What is Rectal Bleeding? Causes & Symptoms

In this blog, I aim to give you a better understanding of rectal bleeding and blood per rectum.

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Rectal bleeding or the common medical term that we doctors refer to as hematochezia is the passage of fresh blood per rectrum. It is generally caused by bleeding from the lower gastrointestinal tract, but may occur in patients with large upper GI bleeds or from small bowel lesions.

For example, a bleeding ulcer in the stomach can have the blood excreted in the person’s fecal material. Rectal bleeding may be due to problems in the rectrum itself or from many other problems that occur elsewhere in the GI tract. Perirectal bleeding is bleeding in an area adjacent to the rectrum and may be due to abscesses or fistulas.

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Causes of Rectal Bleeding

  • Common anorectal causes are hemorrhoids, and anal fissures (tears in the rectal tissue)
  • Diverticula (diverticulitis)
  • Infections (bacterial and other pathogens)
  • Inflammatory bowel diseases (Crohn’s disease and ulcerative colitis)
  • Angiodysplasia (fragile blood vessels)
  • Tumors
  • Anal cancer
  • Polyps
  • Bowel trauma
  • Less common causes include upper GI tract problems like ulcers and Mallory-Weiss tears in the esophagus
  • A dilated vein or varix

Symptoms of Rectal Bleeding

  • The quantity and nature of bleeding:
    • Fresh bright red blood usually comes from low down in the GI tract. For example, fissures and haemorrhoids.
    • Bright red blood, however, can also occur with pathology higher in the GI tract.
    • Blood mixed in with the stool has usually originated higher in the GI tract.
    • The quantity of blood is very difficult to assess from the history but it is important to obtain a description from the patient. Indirect measures of the severity of bleeding are helpful.
  • Unexplained weight loss
  • Change in bowel habit (both frequency of defecation and consistency of stool) must be recognised.
  • Tenesmus may also be a feature.
  • Anal symptoms, examples may include soreness or pain that may occur with fissures, itching with piles.
  • Family history of bowel cancer or polyposis.
  • Past medical history. Careful documentation with particular reference to causes of bleeding and GI tract pathology. Any history of trauma should not be overlooked.
  • Medical history may also help identify the causes of bleeding, for example, warfarin and aspirin.

On a daily basis, you can take some steps like drinking lots of water, cleansing the area around your anus and having a fibrous diet to avoid this disease or even treating it on a very minor level at home. But always getting it consulted by a doctor is necessary and I would strongly suggest you do so.

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