Bleeding and Blood in the Stool

Causes of blood in the stool

Sometimes with IBD, blood might appear on or in your stool. If the blood is bright red, it usually is coming from the rectum or large intestine. Darker or black stools could be due to blood higher up in the digestive system.

Some people might bleed even when they are not passing stool. The bleeding in this case is usually slow and steady.

If you are bleeding and you feel faint, or the bleeding is severe, or you are vomiting blood, you should seek emergency attention. Otherwise, make sure to discuss the bleeding with your healthcare provider.  

In ulcerative colitis, bleeding can arise from the lining of the rectum or large intestine, and this blood can be visible in the stool. The bleeding generally comes from the ulcers that have formed in the lining of the large intestine or rectum.

Bleeding in Crohn’s disease is less common than in ulcerative colitis but it depends on where the inflammation is occurring. Crohn’s disease in the colon (large intestine) or rectum is more likely to cause blood in or on the stool. 

You can also develop blood in your stool if you have an anal fissure or a hemorrhoid. Anal fissures are small painful tears or sores in the lining of the anus. Hemorrhoids are swellings around the anus that contain enlarged blood vessels. Find out more information on our Anal Fissures and Hemorrhoids section

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Managing blood in the stool

Bleeding can be part of an IBD flare and inflammation. It might mean you need a change in your medications. Some anti-inflammatory medications for Crohn’s disease and colitis can help stop bleeding.

It may also be necessary to treat the loss of blood that has happened. If you have developed anemia from blood loss, you may need to supplement with iron, folic acid, or vitamin B12, depending on what your health provider says. In serious cases of blood loss, a blood transfusion might be required.

With severe bleeding, called hemorrhaging, you might need surgery to remove the colon and create an ileostomy, but this is rare. An ileostomy, or stoma, is an opening on the abdomen connected to your digestive system to allow waste to be diverted out of your body. 

In patients with ulcerative colitis, after this initial surgery, another surgery can be done to create a J-pouch. A J-pouch is a short name for ileal pouch. In J-pouch surgeries, after the surgeon removes the colon, a pouch shaped like the letter J is created from the end of the small intestine and attached to the rectum. This type of surgery is done to avoid needing a stoma. This is generally not done in Crohn’s disease because there is a possibility the disease could reappear in the J-pouch.

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Mucus in the stool

Your stool normally contains mucus but usually it is not visible. Your intestines produce mucus to protect the inner lining and ease the passage of stool. Passing mucus can be very normal and is not of concern if you are otherwise well.

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