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Bloody or tarry stools

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

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

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Lower digestive anatomy

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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 most often 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. It can be due to:

When to Contact a Medical Professional

Call your health care provider right away if you notice blood or changes in the color of your stool. You should see your provider and have an exam even if you think that hemorrhoids are causing the blood in your stool.

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

What to Expect at Your Office Visit

Your provider will take a medical history and perform a physical exam. The exam will focus 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:

Related Information

Diverticulitis
Vomiting blood
Diverticulitis and diverticulosis - discharge
Ulcerative colitis - discharge
Diverticulitis - what to ask your doctor

References

Holster IL, Kuipers EJ. Update on the endoscopic management of peptic ulcer bleeding. Curr Gastroenterol Rep. 2011 Dec;13(6):525-31. PMID: 21918857 www.ncbi.nlm.nih.gov/pubmed/21918857.

Jensen DM. Gastrointestinal hemorrhage and occult gastrointestinal bleeding. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap137.

Laine L, Jensen DM, American College of Gastroenterology guideline for management of patient with ulcer bleeding. Am J Gastroenterol. 2012; 107;345-360. PMID: 22310222 www.ncbi.nlm.nih.gov/pubmed/22310222.

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. PMID: 19240698 www.ncbi.nlm.nih.gov/pubmed/19240698.

Lieberman DA. Clinical practice. Screening for colorectal cancer. N Engl J Med. 2009;361:1179-1187. PMID: 19759380 www.ncbi.nlm.nih.gov/pubmed/19759380.

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Review Date: 1/11/2015  

Reviewed By: Todd Eisner, MD, Private practice specializing in Gastroenterology, and Affiliate Assistant Professor, Florida Atlantic University School of Medicine, Boca Raton, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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