Definition and Overview

Rectal bleeding in itself is not a disease, but a symptom of an underlying condition that typically affects the lower digestive tract. However, problems in any part of the digestive system can also display this symptom.

Bleeding from the anus can be quite disconcerting, especially if there is a significant amount. Fortunately, severe cases of rectal bleeding are not quite common. Usually, the condition is presented in small amounts of blood in the stool. Blood may appear bright red or dark maroon in color. In some cases, blood may not be visible to the naked eye and can only be detected during a stool examination.

Cause of Condition

Rectal bleeding can be a symptom of a wide variety of conditions. Some of the most common are problems that occur in the lower digestive tract, such as hemorrhoids, chronic constipation, hard stools, and anal fissure. Anal cancer, Crohn’s disease, diarrhea, colon cancer, inflammation of the rectum, and colon polyps may result in blood passing through the anus as well.

Other conditions and circumstances that result in rectal bleeding include:

  • Gastroesophageal reflux, a condition wherein stomach acid returns to the esophagus, causing irritation and inflammation.
  • When abnormal veins (varices) located at the lower part of the esophagus rupture
  • Excessive vomiting that places a lot of pressure on the lining of the esophagus, creating a tear.
  • Stomach problems, such as gastritis, stomach ulcers, and cancer

Key Symptoms

Rectal bleeding is a symptom of an underlying condition and is usually accompanied by other symptoms of that particular condition, such as pain, fatigue, anemia, paleness, and a general feeling of weakness.

Rectal bleeding that is accompanied by confusion, fainting, blurred vision, dizziness, and rapid shallow breathing requires immediate medical attention.

Who to See & Types of Treatment Available

If you experience rectal bleeding, you should consult your family doctor or a general practitioner as soon as possible. In most cases, your doctor should be able to provide treatment after determining the exact cause. However, your doctor may also refer you to a specialist, such as to an oncologist if the underlying cause is stomach cancer.

To diagnose the underlying condition, the diagnosing physician will ask when you first experienced the condition and if the bleeding is continuous or if it’s intermittent. Your medical history will also be reviewed while a physical exam will be performed to check for tender and painful areas, which will give a general indication of the location of the problem, such as in the lower or upper digestive tract.

It’s likely that your doctor may ask you to submit a stool sample for examination to determine the presence of an infection or disease. Your blood will also be tested to determine the extent of the bleeding.

If the doctor determines that the source is in the lower digestive tract, an endoscopy will be performed, wherein an endoscope is used to view the digestive tract and locate the source. The procedure can be both diagnostic and therapeutic in nature. Using the endoscope, chemicals can be injected into the affected site while lesion can be cauterized to stop the bleeding.

If the doctor is unable to use an endoscope to locate the source of the bleeding, other imaging tests, such as an x-ray, angiography, or radionuclide scanning will be ordered. Prior to performing an x-ray, the doctor will have you drink a fluid containing barium or inject the fluid through the rectum. The doctor will then use the x-ray to check the flow of barium and look for any abnormalities.

In an angiography, a certain material is injected into the veins. The flow of this material can be viewed using a special camera. By inspecting the flow, the doctor will be able to locate the source of the bleeding. The same procedure is followed when performing a radionuclide scan except that the doctor will use radioactive material.

In some cases, the doctor will be able to treat the bleeding as soon as it’s located. However, there are cases that require surgical procedures to remedy the problem. You will then be prescribed medications that will prevent bleeding from reoccurring.

If the doctor determines that the cause of bleeding is cancer, you will be referred to an oncologist (cancer specialist). The treatment of cancer (such as chemotherapy), can be initiated once the bleeding has been managed or stopped altogether.

References:

  • Sneider EB, Maykel JA. Diagnosis and management of symptomatic hemorrhoids. Surg Clin North Am. 2010 Feb;90(1):17-32, Table of Contents.

  • Nelson H. Anus. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 53.Mayo Clinic

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