Rectal Bleeding

What is Rectal Bleeding?

Rectal bleeding refers to the passage of blood through the anus along with the stools. The rectum is the last part of the large intestine present just above the anus. Rectal bleeding is referred to as bright red to dark maroon coloured blood passing along with stools through the anus. The amount of blood loss varies from mild traces to severe life-threatening bleeds. Bleeding can occur from any part of the gastrointestinal tract due to various causes.

Causes of Rectal Bleeding

Following are 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.

What are the Signs & Symptoms of Rectal Bleeding?

The colour of blood and consistency of stools varies depending on the location and the cause of bleeding in the gastrointestinal tract. The colour of stool may vary from bright red to maroon to dark red or black.

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.

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.

What are the methods of Screening & Diagnosis of Rectal Bleeding?

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 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:

Anoscopy is an evaluation of the rectum in which a lubricated flexible tube (anoscope) is inserted into the rectum through the anus to detect abnormalities such as haemorrhoids and anal fissures.
Flexible sigmoidoscopy uses a flexible sigmoidoscope to examine the sigmoid colon and the rectum.
Colonoscopy is a procedure to evaluate the colon for polyps, cancer, ulcerative colitis and Crohn’s disease.
Radionuclide scan is used to determine the location of gastrointestinal bleeding. A radioactive substance is injected and a nuclear camera is used to scan the stomach. The area affected with Meckel's diverticulum will concentrate the radioactive substance and show up on the scan. Another method involves attaching the radioactive substance to the blood of the patient and injecting the blood back into the veins. The tagged blood cells will leak into the bleeding area of the gastrointestinal tract and appear on the scan.
Visceral angiogram uses X-rays to study the blood vessels of the digestive tract. This is an accurate test to locate rapid bleeding point in the digestive tract.

What are the Treatment Options for Rectal Bleeding?

Rectal bleeding can effectively be treated depending upon the related cause and underlying diagnosis.

Treatment of anaemia

Iron infusions will be prescribed to build up your iron levels and correct iron deficient anaemia. In some cases a blood transfusion is given.

Haemorrhoidal creams and stool softeners may be prescribed to treat rectal bleeding associated with anal fissures or haemorrhoids.
Medications to relieve pain
Endoscopy can be used to stop bleeding by injection or application of clips , to stop the actively bleeding blood vessels.