What does blood in stool mean?

Monday July 13 2020


By Dr Vincent Karuhanga

For the last six months, I keep passing stool with blood in it. I have not visited a doctor yet because I do not feel any pain. What could be the cause? –Santos
Dear Santos,
Although you do not feel any pain, bright red blood mixed with or coating stool may point to bleeding from piles, which may be seen or felt at the anal opening (anal or external piles) or deeper in the rectum where they may not be seen or felt (internal or rectal piles).

Piles are usually related to constipation or childbirth. Correcting constipation by taking lots of fluids, vegetables and fruits while cutting down wheat and finger millet products can help ease constipation as well as engaging in physical exercise and avoiding drugs that cause constipation, among other measures.

Worryingly, however, fresh blood in stool may be due to cancer of the rectum or big intestine (colorectal cancer) in which case apart from trying to correct constipation, you need to visit your doctor as soon as possible.

Sometimes, one may have black stool which could be due to bleeding much higher up in the digestive system as happens due to bleeding peptic ulcers but these usually cause pain in the upper middle abdominal area, which pain may be overlooked because it may not be related to emptying of the bowels.
Also, food and drink colouring or food supplements containing iron may make stool red/black hence creating confusion that you are passing blood in stool whereas not.

Pin pointing and avoiding the said substances will take away the suspicious stool colour.
It is important to go for regular medical check-ups including a test that looks at the inside of the big intestines and rectum (colonoscopy) because by the time one starts passing blood in stool due to the dreaded but common colorectal cancer, the cancer may have already spread and difficult to contain.

Checks like stool occult blood which look for presence of blood in stool which may not be seen with a naked eye can also be done to help catch problems of bleeding in the digestive system early for better treatment outcomes.


As a diabetic, I take beetroot but I find it too sweet. Will it worsen my symptoms? –Amos
Dear Amos,
Diabetics are wary of taking anything with sugar but if your blood sugar is in control, once in a while you can safely take small amounts of even the sweetest food, honey.
Although some varieties of beetroot contain a sugar (sucrose) they also have other substances that reduce insulin resistance and, therefore, may be helpful in lowering sugar in diabetics. Beetroot may help to protect diabetics from the common complications to eyes (blindness), kidneys (diabetic nephropathy), heart (heart attacks) and brain (stroke). Also, beetroot has other healthy substances including nitrates, which lower high blood pressure that commonly coexists with diabetes.