Why There Might Be Bloody Mucus In Your Stool
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Medically reviewed by Robert Burakoff, MD
Bloody mucus in your stool can be a symptom of several conditions. The blood and mucus you have when you make a bowel movement may be due to proctitis, which is inflammation to the rectum, or damage to the rectum. Several conditions can cause inflammation and damage to the rectum, some of which are temporary and some of which are chronic. With proper treatment, the inflammation or damage can be stopped or minimized and the bloody mucus eliminated.
Inflammatory Bowel Disease
There are two forms of inflammatory bowel disease (IBD): ulcerative colitis and Crohn's disease. The chronic conditions cause inflammation and damage to the lining of the intestines, leading to symptoms like abdominal pain and changes to your bowel movements. You might also see bloody mucus in your stool if you have IBD.
Ulcerative Colitis
Ulcerative colitis causes the inner lining of the rectum and colon, or large intestine, to become inflamed. The condition can lead to a variety of symptoms, a common one being bloody stool. People with ulcerative colitis may also pass mucus or pus with their stool.
In addition to making it seem like your stool has bloody mucus in it, ulcerative colitis can cause the following symptoms:
Diarrhea
Stomach pain and cramps
A sensation of needing to pass a bowel movement even if you don’t have to
An urgent need to make a bowel movement
Symptoms can range in severity. And symptoms may come and go in periods known as flares and remission.
Ulcerative colitis can develop at any age, but it most commonly develops among people who are aged 15 to 30.
Crohn's Disease
Crohn’s disease most often causes inflammation at the end of the small intestine and the beginning of the colon, but it can affect any part of your digestive tract. If the inflammation affects the lining of your rectum, you may see blood and mucus with your stool.
The most common symptoms of Crohn’s disease are diarrhea, stomach cramps, and abdominal pain. other symptoms may include:
While someone can develop Crohn's disease at any age, it most often develops between the ages of 20 and 29.
Infections
Some infections can cause inflammation of your rectum's lining, leading to the presence of blood and mucus when you have a bowel movement.
Certain sexually transmitted infections (STIs) can make your rectum inflamed and cause bloody mucus in your stool. These STIs include:
Bacterial infections that inflame the rectum can also lead to bloody mucus in the stool. The intestinal infections are typically caused by food poisoning, or consuming food or drinks that are contaminated with bacteria like Salmonella, Shigella, or Campylobacter.
Clostridioides difficile (C. diff) is another infection that can lead to inflammation of the rectum and cause you to pass blood and mucus with your stool. People may develop C. diff while they are taking or shortly after they have taken antibiotics.
Radiation
Radiation to treat cancers of the pelvis or lower abdomen—such as cervical, prostate, and rectal cancers—can damage the lining of your rectum. The damage is referred to as radiation proctopathy. Signs of radiation proctopathy include blood and mucus with your bowel movements.
Symptoms of any radiation-related injury to your rectum typically take about six to 12 months to develop. However, it can take years after the therapy for symptoms to appear. Besides blood and mucus production, radiation proctopathy may also cause diarrhea, an urgency to make a bowel movement, or the inability to make a bowel movement even though you feel like you need to go.
Ostomy Surgery
An ostomy is a surgery to create an opening in your body so that your waste can be rerouted from your intestinal tract to a pouch that is on the outside of your body. An ostomy might be needed for certain digestive conditions.
If part of your rectum is remaining following ostomy surgery, your rectum can become inflamed. The inflammation can cause you to pass blood and mucus with your bowel movements.
It's unclear why the inflammation happens following an ostomy, but the inflammation will usually go away after a follow-up surgery to close the ostomy.
Editor's Note: Irritable bowel syndrome (IBS) is a group of digestive-related symptoms that occur together. While mucus in the stool is a typical symptom of IBS, blood in the stool is not. However, constipation and diarrhea—two main symptoms of IBS—can lead to tiny tears in your anal canal known as anal fissures, which can cause anal bleeding. So while you might see blood and mucus when making bowel movements, it would not be IBS alone causing it but may be IBS in combination with a complication of anal fissures.
Should You Be Concerned About Bloody Mucus In Stool?
If you notice bloody mucus in your stool, you should contact a healthcare provider. You should especially get medical advice if that bloody stool is accompanied by severe abdominal pain.
Bloody mucus may be a sign of a short-lasting condition that can go away on its own, like food poisoning. It may also be an expected side effect of a treatment you've received for a condition, as in the case of radiation or ostomy for cancer. But bloody stool may be a sign of a condition that needs long-lasting treatment, such as IBD. Only a healthcare provider will be able to let you know for sure what is causing the bloody mucus in your stool.
Diagnosis
To determine the reason that you could be noticing bloody mucus when you have a bowel movement, your healthcare provider will ask you about your symptoms and when they started. They will also review your medical history, your family's history of digestive conditions, and any medications you’re taking. They might also ask about your history or risk factors for STIs.
They may also perform a physical exam, which could include feeling the inside of your rectum with their fingers to check for any problems, like signs of inflammation.
Depending on your history, symptoms, and physical exam, they may perform a diagnostic test, such as a blood or stool test. They may also perform a rectal culture, which is when they swab your rectum for a sample of any bacteria that might be there.
To look inside your intestines and potentially take any samples for testing, a healthcare provider may also perform an endoscopy such as a colonoscopy or flexible sigmoidoscopy. While a colonoscopy views the lining of your entire colon, a flexible sigmoidoscopy views the lining of only your rectum and lower colon.
Treatment
The treatment options for bloody mucus in your stool will depend on the underlying cause.
IBD is a chronic condition that cannot be cured. Instead, the goal with ulcerative colitis and Crohn's disease is to manage symptoms by reducing inflammation. Medication like mesalamine (sold under brand names Lialda and Canasa) or corticosteroids is one way to reduce inflammation.
If Crohn's disease symptoms are severe, it might be recommended that you go on bowel rest. This would mean going on a liquid diet for a few days to weeks so that your intestines can heal.
For both forms of IBD, surgery to remove the affected part of your intestines is another treatment option.
If an infection is causing your bloody mucus, you will need to clear the infection. Treatment depends on what infection is causing the symptom. For instance, Salmonella infection usually clears on its own in four to seven days. If you have diarrhea, you should drink plenty of water to avoid dehydration. Antibiotics may be recommended in severe cases or for certain populations, such as people who 65 or older.
Treatment for radiation proctopathy is not so clear-cut, but a wide range of therapies have been used and shown to potentially be helpfully. These therapies include non-steroidal anti-inflammatory drugs (NSAIDs) and vitamins A, C, and E.
If you experience bloody mucus in your stool after ostomy surgery, the symptom should go away once you have a second surgery to close the ostomy and reconnect your rectum to the rest of your intestines. If you are unable to have the reconnecting surgery, then treatment may include an enema of short-chain fatty acid or topical medications like mesalmaine or glucocorticoids.
A Quick Review
Bloody mucus in stool is usually due to inflammation or damage to your rectum. Conditions like ulcerative colitis or Crohn's disease might be causing the symptom. Sexually transmitted infections or food-related illnesses could also be the cause. If you've had radiation treatment to your lower abdomen or have undergone ostomy surgery, you might experience changes to your rectum that cause blood and mucus with your bowel movements. If you notice that you pass blood and stool with your bowel movements, consider seeing a healthcare provider. They can diagnose what is causing the inflammation or damage and then help manage it.
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