Blood in stool is a very common complaint. It occurs in upto 15% of the population. A lot of people never report it and only a few report this to the physician. Small amounts of blood on the surface of the stool is also considered minimal BRBPR, but red blood intermixed with stool is not. Commonly it is from benign causes particularly in younger population. It could however be the first presentin symptom of colorectal cancer.
Hemorrhoids are present in 30-90% of cases. People older than 40 and those with family history of colon cancer should be evaluated with colonoscopy for colon cancer.
Common causes of blood in stool include:
Red flags – Patients with minimal BRBPR in the following categories should undergo additional testing with colonoscopy regardless of age:
History of black stools
Presence of weight loss, anemia, loss of appetite
Change in frequency, caliber or consistency of stools
Positive occult blood in stool
Family history of colon caner
Age over 40
Persistent bleeding despite treatment of hemorrhoids or anorectal lesions