to potential sources of bleeding.
Bowel Inflammation
Diseases that cause inflammation in the digestive tract can cause blood in the stool. Inflammation can occur anywhere along the GI channel in Crohn's disease, or in the colon if someone has ulcerative colitis.
- Crohns's disease
- Ulcerative colitis
colitis
- Enteritis - small inflammation, which may be caused by different shapes and by other conditions.
Infectious colitis
- Food poisoning - bacteria associated with bloody diarrhea usually E. coli
- Campylobacter enteritis
- Shigellosis
- Salmonellosis (Salmonella enteritis/Salmonella enterocolitis)
- Bacterial gastroenteritis
- Campylobacter jejuni
- Clostridium dificile
- Escherichia coli enteritis - the most common cause of diarrhea travelers
- Salmonella enterica
- Shigella dysenteriae see also dysentery
- Staphylococcus aureus
Drug-induced colitis
- Radiation enteritis
Vascular compromise
- Angiodysplasia of the GI channel
- Arterial malformation is open
- Anal fissure
- Varises esophagus
- Hemorrhoids
- Internal hemorrhoids are covered by mucosal and epithelial layers, making them more likely to bleed, but usually do not cause pain.
- External hemorrhoids tend to not bleed, they are covered by different types of epithelium (squamous) but may cause significant pain as a result of thrombosis of blood vessels in them.
- Polypectomy during colonoscopy may cause small amounts of bleeding to be seen in the stool after the procedure
Other causes
- Blood in the food, for example, traditional Masai food includes a lot of blood taken from livestock.
Maps Blood in stool
Evaluation
The tests considered to evaluate the release of blood in the stool are based on the characteristics of bleeding (color, quantity) and whether the person passing blood has low blood pressure with an elevated heart rate, compared to the normal vital signs. The following tests are combined to determine the cause of the source of the bleeding.
- Anal rectal examination (DRE) and fecal occult blood test (FOBT)
- Colonoscopy
- Anoscopy
- Esophagogastroduodenoscopy (EGD)
- Capsule endoscopy
- CT Scan
Melena is defined as dark dirt, dwelling, often black due to the partial digestion of red blood cells.
Haematochezia is defined as the bright red blood seen in the toilet either inside, or around the stool.
Haematochezia is usually thought to originate from the lower part of the gastrointestinal tract, and the initial diagnostic steps include DRE with FOBT, which, if positive, will lead to colonoscopy. If the person has large amounts of blood in their stools, an EGD test may be necessary. If no active bleeding source is found in this examination, capsule endoscopy may be performed, to more closely examine the small intestine, which can not be seen with other types of research. With melena, DRE with FOBT is also often performed, but suspicion for the source of the upper GI tract is higher, leading first to the use of EGD with other tests that are required if no source is identified. Anoscopy is another type of examination, which can be used in conjunction with a colonoscopy, which checks the rectum and the distal portion of the descending colon.
Other features
Mucus can also be found in the stool.
The texture described as living stool is commonly associated with the dark black feces seen in partially digested blood. This is commonly associated with melena.
Patient age
A person's age is an important consideration when assessing the cause of the bleeding.
Treatment
The treatment of bloody stools depends heavily on the cause of the bleeding. Bleeding is generally associated with symptoms of fatigue, dizziness, headache, or even shortness of breath, and these associated symptoms also require treatment. These symptoms are the result of blood loss, and occur due to the lack of red blood cells (red blood cells) circulating in the vascular system, resulting in less oxygen reaching the tissues and organs. Blood in the stool can be associated with serious complications as a result of loss of blood volume (bleeding) or a slow blood leak that leads to low levels of circulating hemoglobin (anemia).
Anemia
Anemia is a common complication of blood in the stool, especially when there is a lot of blood or bleeding going on for long periods of time. Anemia is also often associated with iron deficiency, because of the importance of iron in the formation of red blood cells (RBC). When anemia is diagnosed as a result of blood in the stool, vitamins that are important for RBC formation (folate, vitamin B12, and vitamin C) are often prescribed to ensure that all ingredients are available for the cells that are made.
Special care
Diagnostic measures can be used as an intervention to help stop the bleeding in some cases. Bleeding that occurs due to neoplasm (cancerous growth) can be treated by using colonoscopy and clipping, surgical intervention, or other action, depending on the shape and stage of the cancer. Similarly, stomach cancer is treated depending on the stage, although it usually requires surgical and medical therapy.
Treatment for motility problems, namely constipation, usually to improve the movement of waste through the digestive tract. This is done by using stool softeners (which work by pulling water into the stool while in the colon), the addition of dietary fiber, and the use of osmotic laxatives (which helps the movement of fluids through the colon, improves overall motility). Increasing one's gut motility can reduce tension during deflection and reduce the risk of developing anal gaps. Anal fissure deals with pain and blood in toilet paper, and takes time for healing. Treatments include topical nitrate or calcium channel blockers and surgical interventions for chronic or complex cases. Similar to anal fissure, internal hemorrhoids can cause blood in the tissue while wiping, and are felt at the opening of the anus. Treatment options for hemorrhoids can depend on whether the underlying cause exists. Anorectal varices associated with hemorrhoids caused by cirrhosis, but symptomatic treatment often involves removal.
Colitis can be divided into infections and induced drugs, as well as treatments for this condition. With infectious colitis, treatment depends on the pathogen, and generally requires the use of antibiotics. With drug-induced colitis, treatment usually involves removal of the offending agent, as does the NSAID induced PUD, however, eliminating radiation from cancer patients is not always practical in a treatment regimen, so medical care is the primary means of treatment.
The structural compromise that causes blood in the stool is caused by various conditions, and therefore requires different treatment for each condition. Peptic ulcer disease alone can be divided into several causes, but is generally initially controlled mainly by proton pump inhibitors, with the addition of H 2 blockers, or in serious cases, requiring surgical intervention. Diverticulitis and diverticulosis require antibiotic treatment, and may require surgical intervention.
Inflammatory bowel disease is also divided into separate conditions, namely ulcerative colitis and Crohn's disease, which have different treatment regimens, and may require surgical intervention in more serious conditions.
See also
- Fecal occult blood
References
Source of the article : Wikipedia
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