What causes blood in stool in the elderly and how to manage it?
Jun 30, 2025
Source: Cainiu Health
Dr. Li Jingxiang
Introduction
In general, symptoms of rectal bleeding in the elderly may be caused by dietary factors, medication, hemorrhoids, anal fissures, ulcerative colitis, or other conditions. Treatment may include general management, medication, or surgical intervention under a doctor's guidance. It is advisable to maintain a regular作息 (作息 translates to作息 should be replaced with "lifestyle" or "routine"), avoid staying up late, and ensure adequate sleep to help maintain normal bowel function.
In general, symptoms of rectal bleeding in the elderly may be caused by dietary factors, anal fissures, hemorrhoids, medication factors, ulcerative colitis, and other reasons. Treatment options include general therapy and medication therapy, under the guidance of a physician. Detailed analysis is as follows:
1. Dietary factors
If elderly individuals have recently consumed large amounts of spicy foods, such as chili peppers, Sichuan peppers, and similar items, the irritating components in these foods can stimulate the intestinal mucosa, causing congestion and edema of the mucosa, leading to rupture of small local blood vessels and resulting in rectal bleeding. The diet should be adjusted to reduce intake of spicy foods, and more fiber-rich foods such as vegetables, fruits, whole grains should be consumed.
2. Hemorrhoids
Hemorrhoids are usually caused by congestion or blood stasis and swelling of the venous plexus in the anal canal or lower rectum in elderly individuals. Due to reduced physical activity and slower gastrointestinal motility in the elderly, constipation is more likely to occur, which can worsen the formation of hemorrhoids. During defecation, friction from stool can easily cause the hemorrhoids to rupture and bleed, resulting in rectal bleeding. Symptoms may also include prolapse of anal masses, anal itching, and pain. Under medical guidance, medications such as Ma Ying Long Musk Hemorrhoid Ointment, Compound Carrageenan Suppositories, and Compound Lidocaine Cream may be used for treatment.
3. Anal fissure
Anal fissures may be caused by factors such as hard stools or excessive straining during bowel movements. After an anal fissure develops, the stool can irritate the wound, causing bleeding and rectal bleeding. Symptoms such as anal pain and swelling may also occur. Patients should use medications such as glyceryl trinitrate ointment, diclofenac sodium suppositories, and Cannabis Seed Moistening Pills according to medical advice.
4. Medication factors
Some elderly individuals, due to conditions such as cardiovascular disease or thrombotic disorders, may need to take anticoagulant medications long-term, such as enteric-coated aspirin tablets, warfarin sodium tablets, etc. These medications inhibit the clotting function of platelets, prolonging blood coagulation time, which can easily lead to bleeding from the gastrointestinal mucosa and consequently rectal bleeding. When using such medications, it is important to strictly follow medical instructions, regularly retest coagulation function, and adjust medication dosages according to the doctor's recommendations.
5. Ulcerative colitis
Ulcerative colitis may be related to multiple factors such as heredity, immunity, infection, and environment. Under continuous inflammatory stimulation, ulcers and erosion may develop on the intestinal mucosa, leading to blood vessel rupture and bleeding, thus causing rectal bleeding. Symptoms such as abdominal pain and diarrhea may also accompany. Under the doctor's recommendation, medications such as sulfasalazine enteric-coated tablets, prednisone tablets, and mesalazine suppositories may be used to alleviate symptoms.
In daily life, maintaining a regular routine, avoiding staying up late, and ensuring sufficient sleep are beneficial for maintaining normal intestinal function. Appropriate physical activity such as walking or practicing Tai Chi should also be performed to promote gastrointestinal motility and prevent constipation.
