When we are using the term “rectal bleeding”, then it is refering to any blood which is passing from the anus. In the most cases the rectal bleeding is usually assumed to refer to bleeding from the lower colon or rectum. Our rectum is making up the last few inches of our large intestine. The medical term for the rectal bleeding is hematocheiza [1]. The rectal bleeding can show up as blood in the stool, in the toilet bowl or on the toilet paper. There are many people who have said that only observe a few drops of fresh blood which turns the toilet water pink or they observe spots of blood on the tissue paper after they wipe. Also there are other cases when patients are reporting a brief passage of a spoonful or 2 of blood. The blood which is resulting from the rectal bleeding is usually bright in color and occasionally can be dark maroon. The bleeding from the rectum can be mild, serious or even life – threatening. If you have rectal bleeding, then this means that something is wrong in your GI (gastrointestinal) tract. Also the rectal bleeding can be occult which means that it is not visible with the human eye. There are some cases when the rectal bleeding can be seen with bleeding which is coming from higher in the intestinal tract, from your stomach, your duodenum or from your small intestines, for example Meckel’s diverticulum [2]. The rectal bleeding in some cases may not be painful. There are other symptoms which are accompanying the rectal bleeding, such as abdominal cramps and diarrhea which are due to the blood in the stool. This condition is commonly evaluated and treated by the gastroenterologists and colorectal surgeons or it can be treated by general surgeons. When small people have rectal bleeding, then this condition should be taken seriously. There are some children who require admission to the hospital and evaluation by a surgeon. Firstly, the rectal bleeding is managed by correcting the low blood volume and anemia if present with blood transfusions. Then, it is determined the site and cause of the rectal bleeding, stopping the bleeding and preventing future rebleeding. If the cause of the rectal bleeding is found, then the rectal bleeding can be prevented and definitively treated, such as removing the tumor or polyp.
Rectal bleeding Symptoms
Symptoms: Here are the most common symptoms of rectal bleeding [3]:
- Fainting, palpitation or rapid heartbeat
- Dizziness, lightheadedness
- Confusion
- Stool test positive for occult blood loss (blood may present, but you cannot see it)
- Change in the stool color to black, red or maroon
- Bright red blood present in or on the stool
- Rectal pain
If you have some of the mentioned symptoms of rectal bleeding, then you need to talk with your doctor as soon as possible. He or she will refer you to a gastroenterologist which is colon and rectal surgeon or they can refer you to proctologist. There are many things which your doctor will make to determine the origin of rectal bleeding, such as physical examination, personal patient history, flexible sigmoidoscopy, anoscopy, radionclide scans, colonscopy, visceral angiograms, blood tests, flexible endoscopy or capsule endoscopy of the small intestine.
Rectal bleeding Symptoms Causes
Causes: It is known that the rectal bleeding can happen for many reasons. Here are some of the most common causes for rectal bleeding:
- Hemorrhoids (swollen and inflamed veins in your anus or rectum) [4]
- Hard stools
- Constipation
- Anal fissure (a small tear in the lining of the anal canal)
Also there can be less common causes for rectal bleeding such as
- Ulcerative colitis (a type of inflammatory bowel disease)
- Solitary rectal ulcer syndrome (a sore on the wall of the rectum)
- Rectal cancer [5]
- Radiation therapy [6]
- Pseudomembranaous colitis (colon inflammation caused by an infection)
- Proctitis (inflammation of the lining of the rectum)
- Ischemic colitis (colon inflammation caused by reduced blood flow)
- Diverticulosis (a benign pouch that forms on the wall of the intestine)
- Diarrhea
- Crohn’s disease (a type of inflammatory bowel disease)
- Colon polyps [7]
- Colon cancer
- Angiodysplasia (abdomen in the blood vessels near the intestines)
- Anal cancer
References:
[1] Wilson D. Chapter 85: Hematemesis, melena, and hematochezia. In Clinical Methods: The History, Physical, and Laboratory Examinations (3rd ed.). Walker HK, Hall WD, Hurst JW. Boston: Butterworths. 1990.
[2] Malik AA, Shams-ul-Bari, Wani KA, Khaja AR. Meckel’s diverticulum — Revisited. The Saudi Journal of Gastroenterology. 2010;16(1):3–7.
[3] Olde Bekkink M, McCowan C, Falk GA, et al. Diagnostic accuracy systematic review of rectal bleeding in combination with other symptoms, signs and tests in relation to colorectal cancer. British Journal of Cancer. 2010;102(1):48–58.
[4] Lohsiriwat V. Hemorrhoids: From basic pathophysiology to clinical management. World Journal of Gastroenterology. 2012;18(17):2009–17.
[5] Adelstein B, Macaskill P, Chan SF, et al. Most bowel cancer symptoms do not indicate colorectal cancer and polyps: a systematic review. BMC Gastroenterology. 2011;11(65).
[6] Laterza L, Cecinato P, Guido A, et al. Management of radiation-induced rectal bleeding. Current Gastroenterology Reports. 2013;15(11):355.
[7] Lieberman D. Rectal bleeding and diminutive colon polyps. Gastroenterology. 2004;126(4):1167-74.
