Rectal Bleeding

Rectal bleeding can refer to any blood that passes from your anus, although rectal bleeding is usually assumed to refer to bleeding from your lower colon or rectum. Your rectum makes up the last few inches of your large intestine. Rectal bleeding may show up as blood in your stool on the toilet paper or in the toilet bowl. Blood that results from rectal bleeding is usually bright red in color but occasionally can be dark maroon.

Symptoms

The most apparent sign of rectal bleeding is red blood on toilet tissue or visible blood or red-tinged stool in the toilet bowl. However, it’s important you pay attention to the color of the blood (and the color of your stools) as it can indicate different things:

  • Bright red blood indicates bleeding somewhere in the lower gastrointestinal tract, such as the colon or rectum.
  • Dark red or wine-colored blood may indicate bleeding in the small intestineor early portion of the colon.
  • Black, tarry stools may indicate bleeding from the stomach or the upper part of the small intestine.

Additional symptoms associated with rectal bleeding include:

  • confusion
  • fainting
  • feeling dizzy
  • rectal pain
  • abdominal pain or cramping

Causes

Rectal bleeding may occur for many reasons. Common causes of rectal bleeding include:

  1. Anal fissure (a small tear in the lining of the anal canal)
  2. Constipation
  3. Hard stools
  4. Hemorrhoids (swollen and inflamed veins in your anus or rectum)

Less common causes of rectal bleeding include:

  1. Anal cancer
  2. Angiodysplasia (abnormalities in the blood vessels near the intestines)
  3. Colon cancer
  4. Colon polyps
  5. Crohn’s disease (a type of inflammatory bowel disease)
  6. Diarrhea
  7. Diverticulosis (a bulging pouch that forms on the wall of the intestine)
  8. Ischemic colitis (colon inflammation caused by reduced blood flow)
  9. Proctitis (inflammation of the lining of the rectum)
  10. Pseudomembranous colitis (colon inflammation caused by an infection)
  11. Radiation therapy
  12. Rectal cancer
  13. Solitary rectal ulcer syndrome (ulcer of the rectum)
  14. Ulcerative colitis

Diagnosis

Your doctor will start by asking you about your symptoms. Questions may include when you first noticed the bleeding, related symptoms you’re experiencing, and what color the blood is.

Doctors most often perform a visual or physical exam to check the affected area. This can include inserting a gloved, lubricated finger into the anus to check for abnormalities, such as hemorrhoids.

Sometimes rectal bleeding may require endoscopic procedures. This involves inserting a thin, flexible lighted scope into the anus. The scope has a camera on the end, which allows the doctor to view the area to pinpoint any bleeding signs.

Examples of endoscopic procedures to view rectal bleeding include a sigmoidoscopy or a colonoscopy.

A doctor may also order a blood test, such as a complete blood count (CBC), to determine if you’ve lost a significant amount of blood.

Treatment

Rectal bleeding treatments depend upon the cause and severity.

You may relieve the pain and discomfort of hemorrhoids by taking warm baths. Applying over-the-counter or prescription creams can also reduce irritation.

Your doctor may perform more invasive treatments if your hemorrhoid pain is severe or the hemorrhoids are very large. These include rubber band ligation, laser treatments, and surgical removal of the hemorrhoid.

Like hemorrhoids, anal fissures may resolve on their own. Using stool softeners can address issues with constipation and help anal fissures to heal. Infections can require antibiotic therapy to eliminate the bacteria.

Colon cancers may require more invasive and long-term treatments, such as surgery, chemotherapy, and radiation, to remove the cancer and reduce the risk of recurrence.

At-home treatments to prevent constipation can reduce the risk of rectal bleeding. These include:

  • eating high-fiber foods (unless otherwise directed by your doctor)
  • exercising regularly to prevent constipation
  • keeping the rectal area clean
  • staying well hydrated

 

*** IMPORTANT DISCLAIMER: The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. In no way does any of the information provided reflect definitive medical advice and self diagnoses should not be made based on information obtained online. Always consult your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 911 immediately.