Doctors warn against ignoring blood in stool

Physicians have cautioned Nigerians against dismissing the sight of blood in stool as a minor or temporary issue, warning that it could be an early sign of serious gastrointestinal conditions.

According to them, while some cases may be linked to harmless causes like hemorrhoids, persistent or recurrent bleeding could indicate ulcers, inflammatory bowel disease, or even colorectal cancer.

They noted that many patients often ignore the symptoms until complications arise, making treatment more difficult.

Speaking exclusively with PUNCH Healthwise, Consultant Gastroenterologist, Dr. Olumuyiwa Bojuwoye, explained that blood in stool may present in different forms, including bright red streaks or dark, tar-like stools, each pointing to a different possible source of bleeding within the digestive tract.

He said the presence of bright red blood in stool, medically referred to as hematochezia, in some cases may be life-threatening, while in others, it can be serious and require urgent attention.

Bojuwoye, who is an Associate Professor of Medicine at the University of Ilorin, explained that the most common cause of bloody stool in Nigeria is haemorrhoids, popularly called piles.

According to him, haemorrhoids are enlarged blood vessels in the anorectal region, which can rupture, and when they do, fresh red blood appears in the stool.

He said, “Another cause can be infectious agents, especially those that lead to diarrhoea or what we call dysentery. These infections cause inflammation and irritation in the intestines, leading to blood and mucus in the stool.

“Examples of these infectious agents include organisms like Shigella, Salmonella, Campylobacter, and Entamoeba histolytica (which causes amoebic dysentery). These are usually associated with poor hygiene and consumption of contaminated food or water.

“We also have diverticulosis, which refers to small pouch-like defects in the wall of the colon. These pouches, called diverticula, can bleed, and when they are multiple in the colon, we refer to the condition as colonic diverticulosis. When bleeding occurs from these pouches, we call it diverticular bleeding.”

He explained that another condition involves abnormal blood vessels in the lining of the colon, called arteriovenous malformations or angiodysplasia, which can also lead to bleeding.

“Among all the causes, a very important and potentially life-threatening one is colorectal cancer. Cancer can occur in any part of the colon as well as the rectum, and bleeding may be one of its earliest signs.

“Some people may have bleeding due to anal fissures, which are small tears that occur when a person is passing very hard stool due to constipation. This usually comes with sharp pain during defecation and discomfort when sitting.

“Certain medications, especially anticoagulants and antiplatelets, which are sometimes prescribed in patients with conditions like hypertension, diabetes, or heart disease, can also cause bleeding as a side effect if not properly monitored,” he said.

He urged Nigerians to seek medical evaluation once the symptom is noticed rather than relying on guesswork or home remedies.

Bojuwoye said, “It is very important not to assume that blood in stool is just something minor. While sometimes it may be due to benign causes like haemorrhoids or anal fissures, it could also be something serious like colorectal cancer. Early diagnosis improves treatment outcome, while late presentation reduces treatment options and worsens results/outcomes.”

The expert further advised the public to pay attention to accompanying warning signs such as weight loss, persistent abdominal pain, chronic fatigue (which may be due to anaemia), and changes in bowel habits.

The gastroenterologist said, “The presence of blood in stool should never be taken lightly. For instance, if it is associated with diarrhoea, fever, or abdominal pain, and the symptoms last for up to a week or more, we may begin to consider infectious causes. In such cases, we often need to test the stool to identify the specific organism responsible so that appropriate treatment, including antibiotics where necessary, can be given.

“However, if a person notices blood in their stool along with constipation (difficulty passing stool), passage of pellet-like or paste-like stools, chronic diarrhoea, or experiences alternating episodes of diarrhoea and constipation, that is concerning.

“Also, when there is unexplained weight loss, meaning the person is losing weight without intentionally trying to, we take it seriously. Another important factor is family history. If the individual has a relative (especially a first-degree relative) who has been treated for colorectal cancer or other cancers of the gastrointestinal tract, they should not ignore the symptom.

“Any significant change in bowel habits is also an important red flag. People generally have their natural bowel pattern—some go once daily, some twice daily, some once in three days. When there is a clear and persistent change in that pattern with or without blood in the stool, it should be investigated.”

Early diagnosis, Bojuwoye emphasised, remains key to better outcomes, especially in preventing life-threatening conditions like colorectal cancer.

“Anyone who notices blood in their stool, especially with other symptoms, should see a doctor for proper evaluation. This applies regardless of age. Even children may have conditions such as inflammatory bowel disease, which require specific treatment beyond the use of antibiotics. If not diagnosed early, such conditions can progress and lead to serious complications,” the expert warned.

On his part, a Professor of Public Health, Tanimola Akande, urged Nigerians not to only suspect haemorrhoids when they notice blood in their stools, stressing that it could also be a sign of colon cancer.

He said, “Haemorrhoid is not the only cause of blood in the stool. There are other causes like infection due to amoebic dysentery, bacillary dysentery, and also cancer of the colon.

“In addition to blood in stool for haemorrhoids, other symptoms include painful defecation, constipation, and protrusion of a mass (swelling) from the anus.

“Constipation is also common in people with colon cancer, in addition to blood in the stool. If it progresses, there will be severe weight loss. It is better detected early through screening, even before the onset of symptoms.”

Provided by SyndiGate Media Inc. (Syndigate.info).