10 Years of Immunotherapy: Advances, Innovations, and Better Patient Outcomes
What Does It Mean When There Is Blood In Stool?
Possible causes of blood in stool include gastroenteritis, anal fissures, hemorrhoids, inflammatory bowel disease, and more. Treatment can depend on the underlying cause.
Below, learn more about the possible causes of bloody stool, including those more common in children. Also, find out how doctors diagnose and treat these issues.
An injury to the gastrointestinal (GI) tract, inflammation, and ulcers can all cause the lining of the digestive tract to bleed. In some cases, perforation may occur, resulting in bleeding, abdominal pain, and severe illness.
If bleeding occurs in the GI tract, the blood passes out of the body with the stool.
Specific health issues that can lead to bleeding include the following:
GastroenteritisGastroenteritis refers to viral, fungal, or parasitic infections that affect the stomach and intestines.
It can cause:
In rare cases, some types of bacteria can cause bloody diarrhea.
Symptoms of gastroenteritis can last up to 10 days, depending on the cause.
Infection usually results from:
In the past, people often referred to viral gastroenteritis as stomach flu. Doctors no longer use this term as this is a gastrointestinal disease, while flu is a respiratory disease.
What is bacterial gastroenteritis?
Anal fissureAnal fissures are small tears in the lining of the anus. They may bleed and cause pain during a bowel movement.
Possible causes include:
Hemorrhoids are swollen veins in the lower rectum. Straining or passing hard stool can rupture these veins, leading to bloody bowel movements.
People with hemorrhoids may notice a few drops of blood on the stool, on tissue, or in the toilet bowl. Factors that increase the risk of hemorrhoids bleeding include:
Peptic ulcers are open sores that develop in the lining of the stomach or duodenum.
A peptic ulcer that forms on a blood vessel may cause bleeding and bloody stools.
Other symptoms include:
These ulcers can result from infection with Helicobacter pylori bacteria or from the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).
DiverticulaDiverticula are small pockets that can form inside the colon. They are prone to infection and inflammation and can sometimes rupture and bleed.
The medical term for infection and inflammation of diverticula is diverticulitis. Diverticulitis is a type of diverticular disease.
Other symptoms of diverticular disease include:
Experts do not know what causes diverticular disease.
Inflammatory bowel diseaseInflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, can cause bloody stool.
As well as rectal bleeding or blood in stool, symptoms include:
Experts do not know exactly what causes IBD, but it involves changes to the immune system. Genetic factors may also play a role.
Anal fistulaAn anal fistula is a small tunnel that forms between the end of the bowel and the skin near the anus. Fistulas can also start in the colon and lead to another organ or the surface of the skin.
Colonic and anal fistulas are rare but can result as a complication of:
After an infection, pus can collect in tissues surrounding the anus. As the pus drains, it leaves behind the fistula, which may continue to ooze pus or blood.
Symptoms include:
A person may experience GI bleeding as a side effect of blood-thinning medications, such as:
Anyone who takes a blood-thinning medication and has a bloody bowel movement should notify their doctor immediately if they see blood in their stool.
Colon polypsColon polyps can lead to bloody stools. These small growths may be benign or precancerous.
Often, there are no symptoms, but a person may notice:
Experts do not know why polyps occur, but they become more likely as people get older. A family history of polyps can also increase the chance of having them.
CancerCancerous tumors of the GI tract can weaken the lining of the GI tissues, causing them to bleed.
However, cancer may be present without any visible signs of bleeding. People with a higher risk of cancer in the digestive system can ask a doctor about screening with a FIT test, also known as a fecal occult blood test.
This can show if small traces of blood are present in stool that are not visible to the eye.
Bloody stool may be especially common in infants. Some causes include:
Blood in stool may result from bleeding in the upper or lower GI tract — and the color of the blood can help indicate its source.
Black, tarry stoolBlack, tarry stool may point to a bleed in the upper GI tract. As a general rule, the darker the blood, the higher the source of the bleed.
The upper GI tract includes the mouth, esophagus, stomach, and upper part of the small intestine, called the duodenum.
According to the American College of Surgeons, upper GI bleeding is more common than lower GI bleeding, accounting for about 70% of all GI bleeds.
Bright red bloodThis is usually a sign of a bleed in the lower GI tract. This section consists of the large intestine, rectum, and anus.
No change in colorSometimes there is blood in stool, but it only shows up in a lab test. It is not visible in the stool. For people with a family history of bowel cancer, a doctor may recommend screening.
A doctor will likely ask:
They may carry out an examination of the rectum and order tests to help identify the cause and check how much blood the person has lost.
The next steps depend on how much blood was lost.
Emergency situationsIf a person reports significant blood loss, a doctor may order a CT scan to rule out perforation.
If there is no perforation, they may perform an urgent endoscopy.
This involves inserting a thin, flexible tube with a camera at one end into the upper or lower end of the GI tract, depending on the type of blood the person has seen. In this way, they will look for the source of the bleeding.
An upper endoscopy involves guiding the endoscope through the mouth and down into the upper GI tract. A colonoscopy is a form of endoscopy that involves inserting the endoscope into the anus and through the lower GI tract.
Once the doctor has identified the source of the bleeding, they can insert tiny instruments through the endoscope and use them to repair the damaged tissue.
If the doctor is unable to resolve the bleed, they may recommend surgical removal of all or part of the damaged area.
Nonemergency situationsIf the bleeding does not appear to be life threatening, the doctor may order or perform a:
The best approach depends on the cause and source of the bleeding within the GI tract.
If bleeding results from an ulcer, infection, or inflammation, the doctor may prescribe medications.
If cancer is present, they will recommend a suitable course of treatment, depending on the stage and other factors.
In some cases, surgery is necessary to prevent further bleeding. The doctor may perform it using endoscopy or colonoscopy. The procedure may involve:
A person should seek medical attention as soon as possible if they notice black or dark red stool or have bloody diarrhea.
A person with the following symptoms may be losing a large amount of blood and should seek emergency medical help:
Some symptoms are less severe but still warrant investigation. A person should see a doctor if they experience:
Here are some answers to questions people often ask about blood in stool.
Is blood in your stools serious?Often, blood in stool is a sign of hemorrhoids or piles. In some cases, however, it can be a sign of a more serious condition, such as bowel cancer or internal bleeding.
It is always best to check with a doctor if you notice blood in your stool. If you do not have blood in your stool, but there is a family history of bowel cancer, ask about screening.
When should I be worried about blood in my stool?People should see a doctor as soon as possible if:
Non-stop bleeding is a medical emergency. A person should call 911 or go to the emergency room.
Blood in the stool may turn out to be nothing alarming but it is always best to discuss it with a healthcare professional. They can help determine whether or not further testing is necessary.
A person should seek emergency medical care if there is a lot of blood, if there are blood clots, or if they have other signs of blood loss, such as dizziness or fainting.
Understanding Prostate Cancer -- The Basics
The prostate is a gland in the male reproductive system. It makes most of the semen that carries sperm.
It sits directly beneath your bladder and in front of your rectum. Because the first portion of the urethra passes through the prostate, the passage of urine or semen through the urethra can be blocked if the gland is enlarged.
Prostate cancer is a malignant tumor of the prostate.
The disease is less common before age 50, and experts believe that most elderly men have traces of it.
African American men are more likely to get prostate cancer and have the highest death rate. Other than skin cancer, prostate cancer is the most common cancer in American men. In other parts of the world -- notably Asia, Africa, and Latin America -- prostate cancer is rare.
Prostate cancer is usually a very slow-growing cancer, often causing no symptoms until it is in an advanced stage. Most men with prostate cancer die of other causes and many never know that they have the disease. But once prostate cancer begins to grow quickly or spreads outside the prostate, it is dangerous.
Prostate cancer in its early stages (when it's found only in the prostate gland) can be treated, with very good chances for survival. Fortunately, about 85% of American men with prostate cancer are diagnosed in an early stage of the disease.
Cancer that has spread beyond the prostate (such as to the bones, lymph nodes, and lungs) is not curable, but it may be controlled for many years. Because of the many advances in treatments, most men whose prostate cancer becomes widespread can expect to live 5 years or more. Some men with advanced prostate cancer live a normal life and die of another cause, such as heart disease.
Prostate cancer affects mainly older men. About 80% of cases are in men over 65, and less than 1% of cases are in men under 50. African American men and those with a family history of prostate cancer are more likely to get it.
Doctors don't know what causes prostate cancer, but diet contributes to the risk. Men who eat lots of fat from red meat are most likely to have prostate cancer. Eating meat may be risky for other reasons: Meat cooked at high temperatures produces cancer-causing substances that affect the prostate. The disease is much more common in countries where meat and dairy products are common than in countries where the diet consists of rice, soybean products, and vegetables.
Hormones also play a role. Eating fats raises the amount of testosterone in the body, and testosterone speeds the growth of prostate cancer.
A few job hazards have been found. Welders, battery manufacturers, rubber workers, and workers frequently exposed to the metal cadmium seem to be more likely to get prostate cancer.
Not exercising also makes prostate cancer more likely.
Drugs that may lower the risk of prostate cancer include aspirin, finasteride (Proscar), and dutasteride (Avodart).
There's no evidence that you can prevent prostate cancer. But a few simple things may help lower your odds.
Healthy food
A diet that helps you stay at a healthy weight may cut your chances of having prostate cancer. These steps can help:
Antioxidants in foods, especially in fruits and vegetables, help prevent damage to the DNA in your cells. Such damage has been linked to cancer. Lycopene, in particular, is an antioxidant that has been thought to lower the risk of prostate cancer. It can be found in foods such as:
Frequent ejaculation
Whether it's from sex, masturbation, or wet dreams, men who ejaculate more appear to be less likely to get prostate cancer. Doctors aren't sure why it helps, but they think it may help move potentially irritating substances out of the prostate.
Symptoms of prostate cancer include:
Doctors use two tests to look for prostate cancer: a digital rectal exam and a PSA blood test.
The PSA blood test looks for prostate-specific antigen in the blood. Experts are divided on who should have a PSA test and when to have it:
PSA levels in blood are higher if there is prostate cancer, making it a valuable tool in finding early prostate cancer. But PSA levels can also be high from infection or inflammation in the prostate or from an enlarged prostate.
It's important to discuss this test with your doctor before you have it. A high PSA level does not mean you have cancer; a normal PSA level does not mean you don't have cancer.
If PSA levels are high or have gone up since your last PSA test, your doctor will do a biopsy of the prostate gland using a small ultrasound probe inserted in the rectum (transrectal ultrasound). Tissue samples will be tested for cancer.
If cancer is found, the doctor may do abdominal and pelvic X-rays to see if the cancer has spread outside the prostate. You may also have an MRI and a bone scan.
If you have high PSA levels but biopsies don't find cancer, a urine test known as a PCA-3 looks for cancer. This can prevent the need for repeat biopsies in some men.
If you need treatment, your doctor will decide the type. Decisions about how to treat this cancer are complex, and you may want a second opinion before making a treatment decision. Treatment may include watchful waiting, a single therapy, or some combination of radiation, surgery, hormone therapy, and less commonly chemotherapy. The choice depends on many things. Prostate cancer that hasn't spread usually can be cured with surgery or radiation.
Watchful waiting
Since prostate cancer can grow slowly and may not be fatal in many men, some patients -- after discussing the options with their doctors -- opt for "watchful waiting." This means not treating it. Instead, the doctor regularly checks the prostate cancer for signs that it is becoming more aggressive. Watchful waiting is typically recommended for men who are older or have other life-threatening conditions. In these cases, a less aggressive cancer may be growing so slowly that it's not likely to be fatal.
Surgery
The standard operation, a radical retropubic prostatectomy, removes the prostate and nearby lymph nodes. In most cases, surgeons can remove the gland without cutting nerves that control erections or the bladder, making impotence or incontinence much less common than in the past. Depending on the man's age and the amount of surgery needed to remove all the cancer, nerve-sparing operations allow many men who were able to get erections before surgery to be able to do so after surgery without the need for erectile dysfunction treatments.
Laparoscopic robotic prostatectomy is a surgery using a laparoscope aided by robotic arms. This operation is now the most popular form of radical prostatectomy in the United States.
After surgery, most men have temporary incontinence, but they usually regain complete urinary control over time. If it is severe or lasts a long time, incontinence can be managed with special disposable underwear, exercises, condom catheters, biofeedback, penile clamps, implants around the urethra, or a urethral sling.
After surgery or radiation, men may have impotence. Treatment includes drugs such as sildenafil (Revatio, Viagra), tadalafil (Adcirca, Cialis), and vardenafil (Levitra, Staxyn). Other treatments include teaching the man to perform a painless self-injection into the penis (of a drug called Caverject), or vacuum pumps. A penile prosthesis is used only when all other options have failed.
Radiation
Radiation is often the main treatment for prostate cancer that has not spread. It may also be given as follow-up to surgery. Radiation may also be used, in advanced cases, to relieve pain from the spread of cancer to bones. Incontinence and impotence may also happen after radiation. Radiation to the pelvis may also be done if PSA levels rise after surgery.
An advanced form called intensity modulated radiation therapy (IMRT) can increase the dose of radiation to the prostate with fewer side effects to the nearby tissues. Proton beam therapy can increase the dose to the prostate even more. But proton therapy has not been found to be better than IMRT. A more focused form of radiation, stereotactic radiation, is being used for early forms of prostate cancer. This treatment also has not been shown to improve the outcome of prostate cancer. Though it may take less time than IMRT, it may have more side effects.
Radioactive seeds (brachytherapy) deliver radiation to the prostate with little damage to nearby tissues. Your doctor implants the tiny radioactive seeds, each like a grain of rice, in the prostate gland using ultrasound guidance. The implants remain in place permanently and become inactive after many months. In some patients, this method may be used with traditional radiation. Or, if the prostate gland is too large for brachytherapy, hormone therapy can shrink the prostate to allow brachytherapy to be done.
Hormone therapy
Hormone therapy is the recommended treatment for advanced prostate cancer. Since testosterone can make prostate cancer grow, hormone therapy works by tricking the body to stop making testosterone, stopping or slowing the cancer's growth. The following drugs decrease the amount of testosterone being made by the testicles:
Even advanced cases that cannot be cured may be controlled for many years with hormone therapy. But there is a higher risk of heart disease with this treatment. Fractures are also a risk because of thinning bone. Medications can reduce the risk of osteoporosis and fractures.
Testosterone can also be removed from the bloodstream by surgically removing the testicles (orchiectomy) or by giving female hormones such as estrogen or other drugs that block testosterone production. Estrogen therapy is no longer used routinely. Men generally prefer the testosterone-blocking drug treatment because it is effective, is less invasive, and causes fewer side effects than surgery or female hormone drugs.
Other treatments
Chemotherapy is effective for some men with advanced prostate cancer who didn't do well on or respond to hormone therapy. When traditional hormonal treatments stop working, newer hormonal therapies may be considered.
Abiraterone (Zytiga) blocks tissues from making testosterone. Apalutamide (Erleada) and enzalutamide (Xtandi) prevent cancer cells from getting the signal to grow and divide.
Darolutamide (Nubeqa) has been approved to treat those whose cancer has not spread to other parts of the body but has not responded to surgical treatment or standard androgen deprivation therapy (it's used for prostate cancer in men with castrate testosterone levels whose PSA levels continue to rise). This is also known as nonmetastatic castration resistant prostate cancer (nmCRPC).
Biological therapy (immunotherapy) is a treatment that works with your body's immune system to fight cancer or manage side effects from other treatments.
High-intensity focused ultrasound (HIFU) uses high-energy sound waves to kill prostate tissue. But it's not approved to treat prostate cancer itself. Research is ongoing to see how it works.
The goal of prostate cancer treatment is long-term survival, and that is likelier in men diagnosed early. All prostate cancer survivors should be examined regularly and have their PSA and testosterone levels monitored closely.
Although the number of men diagnosed with prostate cancer remains high, so does the number of men who get it and live. Survival rates after diagnosis of common types of prostate cancer are:
Prostate Cancer News
Jan. 23, 2024 — Combining testosterone-blocking drugs in patients with prostate cancer relapse prevents the spread of cancer better than treatment with a single drug, a multi-institution, Phase 3 clinical trial has ...
July 19, 2023 — Three new biomarkers for prostate cancer have been identified to help pinpoint potentially aggressive cases of the disease, which kills 300,000 men each ...
July 12, 2023 — Prostate cancer is a leading cause of death among American men, and it's resistant to one of the most powerful chemotherapy medications -- cisplatin. Now, researchers have developed the first ...
Apr. 10, 2023 — A new drug, a monoclonal antibody known as enoblituzumab, is safe in men with aggressive prostate cancer and may induce clinical activity against cancer throughout the body, according to a phase 2 ...
Mar. 16, 2023 — The combination of two oral medications has shown positive results in people with prostate cancer, whose disease has spread to other parts of the body. Compared with XTANDI plus placebo, the ...
Mar. 9, 2023 — New research shows that men who stick to a predominantly Mediterranean diet are less likely to be diagnosed with prostate cancer. This diet also improves their chances of recovery if they have PC and ...
Mar. 8, 2023 — The nitrate ingested over the course of a person's adult lifetime through the consumption of tap water and bottled water could be a risk factor for prostate cancer, particularly in the case of ...
Feb. 7, 2023 — Researchers have helped develop a new blood test to detect prostate cancer with greater accuracy than current methods. New research shows that the Prostate Screening EpiSwitch (PSE) blood test is ...
Jan. 23, 2023 — Researchers discover a potential therapeutic avenue via neuronal endocrine receptors that could be helpful in battling an aggressive form of prostate ...
Jan. 12, 2023 — For men who undergo radiotherapy for localized prostate cancer, the precise targeting capabilities of MRI guidance resulted in fewer toxicities and better quality of life according to new ...
Dec. 14, 2022 — A single bout of exercise has been shown to elevate anti-cancer proteins called myokines in people with advanced prostate cancer, to levels which can significantly suppress tumour ...
Dec. 13, 2022 — Researchers have characterised prostate cancer cell dynamics at a single-cell resolution across the timespan of the disease -- from its beginning to the point of androgen independence, where the ...
Dec. 9, 2022 — Scientists have created a comprehensive tool for predicting an individual's risk of developing prostate cancer, which they say could help ensure that those men at greatest risk will receive the ...
Nov. 29, 2022 — A family history of cancer and genetic variants that might be inherited appear to be important risk factors for Black men diagnosed with early-onset prostate cancer, a study has ...
Nov. 23, 2022 — A single drug compound simultaneously attacks hard-to-treat prostate cancer on several fronts, according to a new study in mice and human cells. It triggers immune cells to attack, helps the immune ...
Nov. 13, 2022 — Researchers have found a new theranostic compound that effectively shrinks prostate tumor in mice. Theranostics is a cancer treatment that involves finding cancer cells anywhere in the body and ...
Nov. 2, 2022 — In a recent trial, nine patients whose tumors were resistant to androgen-blocking therapy continued that therapy but were also given a CD105 inhibitor called carotuximab. Forty percent of those ...
Oct. 3, 2022 — New epigenetic biomarkers to predict more aggressive forms of prostate cancer have been ...
Sep. 22, 2022 — Researchers have identified critical genomic changes in response to abiraterone acetate/prednisone, a standard treatment option for men with progressive, incurable and castration-resistant prostate ...
Sep. 21, 2022 — Researchers have made an important discovery about how prostate cancer may start to develop. A new study reveals that the prostate as a whole, including cells that appear normal, is different in men ...
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