Rectal bleeding is bleeding through the anus. The bleeding may be bright red, dark maroon or a tarry colour, which you may notice in your stools, toilet bowl or toilet paper.Rectal bleeding may occur from any part of the gastrointestinal tract due to various causes.Following are the common causes of rectal bleeding:
Piles (haemorrhoids) are the swollen blood vessels found in and around the rectal region. These can cause bleeding when passing stools and irritate the surrounding skin making you feel uncomfortable.
Anal Fissure is a small painful tear in the tissue lining of the anus.
Angiodysplasia of the colon is related to aging and occurs due to enlarged blood vessels in the colon.
Gastroenteritis: Viral or bacterial stomach infection causing bloody diarrhoea with abdominal cramps and vomiting.
Diverticula: Refers to tiny bulges that develop on the intestinal lining. The deteriorated blood vessels in the diverticula may burst or bleed.
Other conditions such as stomach ulcers, ulcerative colitis, Crohn’s disease and cancer of the colon or rectum may also cause rectal bleeding.
Abdominal pain, visible blood clots or bleeding without pain are the typical symptoms associated with rectal bleeding. You may also experience weakness, chest pain, dizziness, shortness of breath, or blood pressure variations based on the amount of blood loss.
The diagnosis of rectal bleeding depends to a large extent on the patients’ age and medical history. Your doctor may ask questions about the bleeding, such as the colour of the blood, amount of blood loss or other associated symptoms. A physical examination of the anus can confirm the presence of anal fissures or haemorrhoids and helps to rule out other associated diseases. Some diagnostic tests may be ordered to determine the cause of rectal bleeding and may include:
Faecal occult blood test: check for small traces of blood present in the stools, whichare invisible to the naked eye
Anoscopy: evaluation of the rectum with a flexible lubricated tube
Flexible sigmoidoscopy: examine sigmoid, colon and rectum with a flexible tube
Colonoscopy: evaluate the colon for polyps, cancer, ulcerative colitis and Crohn’s disease
Radionuclide scan: determine the location of gastrointestinal bleeding by injecting and following a radioactive substancethrough a scan
Visceral angiogram: uses X-rays to study the blood vessels of the digestive tract
Rectal bleeding can effectively be treated depending upon the related cause and underlying diagnosis. The treatment for rectal bleeding comprises of the following:
Anaemia and decreased blood volume, as a result of excessive blood loss is treatedwith intravenous fluids, blood transfusion andiron supplements to build up your levels of iron in your blood.
Haemorrhoidal creams and stool softeners may be prescribed to treat rectal bleeding associated with anal fissures (tear in the skin lining the anus) or haemorrhoids (enlarged blood vessels in rectum and anus).
Haemorrhoidal artery ligation (HALO), a surgery that involves reducing the blood flow to haemorrhoids, or haemorrhoidopexy, which involves gradual shrinking of the haemorrhoids, may be recommended to treat associated rectal bleeding.
Medications to relieve pain or vasoconstrictors (decreases the size of blood vessels) to stop bleeding may be prescribed.
Endoscopy can be used to stop bleeding by constricting or cauterizing the actively bleeding blood vessels.
Constriction is achieved by infusion of medications through the endoscopic needle at the site of bleeding.
Cauterization during endoscopy is usually accomplished by inserting a cautery probe through the endoscope.
Surgery may be recommended to remove polypsor tumours.
Do not ignore any type of bleeding in the stools. Rectal bleeding can occur due to a mild condition like piles or a more severe condition that may require immediate intensive treatment to control it and thus should never be ignored. Your embarrassment should not stop you from seeing a doctor.