When to worry about blood in stool with Crohn's disease

Crohn's disease can inflame the bowel lining, causing blood mixed with stool, streaks on the outside, or bleeding with diarrhoea. Flares may also bring urgency, cramps, loose stools, fatigue, or reduced appetite. Bright red blood often comes from the lower bowel, while black, tar-like stool can indicate bleeding higher in the digestive tract. Haemorrhoids and anal fissures can cause bleeding too, so do not assume every episode is a Crohn's flare.

Note the colour and amount of blood, whether it is mixed through the stool, how often it occurs, and any diarrhoea, fever, pain, dizziness, or vomiting. Take prescribed Crohn's medicines as directed and do not start anti-diarrhoeal medicine or anti-inflammatory painkillers without advice. Arrange prompt review if bleeding is new, recurring, or happening with worsening bowel symptoms; your clinician may need to assess inflammation, anaemia, infection, or another source.

Go to an emergency department for a large or continuing amount of blood, black tarry stool, clots, fainting, confusion, marked weakness, a racing heartbeat, pale clammy skin, severe abdominal pain, a swollen abdomen, or repeated vomiting. These features can signal significant blood loss or a serious bowel problem. If you feel light-headed while bleeding, lie down safely and have someone help you obtain urgent care.

Could this be a Crohn's flare, an infection, haemorrhoids, or another cause? Do I need blood tests, stool tests, or a bowel examination? Should I change any medicine, and what amount or pattern of bleeding should trigger the emergency plan?