Rectal Bleeding: Causes and Treatment

Rectum is the last part of your digestive system where the fecal matter is temporarily stored before eliminating it through the anal canal. Rectal bleeding generally refers to ant blood that comes out from your anus whose source is suspected to be the lower part of gut that includes lower colon, rectum and anal canal. The patient complains of blood on stools or on the toilet paper which is usually bright red in color. There are various causes which can lead to rectal bleeding.

Signs and symptoms of Rectal Bleeding

• Bright red blood on stools or toilet paper
• Blood mixed with the stools
• Occasionally blood can be dark in color

These symptoms can appear in the healthy person and disappear on their own but if it is associated with the following features then your need to seek advice of your doctor as early as possible

• Bleeding lasting for more than 2 weeks
• Unintentional weight loss
• Pain during defecation or in abdomen
• Fever, nausea, vomiting
• Constipation or diarrhea
• Any other symptoms which is very unusual

Causes of Rectal bleeding

There are various causes which can lead to the condition of rectal bleeding

Some of the most common cause

• Hemorrhoids: it is the common and treatable cause of rectal bleeding in which the anal blood vessels become tortuous and inflamed. This is commonly known as piles and more common in the people who are pregnant women, having chronic constipation, diarrhea or taking low fiber diet.
• Anal fissures: It is a tear in the tissue which form the lining of the anus resulting in bleeding and pain.
• Anal fistulas: A connection is formed between the outside of the body and the anal canal through the skin

Less common causes are

• Diverticulitis: diverticula is the small pocket which develops in the wall of the colon where the wall is weak. Some diverticula have tendency to bleed
• Colitis: Inflammation or irritation of the wall of the colon
• Crohn’s disease or Ulcerative colitis
• Radiation therapy
• Colon polyp
• Colon cancer
• Rectal Cancer
• Anal Cancer

Diagnosis of Rectal bleeding

Your doctor will use your medical history, conduct a physical examination and order some test to establish a diagnosis

Medical history: Your doctor will basically ask you complete details of the signs and symptoms associated with the illness

Rectal examination: Your doctor will examine the inner condition of the rectum or anus by putting inside a lubricated gloved finger

Proctoscopy: Proctoscope is a hollow device which is inserted into your anus to look for abnormalities like hemorrhoids, anal fissure

Analysis of stool sample: The stool sample is analyzed for the presence of different types of inflammatory cells.

Colonoscopy: the colon is examined by inserting an endoscope which is a flexible hollow tube with camera and lights to look for conditions like diverticulitis or polyps.

Biopsy of the gut tissue: A small sample of the gut tissue is taken and studies to look for inflammatory(Crohn’s) and cancerous conditions

CT scan: A CT scan of the abdomen can be done to look for any other problems that can be associated with your digestive symptoms

Your doctor can refer you to GI expert, specialist who are expert in the field of gastroenterology.

Treatment of Rectal bleeding

The main goals of the management are to treating underlying cause and reducing the signs and symptoms.

• For hemorrhoids your doctor will advise you to have sitz bath, increase fiber content in the diet and over the counter stool softener can be used. Other treatment options are also available
• If the diagnosis is anal fissure, it can go away on its own. If treatment is required then muscle surrounding the anal fissure can be cut
• Some conditions like Crohn’s disease can be managed only and can’t be treated.
• Some cancers can be cured if detected early.

Resources

 American Gastroenterological Association