Rectal Bleeding

What is rectal bleeding?

Rectal bleeding refers to blood coming from the anus. Rectal bleeding is a symptom of many different medical conditions. It can vary from being mild to being a sign of a serious condition like colorectal cancer. If you’re experiencing rectal bleeding, you may see blood in a few different ways — in the water of the toilet bowl, on your toilet paper as you wipe, or in your stool. The colours of stool can range from bright red to dark maroon to black.

What can cause rectal bleeding?

Various conditions can cause rectal bleeding, including:

Haemorrhoids: These are the most common cause of rectal bleeding. Haemorrhoids are swollen veins in the rectum or the anus that can cause bleeding.

Anal fissure:  An anal fissure is a tear or split in the skin around the anus. This condition occurs when you have a very hard stool that’s difficult to pass.

Anal abscess or fistula: There are small glands inside your anus that are meant to help you pass stool. These glands can become infected, causing fistulas or abscesses.

Inflammatory bowel disease (IBD): Inflammatory bowel disease refers to swelling of the small or large intestine.

Diverticulosis/Diverticulitis: These conditions occur when small pouches develop in weakened sections of your intestine. The pouches can protrude through the walls of your bowels, causing bleeding and infections.

Ulcers: When the amount of digestive fluids in the intestines is out of balance, it can damage the digestive tract lining and lead to ulcers. These ulcers can bleed, causing you to have black stool that’s sometimes tar-like in appearance.

Large polyps: A polyp is a growth that grows out of the side of the bowel. Large polyps can bleed and lead to rectal bleeding.

When should you book an appointment with us?

When rectal bleeding is present with one or more of the following symptoms, be sure to book an appointment with us:

• Stomach pain or swelling
• Nausea or vomiting
• Bleeding continues or worsens
• Recent weight loss
• Altered bowel habits
• Severe or prolonged diarrhoea
• Pencil-sized stools
• Involuntary seepage of stools
• Inability to have a bowel movement

What to expect at your consultation

Dr Taylor will first record your medical history and then perform a physical examination.

He may ask you the following questions:

• Have you had any trauma to the rectum or abdomen?
• Have you had more than one episode of blood in your stool?
• Is there blood in every stool?
• Have you lost any weight recently?
• Do you find blood on the toilet paper only?
• What colour is the stool?
• When did the problem develop?
• What other symptoms are present? (vomiting, abdominal pain, bloating, excessive gas, diarrhoea, or fever)

The physical examination may include one or more of the following:

• A physical examination of the rectum and anus.
• Colonoscopy: A thin tube with a camera at the end is inserted into the anus to find or treat the source of bleeding
• Sigmoidoscopy: a thin, lubricated sigmoidoscope is passed through the rectum into the lower intestine

Dr Taylor may also additional testing, such as:

• Angiography: An imaging test that uses X-rays to view blood vessels
• Faecal occult blood test: A lab test to detect hidden blood in the stool.
• Complete blood count (CBC)
• Serum chemistries
• Clotting studies
• Stool culture

How we can treat rectal bleeding

In most cases, we treat rectal bleeding by treating the underlying cause of the bleeding. Rectal bleeding is frequently a part of a bigger problem that needs to be managed. Once that condition has been treated, the bleeding usually stops. Treatment options may vary depending on the condition.

Conditions like anal fissures may go away on their own over time or be treated with ointments.

Haemorrhoids can be treated by either resolving any constipation issues, changing your diet and water intake, or having surgery in more severe cases.

If the cause of bleeding is colorectal cancer, we will develop a treatment plan to treat the cancer, often removing any tumours.