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Blood in Stool Diagnosis

It is important to have a doctor evaluate any bleeding in the stool. Any details you can give about the bleeding will help your doctor locate the site of bleeding. For example, a black, tarry stool is likely an ulcer or other problem in the upper part of the digestive tract. Bright red blood or maroon-colored stools usually indicate a problem in the lower part of the digestive tract such as hemorrhoids or diverticulitis.

After getting a medical history and doing a physical exam, the health care provider may order tests to determine the cause of bleeding. Tests may include:

Nasogastric lavage. A test that may tell your doctor whether bleeding is in the upper or lower digestive tract. The procedure involves removing the contents of the stomach through a tube inserted into the stomach through the nose. If the stomach does not contain evidence of blood, the bleeding may have stopped or is more likely in the lower digestive tract.

Esophagogastroduodenoscopy (EGD). A procedure that involves inserting an endoscope, or flexible tube with a small camera on the end, through the mouth and down the esophagus to the stomach and duodenum. The doctor can use this to look for the source of bleeding. Endoscopy can also be used to collect small tissue samples for examination under a microscope (biopsy).

Colonoscopy. A procedure similar to an EGD except that the scope is inserted through the rectum to view the colon. As with an EGD, colonoscopy can be used to collect tissue samples to biopsy.

Enteroscopy. A procedure similar to EGD and colonoscopy used to examine the small intestine. In some cases this involves swallowing a capsule with a tiny camera inside that transmits images to video monitor as it passes through the digestive tract.

Barium X-ray. A procedure that uses a contrast material called barium to make the digestive tract show up on an X-ray. The barium may either be swallowed or inserted into the rectum.

Radionuclide scanning. A procedure that involves injecting small amounts of radioactive material into a vein and then using a special camera to see images of blood flow in the digestive tract to detect where bleeding is happening.

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