Call your health care provider if:

Call your doctor immediately if you notice blood or changes in the color of your stool. Even if you think that hemorrhoids are causing blood in your stool, your doctor should examine you in order to make sure that there is no other, more serious cause present at the same time.

In children, a small amount of blood in the stool is usually not serious. The most common causes are constipation and milk allergies. But it is still worth reporting to your doctor, even if no evaluation is necessary.

What to expect at your health care provider's office:

Your doctor will take a medical history and perform a physical examination, focusing on your abdomen and rectum.

The following questions may be included in the history to better understand the possible causes of your bloody or dark stools:

• Are you taking blood thinners or NSAIDs (ibuprofen, naproxen, aspirin)
• Have you had any trauma to the abdomen or rectum, or have you swallowed a foreign object accidentally?
• Have you eaten black licorice, lead, Pepto-Bismol, or blueberries?
• Have you had more than one episode of blood in your stool? Is every stool this way?
• Have you lost any weight recently?
• Is there blood on the toilet paper only?
• What color is the stool?
• When did it develop?
• What other symptoms are present -- abdominal pain, vomiting blood, bloating, excessive gas, diarrhea, or fever?

Treatment depends on the cause and severity of the bleeding. For serious bleeding, you may be admitted to a hospital for monitoring and evaluation. If there is massive bleeding, you will be monitored in an intensive care unit. Emergency treatment may include a blood transfusion.

The following diagnostic tests may be performed:

• Angiography
• Barium studies
• Bleeding scan
• Blood studies, including a CBC and differential, serum chemistries, clotting studies
• Colonoscopy
• Esophagogastroduodenoscopy or EGD
• Stool culture
• Tests for the presence of Helicobacter pylori infection
• X-rays of the abdomen

Prevention:

• Eat vegetables and foods rich in natural fiber and low in saturated fat. These may reduce constipation, hemorrhoids, diverticulosis, and colon cancer.
• Avoid prolonged, excessive use of anti-inflammatory drugs like ibuprofen, naproxen, and aspirin. These can irritate the stomach and cause ulcers.
• If you drink alcohol, do so in moderation. Large amounts of alcohol can irritate the lining of the esophagus and stomach.
• DON'T smoke. It is linked to peptic ulcers and cancers of the GI tract.
• Try to avoid too much stress -- a possible factor in peptic ulcer disease.
• Your doctor may recommend antibiotics and other medications to prevent a future bleeding ulcer if you have been diagnosed with a helicobacter infection (often related to ulcers).

The earlier you detect colon cancer, the more likely that treatment will be successful. The American Cancer Society recommends one or more of the following screening tests after age 50 for early detection of colon cancer and pre-cancer:

• Fecal occult blood testing every year.
• Flexible sigmoidoscopy or barium enema every five years.
• Colonoscopy every 10 years.

Screening tests should be started earlier if you have a family history of colon cancer or polyps. Tests should also be performed more often if you have had polyps, colon cancer, or inflammatory bowel disease.