What is Rectal Bleeding?
Rectal bleeding refers to the passage of blood from the rectum, which may appear in the stool, on toilet paper, or in the toilet bowl. The blood can range from bright red to dark maroon or even black, depending on the source and duration of the bleeding. While rectal bleeding can result from minor issues like hemorrhoids, it can also indicate more serious conditions such as colorectal cancer or inflammatory bowel disease (IBD).
What Causes Rectal Bleeding?
Rectal bleeding has many potential causes, including:
- Hemorrhoids – Swollen blood vessels in the rectum or anus, often caused by straining during bowel movements or constipation
- Anal fissures – Small tears in the lining of the anus, usually due to hard stools
- Diverticulosis – Small pouches in the colon wall that can bleed
- Colorectal polyps or cancer – Abnormal growths that may become cancerous over time
- Inflammatory bowel disease (IBD) – Includes Crohn’s disease and ulcerative colitis
- Gastrointestinal infections – Bacterial, viral, or parasitic infections can cause inflammation and bleeding
- Angiodysplasia – Fragile, abnormal blood vessels in the colon
- Proctitis – Inflammation of the rectum, sometimes due to infections or radiation
- Rectal ulcers – Chronic sores inside the rectum
What Are the Symptoms of Rectal Bleeding?
Symptoms associated with rectal bleeding can vary depending on the underlying cause and severity:
- Visible blood in the stool, on toilet paper, or in the toilet bowl
- Bright red or maroon-colored blood
- Black or tarry stools (melena), indicating bleeding from higher up in the GI tract
- Anal pain or itching
- Sensation of rectal pressure or incomplete bowel movement
- Abdominal pain or cramping
- Fatigue or dizziness, especially if there is significant blood loss
- Unintended weight loss or changes in bowel habits, in more serious conditions
How Is Rectal Bleeding Diagnosed?
Diagnosis involves identifying the source of bleeding and the underlying condition. Common methods include:
- Medical history and physical examination, including a digital rectal exam
- Anoscopy or sigmoidoscopy to view the lower rectum and anus
- Colonoscopy to examine the entire colon for polyps, inflammation, or cancer
- Stool tests for hidden (occult) blood or infections
- Blood tests to check for anemia or signs of infection
- Imaging studies such as CT scans if bleeding is suspected to originate higher in the GI tract
What Are the Treatment Options for Rectal Bleeding?
Treatment depends on the cause, location, and severity of the bleeding:
- Dietary changes and hydration to ease bowel movements and reduce straining
- Topical or oral medications for hemorrhoids or fissures
- Antibiotics or antiparasitic drugs for infections
- Anti-inflammatory drugs for conditions like IBD
- Endoscopic procedures to remove polyps or treat bleeding vessels
- Surgery in severe cases, such as colorectal cancer or large bleeding diverticula
- Iron supplements or blood transfusions for significant blood loss
Can Rectal Bleeding Cause Complications?
Yes, if left untreated, rectal bleeding can lead to:
- Chronic anemia, causing fatigue, weakness, and dizziness
- Persistent pain or discomfort in the anal or abdominal region
- Progression of serious conditions like cancer or inflammatory disease
- Emotional stress and anxiety from ongoing or unexplained symptoms