Talk:Blood in stool

message: Is anybody going to cover that a common phenomenon is that people find blood in their stool after a night of drinking? I've heard of this before, and when you google it a lot of people report the same phenomenon. I found one explanation that said that your blood flow to your liver gets constricted as your liver tries to process the blood to remove alcohol, and then there is a back up of blood, and that back up goes to the rectum, since a third of the arteries from your rectum/lower intestine go to your liver, and the back up of blood sometimes leaks and causes blood in the stool.  — Preceding unsigned comment added by 108.170.95.180 (talk) 14:51, 22 August 2012 (UTC)
thread_title:  After drinking 

message: * Can eating black pudding cause 'blood in stool'? Anthony Appleyard (talk) 17:51, 18 July 2010 (UTC)
thread_title:  [[Black pudding]]? 

message: Thanks for the reverts. I edited too hastily and wasn't aware of the disambig. guidelines. Kind regards, LT90001 (talk) 21:55, 21 September 2013 (UTC)
thread_title:  Reverts - thanks 

message: The tests that are considered for evaluation of the passage of blood in the stool is based on characteristic of bleeding (color, quantity) and whether or not the person passing blood has a low blood pressure with elevated heart rate, as opposed to normal vital signs. These tests are combined to determine which of the causes below is the source of bleeding.
* Digital rectal exam (DRE) and fecal occult blood test (FOBT)
* Colonoscopy
* Anoscopy
* EGD
* Capsule endoscopy
* CT Scan
Melena is defined as dark, tarry stools, often black in color due to partial digestion of the RBCs
Hematochezia is defined as bright red blood seen in the toilet either inside of, or surrounding the stool
Hematochezia is typically presumed to come from the lower portion of the GI tract, and the initial steps of diagnosis include a DRE with FOBT, which if positive, will lead to a colonoscopyKasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. 'Harrison's Principles of Internal Medicine, 19e New York, NY: McGraw-Hill; 2014. . If bleeding is large in volume, the evaluation may also include an EGD. If no source of active bleeding is found on these examinations, a capsule endoscopy may be performed, in order to more closely examine the small bowel, which cannot be seen with the other types of studies. With melena, a DRE with FOBT is often also performed, however the suspicion for a source from the upper GI tract is higher, leading first to the use of EGD with the other tests utilized if no source is identified. The anoscopy is another examination, which can be used as an adjunct to the colonoscopy, which exams the rectum and distal portion of the descending colon.
Color         	Medical term	Frequency  	Quantity        	Types of bleeding considered
Bright red    	Hematochezia	Occasional 	Small           	HemorrhoidsHemorrhoids, National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health., inflammatory conditions, polyps
Bright red    	Hematochezia	Continous  	Large           	Upper or lower GI tract source of bleeding as a result of numerous causes (see below), rapid bleeding
Dark red/black	Melena      	Every stool	Mixed with stool	Upper GI tract source, peptobismol and iron use can mimic melena
::
:::@JenOttawa you would be correct that some of this is the content I originally inserted,  however, I changed it on the talk page in an effort to make it better meet the standards for WikiMedicine articles. I reorganized some of the sections using the same information in hopes that these sections would better adhere to the guidelines, while still covering the same information. Sarahguess5 (talk) 16:51, 6 December 2017 (UTC)
replies: text: Thanks for the note . Thanks as well for re-organizing the article as per WP:MEDMOS. As long as the modifications/edits already made by WikiProject Medicine volunteers to your content (in the actual article) are maintained, just so we do not have to go through it all over again! JenOttawa (talk) 17:19, 6 December 2017 (UTC)
replies: text: @JenOttawa I definitely understand. I will be sure to check through it again during my work today, to ensure that content is maintained. Thanks  for the help! Sarahguess5 (talk) 17:22, 6 December 2017 (UTC)
thread_title:  Evaluation 

message: Age is an important indicator for the diagnostic workup that is considered for the presence of blood in stool, as a result of the diagnoses that tend to affect each age group.  
Age        	Group      	Types of bleeding considered
<20 years  	Pediatric  	Inherited/autoimmune condition or structural
20-60 years	Middle aged	Inherited/autoimmune condition, vascular malformation
>60 years  	Elderly    	Vascular malformation, liver disease, cancer
Sarahguess5 (talk) 02:36, 4 December 2017 (UTC)
thread_title:  Patient Age 

message: Blood in the stool can come from many sources. The causes range from not harmful to very serious conditions. A common way to divide causes of bleeding is based on the source of bleeding. The GI tract can be divided into upper and lower, with some causes of bleeding affecting the entire tract. Blood in the stool often appears different depending on its source, guiding the diagnostic approach of these conditions, however, depending on the rate of bleeding, it can appear different from the typical presentation of the source. 
=== Upper GI tract ===
The upper GI tract is defined as the organs involved in digestion above the ligament of Trietz and is comprised of the esophagus, stomach, and duodenum. Upper gastrointestinal bleeding is typically characterized by melena, however bright red blood can be seen with active, rapid bleeding.
=== Lower GI tract ===
Bleeding of the lower GI tract will typically appear as hematochezia and can vary in degree of seriousness. Slow bleeding from the ascending portion of the colon can result in partial digestion of the blood and the appearance of melena in the stool.
=== Pathophysiology ===
The development of blood in stool results from a variety of conditions, which can be divided into major categories of disease process. These broad categories include cancerous processes or abnormal structure of bowel wall, inflammatory disease, colitis caused by infection or medications and vascular compromise.
==== Neoplasm ====
* Colorectal cancer
* Gastric cancer
==== Gut wall changes ====
===== Motility =====
The gut wall is important to the movement of waste products through the GI tract. When compromise occurs at varying points along the tract
* Constipation
===== Structural =====
This list of diagnoses include diseases in which the wall of the bowel is compromised by disease.
* Peptic ulcer disease  - divided into either duodenal or gastric ulcers,  most common common causes include:
** NSAID medication
** H. pylori infection
** Chronic disease
* Diverticulosis
* Meckel's diverticulum
===== Inflammatory bowel =====
* Crohns disease
* Ulcerative colitis
==== Colitis ====
Enteritis - inflammation of the small intestine, which may be caused by various forms of as well as by other conditions:
===== Infectious =====
* Food poisoning - the bacteria that is associated with bloody diarrhea is typically E. coli
* Campylobacter enteritis
* ShigellosisShigellosis, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention
* Salmonellosis (salmonella enteritis/samonella enterocolitis)
* Bacterial gastroenteritis
** Campylobacter jejuni
** Clostridium dificile
** Escherichia coli enteritis - most common cause of travelers' diarrhea
** Salmonella enterica
** Shigella dysenteriae see also dysentery
* Staphylococcus aureus
===== Drug-induced =====
* Radiation enteritis
* NSAID induced peptic ulcer (reference above)  — Preceding unsigned comment added by Sarahguess5 (talk • contribs) 17:29, 6 December 2017 (UTC)
thread_title:  Differential diagnoses and pathophysiology 

message: The development of blood in stool results from a variety of conditions, which can be divided into major categories of disease process. These broad categories include cancerous processes or abnormal structure of bowel wall, inflammatory disease, colitis caused by infection or medications and vascular compromise.
==== Neoplasm ====
* Colorectal cancer
* Gastric cancer
==== Gut wall changes ====
===== Motility =====
The gut wall is important to the movement of waste products through the GI tract. When compromise occurs at varying points along the tract
* Constipation
===== Structural =====
This list of diagnoses include diseases in which the wall of the bowel is compromised by disease.
* Peptic ulcer disease  - divided into either duodenal or gastric ulcers,  most common common causes include:
** NSAID medication
** H. pylori infection
** Chronic disease
* Diverticulosis
* Meckel's diverticulum
===== Inflammatory bowel =====
* Crohns disease
* Ulcerative colitis
==== Colitis ====
Enteritis - inflammation of the small intestine, which may be caused by various forms of as well as by other conditions:
===== Infectious =====
* Food poisoning - the bacteria that is associated with bloody diarrhea is typically E. coli
* Campylobacter enteritis
* ShigellosisShigellosis, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention
* Salmonellosis (salmonella enteritis/samonella enterocolitis)
* Bacterial gastroenteritis
** Campylobacter jejuni
** Clostridium dificile
** Escherichia coli enteritis - most common cause of travelers' diarrhea
** Salmonella enterica
** Shigella dysenteriae see also dysentery
* Staphylococcus aureus
===== Drug-induced =====
* Radiation enteritis
* NSAID induced peptic ulcer (reference above)  — Preceding unsigned comment added by Sarahguess5 (talk • contribs) 17:29, 6 December 2017 (UTC)
thread_title:  Pathophysiology 

message: Enteritis - inflammation of the small intestine, which may be caused by various forms of as well as by other conditions:
===== Infectious =====
* Food poisoning - the bacteria that is associated with bloody diarrhea is typically E. coli
* Campylobacter enteritis
* ShigellosisShigellosis, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention
* Salmonellosis (salmonella enteritis/samonella enterocolitis)
* Bacterial gastroenteritis
** Campylobacter jejuni
** Clostridium dificile
** Escherichia coli enteritis - most common cause of travelers' diarrhea
** Salmonella enterica
** Shigella dysenteriae see also dysentery
* Staphylococcus aureus
===== Drug-induced =====
* Radiation enteritis
* NSAID induced peptic ulcer (reference above)  — Preceding unsigned comment added by Sarahguess5 (talk • contribs) 17:29, 6 December 2017 (UTC)
thread_title:  Colitis 

message: * Radiation enteritis
* NSAID induced peptic ulcer (reference above)  — Preceding unsigned comment added by Sarahguess5 (talk • contribs) 17:29, 6 December 2017 (UTC)
thread_title:  Drug-induced 

message: * Angiodysplasia of the GI tract
* Arteriovenous malformation
* Anal fissure
* Esophageal varices
* HemorrhoidsHemorrhoids: Symptoms, Mayo Clinic.
** Internal hemorrhoids are covered by a layer of mucosa and epithelium, making them more likely to bleed, but typically do not cause pain
** External hemorrhoids are less likely to bleed, they are covered by a different type of epithelium(squamous) but can cause significant pain as a result of thrombosis of the blood vessels within them
* Polypectomy during a colonoscopy can lead to a small amount of bleeding seen in the stool after the procedure
Sarahguess5 (talk) 18:12, 3 December 2017 (UTC)
thread_title:  Vascular compromise 

message: Hi  please put all citations after punctuation, no spaces. I have corrected it up to "inflammatory bowl", but more needs to be done. There is also, generally, not a need to place citations in the middle of sentences. We sometimes use them after a comma if you are making a list, but try not to do this in all sentences as it makes it harder to read. Good work so far on your suggestions, I am out of time right now to review this. Please finish going through the article and correct the placement of citations. Thanks again,
JenOttawa (talk) 02:44, 9 December 2017 (UTC)
replies: text: JenOttawa thanks for the recommendation. I went back through the article and fixed any misplaced citations.Sarahguess5 (talk) 20:50, 10 December 2017 (UTC)
replies: text: Thanks very much .Looking good so far. Thanks for improving this article! JenOttawa (talk) 20:56, 10 December 2017 (UTC)
replies: text: Happy to help!! Thanks JenOttawaSarahguess5 (talk) 03:02, 14 December 2017 (UTC)
thread_title:  placement of citations 

message: Wiki article peer review on blood in stool:
The article is very clear and understandable. The lead paragraph is strong and gives me a clear understanding of what blood in the stool is and a brief description of the two main kinds of described blood in the stool (hematochezia and melena). There is, by nature of the topic, lots of medical jargon that had to be used, but there are embedded links when appropriate and terms are defined when appropriate. 
Everything in the article is relevant to the topic. If there was previous excess information, it has now been removed, and every part of the article is essential for getting a full, clear picture of blood in the stool. 
The pathophysiology and evaluation sections of the article are heavier with medical jargon. In my opinion, this is by necessity. However, it would be difficult for a nonmedical person to read and understand these sections without going to other Wikipedia pages for further definitions. The author did a great job of minimizing confusion by embedding many other wikipedia pages for further clarification, which I think is the best solution to problems understanding medical jargon in this article. 
The article is neutral and balanced. There are no statements or words present that would bias the reader toward and particular position. The article is purely informational and provides appropriate references after factual statements. The references provided support the statements where they were cited. The information is summarized nicely from the sources in the Wiki article writer’s own words, and I can see no concern for plagiarism. The majority of the sources were published in the last 5 years but there are some references from 1990—however, the information from these references is concerning history and physical exam, which is information that has not changed and is still relevant to the topic currently. 
Things to change or add: I think it could potentially be helpful to provide images of melena and hematochezia. While there are links to both of these words for further information, I think it could add value to this particular article. Also, I think the table in the evaluation section could be simplified a little to make it easier to read. 
Great job! You’ve done really good work. Vway2209 (talk) 00:41, 11 December 2017 (UTC)
replies: text: Vway2209 Thank you for the great recommendations. I was having a hard time deciding whether to add those photos, so your feedback is helpful. I will also work on that table. Sarahguess5 (talk) 20:16, 13 December 2017 (UTC)
replies: text: So I have searched high and low for a publicly available image of melanic stool to add to this article with no success. I will continue to look and bring it up in a conversation with those who may be able to help more. Another thought is to include the image available for black blood in the upper GI article. Sarahguess5 (talk) 03:05, 14 December 2017 (UTC)
thread_title:  Wiki Article Peer Review