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Conditions Treated
Anorectal Disorders
Rectal Bleeding

What is Rectal Bleeding?

The rectum is a small part of your lower large intestine, measuring only a few inches. Bleeding from the rectum is a common symptom. It is alarming to see blood in your stool, on the toilet paper, or in the toilet bowl. Blood from rectum is usually bright red in color. You must visit your doctor — however, most cases of rectal bleeding can be managed in an outpatient setting.
1. Symptoms of Rectal Bleeding
Bleeding from rectum is often bright red in color, and less often dark brown or maroon. You may first notice the blood while wiping with toilet paper or in the toilet bowl. It is often painless, but may be painful. A long period of blood loss may result in anemia and shortness of breath.
Rectal bleeding is caused by a number of medical conditions. The two most common causes are hemorrhoids and anal fissure. Hemorrhoids — Hemorrhoids are swollen, congested veins in the rectum or anus. Painless bright red bleeding that coats the stool is a common symptom. Anal fissure — An anal fissure is a tear in the lining of the anus. It is a painful condition associated with constipation and rectal bleeding. The other causes of rectal bleeding are:
  • Angiodysplasia
  • Colon cancer
  • Colon polyps
  • Diverticulosis
  • Medicine side effects / use of blood thinners
Rectal bleeding is seen commonly in persons who have a long standing history of constipation and low-fiber dietary intake. It is also more common in old age. Use of blood thinners, receptive anal sex, and personal or family history of cancer are other common risk factors of rectal bleeding.
Most cases of rectal bleeding are caused by non-serious conditions and are limited. Anemia is the most common complication of rectal bleeding. Your doctor will investigate further to rule out precancerous or cancerous conditions.
Your doctor will make a diagnosis of rectal bleeding by taking a detailed history and physical examination. A digital rectal examination (DRE) is often performed. It is a simple bedside examination technique in which your doctor will insert a gloved finger into your anus and rectum and will look for any abnormality.Your doctor may advise routine blood tests to look for anemia and infection. A visualization of rectum and colon may also be needed by using various procedures, such as:
  • Anoscopy — Anoscopy is done in the office without sedation and allows your doctor to inspect the anus and lower rectum.
  • Sigmoidoscopy — During a sigmoidoscopy, the rectum and most of the lower large intestine can be visualized.
  • Colonoscopy — A colonoscopy is a procedure in which your doctor will be able to examine the entire colon. It is performed in an outpatient setting and sedation is often required.
Treatment of bleeding from rectum depends upon the underlying cause.
  • Hemorrhoids are treated with stool softeners and increasing dietary fiber intake. Surgical options are also available to remove the hemorrhoids in case conservative management fails or the hemorrhoids are large.
  • Anal abscesses are initially managed with pain killers, stool softeners, dietary fiber intake, warm baths, and antibiotics.
  • Colon polyps require surgical removal to prevent their progression to cancer.
  • A blood transfusion may be required if person develops severe anemia.
To prevent constipation, patient should Increase water intake, use stool softeners, and increase dietary fiber consumption. There are no limitations on physical activity. Standard moderate physical exercise of at least 30 minutes for at least five days per week is recommended.
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