SYMPTOMS
RECTAL BLEEDING
The rectum is the last few inches of your large intestine and rectal bleeding simply means a flow of blood from the rectum. It refers to any blood (fresh blood, because occult blood cannot have its origin close to anus) that passes from your anus.
A bleed from the rectum may show up as blood in the toilet bowl, in your stool, or on the toilet paper. Blood from the rectal bleeding is usually fresh and bright red in colour because of rectum’s close proximity to the anus, however, sometimes it can be dark maroon. An occult blood in stools is suggestive of some problem that has its origin other than the rectum.
Causes
A flow of blood from the rectum could be due to many reasons.
Common causes include:
- Haemorrhoids (swollen veins in your anus or rectum)
- Chronic constipation
- Anal fissure (a small tear in the lining of the anal canal)
- Hard stools
Less common causes include:
- Local trauma
- Colon polyps
- Anal cancer
- Colon cancer
- Crohn’s disease (a type of inflammatory bowel disease)
- Celiac disease
- Haemorrhagic Diarrhoea
- Diverticulosis
- Ischemic colitis (inflammation of the colon caused by diminished blood flow)
- Rectal cancer
- Radiation therapy
Tests and Diagnosis
For proper prevention and treatment of further rectal bleeding, an exact diagnosis of the bleeding location and its cause is very important. The diagnosis of rectal bleeding relies on
- Detailed history
- Physical examination
- Blood tests
- Anoscopy (anoscope is a small tube used to visualise and detect any cause in the rectum)
- Colonoscopy
- Flexible sigmoidoscopy
- Angiograms (specific tests performed on blood vessels)
- Radionuclide scans
Treatment
The actual treatment is the treatment of an underlying cause. However, its management can include
- Stopping active bleeding
- Locating the bleeding point and make a confirmed diagnosis
- Cauterisation of the bleeding point, if indicated
- Correcting the low blood volume by maintaining IV line or oral medicines
- Preventing re-bleeding
- Looking for other lesions and rectal pathologies that can have the tendency to bleed in the future.