Why There’s Blood in Your Stool and Next Steps
You accidentally glanced into the toilet before flushing, or perhaps you’ve created a habit of always checking what’s coming out of you. Either way, the sight of blood in your toilet water or stool is always surprising and alarming (whether justified or otherwise).
Simple things like your food can make your stool red, such as eating beets. Other times, blood in the stool can tell valuable information about what’s going on in your gut and where it’s happening.
While in some cases the root causes of seeing blood in your stool will need to be addressed, there are many cases in which simple natural solutions will bring the relief that you seek. Let’s learn more about the most common root causes and triggers of seeing blood in your stool, as well as natural solutions that you can use right away.
What Exactly Does Blood in Your Stool Tell You?
Blood in your stool means that there’s bleeding somewhere along your digestive tract. Sometimes blood is visible on toilet tissue, in the toilet after a bowel movement, or in microscopic amounts by doctors running tests on fecal matter. Blood in your stool could imply serious health issues, but not always. The color and amount of blood is a great way to determine the underlying health issue causing it.
How Do You Get Blood in Your Stool?
Blood in your stool can come from a variety of sources, from infection to medications. The most frequents causes are:
Open sores: An open sore in the lining of the stomach or intestines is known as an ulcer. Ulcers occur when the body’s natural protection against stomach acid is compromised and the mucosal lining of the digestive tissue becomes inflamed, eroding into the blood vessels within the wall of the digestive system.
Many ulcers are caused by bacteria called Helicobacter pylori (H. pylori) or with frequent use of anti-inflammatory drugs like NSAIDs. Sources of external sores include hemorrhoids and anal fissures. Hemorrhoids are swollen blood vessels in the rectum and are the most common cause of anal bleeding. An anal fissure is a tear in the tissue lining of the anal opening. Both can be caused by constipation—expelling slow moving, large and/or hardened stool.
Cancer: Almost all colon and rectal cancers start as a polyp, but not all polyps become cancerous. Colon polyps are growths on the inner surface of the colon that protrude slightly. Most colorectal cancers do not produce symptoms until a tumor has grown to a large size.
Infections/Inflammation: In a sense, gut infections and inflammation are a “chicken and egg” scenario; infections cause inflammation, and inflammation can cause infection. It can be hard to decipher which comes first and will be different for each individual.
- Infections occur when some type of agent is decreasing the health of the gut. The gut contains trillions of beneficial bacteria, and gut health is dependent on them. When the healthy bacteria are thriving, they keep the opportunistic bacteria in your gut in check; however, the balance shifts when stress, poor diet, toxins, or infection change the environment, resulting in an infection such as Candida (yeast) or small intestinal bacterial overgrowth (SIBO). Antibiotics and corticosteroid use can alter the gut flora balance, causing infection.
- Infectious organisms can also cause overt GI infections. Parasites, viruses, and bacteria are all sources of serious GI infections. These infections are often transmitted by contaminated water or food, being in close contact with an infected person, or not washing your hands.
- Inflammation occurs in the lining of the intestinal tract and the location, in addition to the types of symptoms, can help determine which diagnosis is appropriate. Common inflammatory conditions include ulcerative colitis, diverticulitis, celiac disease, irritable bowel syndrome, and irritable bowel disease. Inflammation in the intestines can also be produced by dysbiosis, stress, medications, diet, autoimmunity, and toxins. Alcohol is a toxin to the body, and chronic alcohol use is a significant mediator of intestinal inflammation.1
Where’s the Bleeding Coming From?
Bleeding can occur anywhere in the gastrointestinal tract. The color and amount of blood can give an indication of what may be happening in your gut.
- Bleeding from the anus caused by hemorrhoids or anal fissures tends to be bright red and fresh, often seen on toilet paper. It may not be mixed into the stool, but rather seen after passing stool or as streaks of blood covering the stool.
- Bleeding from the colon is often mixed with the stool and may be darker red in color, as seen in gastrointestinal inflammatory conditions. There can be instances where brighter red blood is seen on the stool from a sudden large bleed from diverticulitis or ulcerative colitis. Sometimes parasitic infections can produce blood in the stool that is red to dark red depending upon its location.
Bleeding from the stomach or small intestine travels the length of the intestinal tract and gets mixed in with the stool. The stool can be plum or black in color. If this is the case, it may signal an emergency, and proper steps should be taken immediately. This condition is known as melaena and can indicate a large amount of bleeding.
- Aside from the blood that you’re able to see (and presumably that you’ve seen) in your stool, there are actually times when there can be a small amount of blood in your stool that isn’t visible to the naked eye. For instance, a colon polyp may bleed with no other symptoms. Upper GI ulcers may also produce small bleeds not visible in your stool, and physical symptoms often lead to a diagnosis.
What Triggered The Blood in Your Stool?
There are many triggers that can irritate and damage the gut lining ranging from commonly prescribed medications to infections and stress. All of these leave the gut vulnerable to the effects of the inflammatory process.
Open sores, or ulcers, can be caused by infections such as H. pylori infection or medications. H. pylori bacteria can cause inflammation in the stomach, or less frequently the intestinal lining, that can produce acid reflux, ulcers, and decreased stomach acid.
Common medical treatment for H. pylori, acid reflux, and ulcers are acid-blocking medications known as proton pump inhibitors (PPIs) or over-the-counter antacids. Both of these reduce the production of the stomach acid. However, this also reduces the stomach’s ability to kill harmful ingested microorganisms and decreases the ability to break down the food into nutrients that can be easily absorbed.
This can result in an increase of opportunistic microorganisms like bacteria, yeast, fungus, and parasites in the gut as well as nutrient deficiencies. Additionally, NSAID medications commonly cause direct damage to the intestines, creating inflammation, ulcers, and intestinal perforations.2
Infection can be a trigger itself, or the antibiotics used to treat the infection may produce bloody stools. Antibiotic use eliminates both good and bad bacteria, and corticosteroids decrease the efficiency of the immune system.
When the opportunistic microorganisms recover quicker than the good bacteria or when the immune system is down, infection can occur.
Opportunistic bacteria like C. difficile release a toxin that causes inflammation and bleeding in the lining of the colon. This causes watery diarrhea, bloody stools, and abdominal cramping and tenderness.
Parasites can be acquired by swimming in or drinking contaminated water, consuming contaminated food, walking barefoot, or not washing your hands after using the bathroom, changing a diaper, or even petting your animals. Entamoeba histolytica is a parasite that lives in the large intestine and can create deep lesions in the tissue, producing blood.
External sores are sources of blood from hemorrhoids and anal fissures that can occur more frequently with hard, slow-moving feces associated with the constipation that accompanies a low-fiber or low-water diet, autoimmune conditions, or infection.
Inflammation is one of the most common triggers of blood in the stool and can result from a variety of sources. Diverticulitis is a condition where pouches in the colon become inflamed from trapped feces. The pouches can then burst, causing sudden, severe bleeding with little or no pain. The bleeding usually stops on its own.
Irritable bowel syndrome (IBS) is a disorder that affects the large intestine. Symptoms include cramping, abdominal pain, gas, diarrhea, and constipation, but there is an absence of actual tissue changes like those seen in Irritable Bowel Disease. Certain foods or emotional states can trigger IBS symptoms like spicy foods, fatty foods, and stress. Parasites and small bacterial overgrowths can also produce IBS-like symptoms.
Irritable bowel disease (IBD) is an autoimmune (AI) disease that typically presents as either ulcerative colitis or Crohn’s disease. Ulcerative colitis produces inflammation in the colon, while Crohn’s produces inflammation deep in the tissues of the colon and/or small intestine.
The AI process results in inflammation that infiltrates the intestinal lining and causes bleeding and pain. The exact mechanisms of IBD remain unknown, but current theories maintain that it may be viral or fungal proliferation following antibiotic treatment or an autoimmune response to various organisms in the gut. The known mechanism that is at the root of all AI conditions is leaky gut, which is a product of the inflammation and dysbiosis.
Root Causes of Blood in Your Stool
Many factors can influence gut health, and an imbalanced gut flora and inflammation are produced as a direct result of the root cause mechanisms that underlie bloody stool.
Low Stomach Acid: The most common causes of low stomach acid include H. pylori, other GI infections, and the use of antacids or proton pump inhibitors. The natural aging process also decreases stomach acid production.
Low Levels of Beneficial Bacteria: All health begins in the gut. When the good bacteria are lacking, bad microorganisms flourish, digestive processes work poorly, leaky gut is more likely, and digestive or autoimmune conditions occur. Lifestyle factors such as stress, toxin exposure, and diets low in fiber and prebiotics, low in probiotics, and high in carbohydrates or sugar contribute to low levels of good gut bacteria.
Leaky Gut: A diet high in gluten can cause intestinal permeability, as can any other food intolerance or sensitivity. Additional factors stemming from environmental toxins and low beneficial bacteria can compound the effects of a leaky gut. This can activate the immune system to attack the body’s tissues, creating autoimmune conditions and inflammation as seen in ulcerative colitis, Crohn’s, and Celiac disease.
Stress: Stress, anxiety, and repressed emotions influence the development of digestive disorders. Stressors can be from relationships, finances, work, infection, overexercising, or chronic disease. Managing stressors will promote a healthy gut.
Root Cause of Blood in Stool: Low Stomach Acid
Low stomach acid levels create an environment that is favorable for H. pylori to flourish. H. pylori further reduces stomach acid levels to create a more hospitable environment for itself, compounding the situation.
Even worse, this leaves you more vulnerable to other GI infections like parasites, viruses, and other bacteria, because adequate levels of stomach acid are a first line defense against these pathogens.
Frequently, acid reflux is caused by low stomach acid instead of too much stomach acid, and you might be prescribed acid-blocking medications such as antacids or a proton pump inhibitors (PPI), which further decrease already low stomach acid levels.
Low stomach acid, in addition to acid-blocking medications, severely reduces the ability of the stomach to break down food and nutrients for absorption. It also delays digestion time, as the stomach and other GI organs need to work harder to perform normal digestive processes.
Root Cause of Blood in Stool: Low Levels of Beneficial Bacteria
Diets low in fiber are lacking nutrition for the beneficial bacteria. Fiber is the fraction of plant tissue that humans can’t digest, but the beneficial bacteria can feed from it and proliferate. Foods high in prebiotic fiber include green bananas, blueberries, onions, garlic, chicory, and artichokes. Fiber also helps soften stool and protects against constipation. Foods high in fiber include fruits, vegetables, and seeds like chia seeds or flax seeds.
Diets low in probiotics are unable to replenish the probiotics that die off each day. Beneficial bacteria can die from the additives, preservatives, colorings, pesticides, herbicides, genetically modified organisms, and other chemicals like artificial sweeteners found in our food supply.18,19 Choose organic food and make your food from scratch whenever possible. Eating fermented foods daily is another way to ensure probiotic repopulation. Fermentation is an ancient way of preserving food, before canning was developed. In short, fermentation involves healthy bacteria producing acid in a solution with the food that is being preserved. The acid produced prevents bad bacteria from growing. Fermented foods include refrigerated sauerkraut, kefir, kimchi, fermented organic soybeans, and kombucha tea. A strong, healthy gut perpetuates a strong immune system, which results in less susceptibility to infections, inflammation, and autoimmune conditions.20
A diet high in carbohydrates and sugar feeds harmful or opportunistic bacteria and yeast, as well as pathogens. When harmful organisms increase, susceptibility to infections and inflammation increases as well.
Root Cause of Blood in Stool: Leaky Gut
Leaky gut refers to increased intestinal permeability that occurs when inflammation leads to the breakdown of the mechanism that controls the spaces between the intestinal cells, allowing them to become looser. This allows the “leaking” of either larger and/or foreign particles through to your bloodstream, activating the immune system.
Expert on leaky gut Dr. Tom O’Bryan, DC explains the condition by comparing the intestinal lining to cheesecloth. Normal cheesecloth lets the digested nutrients that the body needs through into the blood. Leaky gut is when there are tears in the cheesecloth, letting larger particles through. The immune system does not recognize these particles and launches an attack, further increasing inflammation.
Some of the protein particles that enter can closely resemble proteins found in various body parts, like our thyroid or joint tissue, and the “confused” immune system begins attacking the proteins in our body.21 This is one way leaky gut contributes to autoimmune conditions.
Food sensitivity and allergy are significant contributors to leaky gut. The most common is gluten, which is a protein found in wheat, rye, and barley. Gliadin, a component of gluten, is what makes tears in the cheesecloth. Gliadin opens up the spaces between the cells of the intestinal lining in most people, letting larger food particles and bacteria through, activating the immune system.
If gluten products are eaten with most meals, the immune system flares up multiple times per day. Gluten sensitivity activates an immune response in the intestinal wall, creating inflammation in the gut as well as throughout the rest of the body.22 Other foods that commonly contribute to inflammation and leaky gut are dairy, soy, corn, eggs, and nuts. Genetically modified organism (GMO) foods also promote leaky gut by the toxins they release in the digestive tract.23
Root Cause of Blood in Stool: Stress
It’s well known that stress can influence how the digestive system works. Having indigestion or a strong urge to go to the bathroom when experiencing stress or nervousness is familiar to most people.
Research shows that chronic stress changes the cell lining of the gut, making it leaky and inflamed. Research is also finding that there is a bidirectional line of communication between the gut bacteria and the brain. This line of communication is known as the gut-brain axis. Emotions can change the populations of gut bacteria, and gut bacteria can influence emotions.24
Your body does not discern between different types of stress, which can include relationships, finances, work, infection, overexercising, food sensitivities, toxins, or chronic disease; it just responds by increasing levels of the stress hormones cortisol and adrenaline. Managing your stressors is essential to long-term GI health. Stress management techniques include exercise, meditation, yoga, deep breathing, laughter, talking to a trusted person, journaling, creating boundaries, staying organized, creating lists, doing things you love to do, and getting outside.
Supplementing with probiotics during stressful periods has been shown to decrease stress-induced intestinal damage.25 Probiotics combined with avoidance of food sensitivities and allergies will help maintain a healthy intestinal lining and digestive health.
Natural Relief from Blood in Your Stool
Natural interventions can provide relatively quick relief to the frustrating symptoms that cause blood in stool. However, it is important to keep in mind that lifestyle changes will provide long-term solutions.
Ulcers can benefit from a variety of treatments, and knowing the cause is essential to effective treatment. Ulcers from H. Pylori are typically treated with antibiotics or botanicals. Dr. Mark Hyman recommends a triple antibiotic treatment.3
However, a resin from a Mediterranean and Middle Eastern variety of pistachio tree called mastic has shown some ability to kill several strains of H. pylori, including some resistant to conventional antibiotics. Trying mastic first, followed by antibiotics if the mastic treatment is not effective, is one approach.4
NSAIDs are used for pain relief, but can cause direct damage in the intestinal tract. Turmeric is a powerful anti-inflammatory herb that has demonstrated in numerous studies to be equally effective or superior to over-the-counter and prescription NSAIDs.5 Turmeric is a traditional spice used in Indian cooking and can be purchased in the spice aisle or as a raw root. Ingesting turmeric with black pepper enhances its bioavailability and absorption.6
GI pain and inflammation can also be reduced by other herbs as well.
Both slippery elm and chamomile can coat and soothe the intestinal tract and be taken as a tea.
Licorice extract demonstrates strong anti-inflammatory properties and is appropriate for short-term use.14 Licorice in the form of DGL has soothing properties to the intestinal mucosa.
Krill oil, superior to fish oil, contains essential fatty acids that down-regulate inflammation and can reduce IBD symptoms.15
Ginger is protective against the formation of ulcers and improves digestion. Ginger tea can be made by adding 2-3 slices of ginger to 2 cups of hot water, then steeping for 30 minutes.7
Witch hazel is a plant traditionally used for hemorrhoids and bruises. It’s a liquid that is distilled from dried leaves, bark, and partially dormant twigs of Hamamelis virginiana. The astringent properties of witch hazel can shrink inflamed veins and provide an instant effect on irritated hemorrhoid tissue, relieving itching, burning, and general discomfort.
Constipation can be relieved by increasing water intake to at least 64 ounces of water per day and by supplementing with psyllium fiber, chelated magnesium, or completing a vitamin C flush.8,9,10 These methods should be only used short-term, as supplements and herbs can be unpredictable and produce sudden urges to go the bathroom. They can also increase your dependence on them. Identification of the root cause is key to resolving constipation.
Infections in the gut can easily occur when the healthy gut bacteria are decreased. The beneficial bacteria in the gut act as a defense system because they crowd out much of the bad bacteria and provide resilience to parasites.
Healthy gut bacteria also protect against inflammation in the gut. Antibiotics can be over-prescribed, and they are sometimes even prescribed for viral infections. Using antibiotics only when necessary and making sure you are actually treating bacterial infection will help you avoid altering your gut bacteria and developing resistance.
If you take antibiotics, adding probiotics is essential to help replenish the good bacteria that are killed from the antibiotics.11
Parasites can be killed by herbs such as oregano oil and garlic supplements.12,13 Reduce exposure to parasites by avoiding contaminated water, properly washing and preparing food, and washing your hands after using the toilet.
Stress reduction and an anti-inflammatory diet can also help reduce inflammation and reverse the bleeding. Avoiding trigger foods will also decrease inflammation. As you can gather, lifestyle changes are of significant importance to the long-term management of an inflammation-based condition.