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Bloody or tarry stools

Definition

Bloody stools often are a sign or a problem in the digestive tract. Blood in the stool may come from anywhere along your digestive tract from your mouth to your anus.

Alternative Names

Stools - bloody; Hematochezia; Melena; Stools - black or tarry

Considerations

Heavy or rapid bleeding in the upper GI tract can cause bright red stools.

Eating black licorice, lead, iron pills, bismuth medicines like Pepto-Bismol, or blueberries can also cause black stools. Beets and tomatoes can sometimes make stools appear reddish. In these cases, your doctor can test the stool with a chemical to rule out the presence of blood.

Bleeding in the esophagus or stomach (such as with peptic ulcer disease) can also cause you to vomit blood.

Causes

Bleeding that takes place in the esophagus, stomach, or the first part of the small intestine most often causes the stool to appear black or tarry. Your doctor may use the term "melena."

Bleeding in the upper part of the GI tract will usually cause black stools due to:

Maroon-colored stools or bright red blood often mean that the blood is coming from the small or large bowel, rectum, or anus. The term "hematochezia" is used to describe this finding. 

When to Contact a Medical Professional

Call your doctor right away if you notice blood or changes in the color of your stool. You should be examined by your doctor, even if you think that hemorrhoids are causing the blood in your stool.

In children, a small amount of blood in the stool is usually not serious. The most common cause is constipation. You should still tell your child's doctor if you notice this problem.

What to Expect at Your Office Visit

Your doctor will take a medical history and perform a physical exam that focuses on your abdomen and rectum.

You may be asked the following questions:

You may need to have one or more tests to look for the cause:

References

Jensen DM. Gastrointestinal hemorrhage and occult gastrointestinal bleeding. In: Goldman L, Schfer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2001:chap137.

Laine L, Jensen DM, American College of Gastroenterology guideline for management of patiant with ulcer bleeding. Am J Gastroenterol. 2012; 107;345-360.

Lanza FL, Chan FK, Quigley EM. Practice Parameters Committee of the American College of Gastroenterology. Guidelines for prevention of NSAID-related ulcer complications. Am J Gastroenterol. 2009; 104;728-738.

Lieberman DA. Clinical practice. Screening for colorectal cancer. N Engl J Med. 2009;361:1179-1187.



Review Date: 1/6/2013
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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