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Can Stress Cause Blood in the Stool?

Can Stress Cause Blood In The Stool

Stress and Blood in the Stool

Stress can contribute to the onset of digestive symptoms, but it can also increase the severity of symptoms.

This can be in the form of a flare-up in IBS symptoms, leading to an increase in:

For some, blood can be a digestive symptom that appears with an IBS flare-up. However, this is not always the case.

It’s also common for stress to trigger a flare-up and once symptoms are more prominent, this may also increase stress, creating a vicious cycle. 

Due to the impact of stress on the body, it is also possible for it to contribute to an increase in symptoms of inflammatory bowel disease. For some, this may lead to a flare-up which can involve an increase in blood. [Source: PubMed]

Does IBS cause blood in the stool?

The underlying issue in the bowel of those with IBS may lead to the presence of blood. In those with IBS, it has been reported that rectal bleeding with fresh blood (often bright red) is present in 17.7% of those with IBS.

In addition to this 12.5% were found to have occult blood in the stool. Occult blood is the term used to describe blood that is not visible to the naked eye. This may indicate bleeding higher up in the digestive tract. While the presence of fresh blood may indicate bleeding closer to the rectum which is often associated with hemorrhoids. [Source: PubMed]

Food Poisoning, tummy bugs and blood in the stool

Post-infectious IBS is defined as IBS symptoms that persist following a gut infection, tummy bug or food poisoning.

During the period of time where the infection or bug is present, there may be an increase in several symptoms. Often these may last for a short period of time as the body deals with the infection.

These symptoms can include

  • Diarrhoea
  • Abdominal cramps
  • Increased stool frequency
  • Blood in the stool
  • Mucous in the stool [Source: PubMed]

The presence of blood in the stool during the acute infectious period can increase the risk of symptoms persisting or developing into IBS. [Source: PubMed]

Why am I pooping blood but no pain?

The presence of haemorrhoids is often painless but if they rupture this tends to lead to blood in the stool.

Haemorrhoids are also referred to as piles which are veins that have swollen at the lower part of the digestive tract. 

While constipation is considered a factor involved in the development of haemorrhoids dyssynergic defecation is another factor. These may increase the pressure in the rectum leading to the swelling of the veins. This swelling may then increase the risk of the veins rupturing and bleeding. [Source: PubMed]

Often when haemorrhoids are internal, they are painless and do not cause any irritation. This may commonly lead to bright red blood on the toilet paper when wiping. 

If the haemorrhoid pushes through the anus, this is termed a protruding haemorrhoid and it is more likely to lead to pain.  [Source: Mayo Clinic]

What is the most likely reason for blood in stool?

One of the most likely reasons for blood in the stool is haemorrhoids. As mentioned, these may not be painful but if they are irritated, they may bleed. This can lead to blood appearing on toilet paper or on the stool itself.

Because this blood is fresh, is it often bright red in its tone. [Source: PubMed]

Haemorrhoids may not always need treatment but in some cases, they may be banded. This is where a tight band is wrapped around the haemorrhoid which reduces the blood supply, causing the haemorrhoid to drop off.

Higher amounts of blood are more commonly seen in cases of inflammatory bowel disease (IBD) as well as in bowel cancer. 

If blood is present this is considered a red flag and a medical examination is required to determine the cause.

What is the cause of black stools?

Black stools can be caused by blood in the stool. While fresh blood is a bright red colour, dark or black stool can indicate blood is present that originates from the upper part of the digestive tract. [Source: PubMed]

This can be from bleeding in the

  • Oesophagus
  • Stomach
  • Small intestine

Possible causes of blood in the stool include:

  • Peptic ulcer
  • Cirrhosis
  • Oesophageal or gastric varices
  • Gastritis
  • Oesophagitis
  • Cancer [Source: PubMed]

Black or tarry stools may require urgent medical attention. 

Is bright red blood in stool an emergency?

Small amounts of bright red blood in the stool may have simple explanations such as haemorrhoids, however, medical attention should be sought out.

This would be to carry out further examination to rule out serious bowel conditions such as bowel cancer or inflammatory bowel disease.

Blood in the stool is considered a red flag symptom which would require further investigation. This may be in the form of stool tests or colonoscopy investigations via a gastroenterologist. [Source: PubMed]

Stress, Blood in stool and Ulcerative Colitis

Stress is understood to be a trigger for an increase in symptoms of inflammatory bowel disease such as Ulcerative colitis. This is where stress can lead to an increase in inflammation in the bowel that may cause inflammation to the gut lining. This may damage the gut to the extent that there is blood that starts to appear in the stool. [Source: PubMed]

This can be via the gut-brain axis with changes in stress levels leading to impacts on the gut microbiome. These stress-induced changes to the gut microbiome may then trigger an inflammatory response in the gut.

Additionally, stress can have an impact on the immune system. Regarding inflammatory bowel diseases such as Ulcerative colitis, this can lead to increased inflammation in the gut. This may be considered a way in which stress can trigger inflammation in the bowel which then leads to blood in the stool. [Source: PubMed]

Also Read: Ulcerative Colitis – How much blood is too much?

What Does Cancerous Blood in Stool Look Like?

Blood in the stool may indicate cancer but there are also other possible causes of blood in stool. These may all look the same and not provide information about the possible causes without further tests being carried out.

Symptoms such as a sudden change in bowel patterns plus unexplained weight loss may also indicate bowel cancer. However, these symptoms are also seen in those with peptic ulcer disease.

In cases where these situations are present, a medical assessment is suggested to determine the cause. [Source: PubMed]

When Should I Start Worrying about Blood in Stool?

Blood appearing in the stool can be stressful and worrying. For those with inflammatory bowel disease or IBS, this stress may lead to an increase in symptoms. 

If any blood appears in the stool, visiting a doctor is considered the best course of action. This may be more of an urgent situation if the stool is black, or tarry or if there is a high amount of blood that is accompanied by pain and fever. These can be more stressful symptoms that should be investigated. [Source: PubMed]

What Does Stress Poop Look Like?

Stress can lead to an increase in gut symptoms such as bloating and in some situations blood in the stool. However, the form of the stool doesn’t always look the same if someone is under lots of stress.

For some, if stress is present constipation may be experienced. This is where it may be hard to pass a stool or bowel movements feel incomplete. In this situation, the stool may look small and lumpy. This may be as type 1 or 2 on the Bristol Stool Chart.

For others, if lots of stress is present, they may experience looser bowel movements or diarrhoea. This can be where the stools are poorly formed or watery. This can be seen as type 6 or 7 on the Bristol Stool Chart. [Source: PubMed, PubMed]

Conclusion

Stress can lead to a wide range of changes in stool form and bowel function. In some, this may lead to blood in the stool, however, this may be more common in inflammatory bowel conditions than it is in IBS. 

While there may be simple explanations for blood appearing in the stool (such as haemorrhoids) if blood is present, medical attention is important. This is to rule out more conditions such as bowel cancer. 

If you are experiencing symptoms of IBS that increase with stress, consider working with a gut health nutritional therapist to get to the root cause of your gut issues.