Rectal Bleeding

Rectal bleeding refers to any blood that passes from your rectum or anus during bowel movements. It can range from small amounts of blood on toilet paper to larger amounts of blood in your stool. While rectal bleeding can be alarming, it is often caused by relatively benign conditions, but it can also indicate more serious health issues. If you are experiencing rectal bleeding, it is important that you are assessed by an expert, such as Mr Ferguson.

Causes of Rectal Bleeding

There are several potential causes of rectal bleeding, which can be divided into common and more serious causes.

Common Causes:

Hemorrhoids: Swollen blood vessels around the anus or rectum, which can bleed during bowel movements. Hemorrhoids are one of the most frequent causes of rectal bleeding.
Anal Fissures: Small tears or cracks in the skin around the anus, often caused by constipation or passing large, hard stools.
Diverticulosis: Small pouches that form in the colon wall (diverticula) that can bleed, often with no other symptoms.
Constipation: Straining to pass stools can cause blood vessels in the rectum or anus to rupture, leading to bleeding.
Polyps: Non-cancerous growths in the colon or rectum that can bleed.

More Serious Causes:

Colorectal Cancer: Cancer of the colon or rectum can cause rectal bleeding, often accompanied by changes in bowel habits, weight loss, or abdominal pain.
Inflammatory Bowel Disease (IBD): Conditions like Crohn’s disease and ulcerative colitis can cause inflammation in the gastrointestinal tract, leading to bleeding.
Bleeding Stomach Ulcer: In some cases, bleeding in the upper GI tract (e.g., from ulcers or esophageal varices) can result in blood in the stool, which may appear black and tarry.

Symptoms to Watch Out For

Rectal bleeding may present in different ways, including:

Bright red blood on toilet paper, in the toilet bowl, or on the surface of the stool. This usually indicates bleeding from the lower part of the digestive tract (Left Colon or anus).
Dark red or black, tarry stools: This could indicate bleeding higher up in the gastrointestinal tract, such as the right colon, small intestine or even stomach.
Pain or discomfort: Bleeding may be associated with anal pain, especially if caused by hemorrhoids or anal fissures.
Changes in bowel habits: You may notice a change in the frequency, consistency, or appearance of your stools.
Fatigue or weakness: If bleeding is significant or chronic, it may lead to anemia (low red blood cell count), causing tiredness or weakness.

When to Seek Medical Help

While minor rectal bleeding may resolve on its own, it is important to seek medical advice if:

The bleeding persists or is frequent.
You notice significant amounts of blood in your stool or toilet bowl.
You have additional symptoms like abdominal pain, weight loss, or changes in bowel habits.
You feel light-headed, dizzy, or weak, as these could be signs of significant blood loss.
You are over 45, have a family history of colorectal cancer, or have any other risk factors.

Investigations for Rectal Bleeding

To determine the cause of rectal bleeding, Mr Ferguson will typically start with a thorough medical history and physical exam. Depending on the symptoms, additional tests may include:

Digital Rectal Exam (DRE): A finger is passed through the anus to examine for abnormalities in the Anus and Low Rectum
Proctoscopy/Rigid Sigmoidoscopy: A short plastic tube is passed through the anus to see the lining of the lower bowel and look for things like inflammation.
Colonoscopy: A procedure where a flexible tube with a camera is inserted into the colon to look for polyps, tumors, or other signs of disease.
Flexible Sigmoidoscopy: A similar procedure to colonoscopy, but it examines only the lower part of the colon.
Faecal Immunochemical Test (FIT): A test to check for hidden blood in your stool that may not be visible to the naked eye.
CT Scan or MRI: Imaging tests may be used to assess the gastrointestinal tract and surrounding structures.

Preventing Rectal Bleeding

To reduce your risk of rectal bleeding, consider the following lifestyle changes:

Eat a high-fiber diet: This can help prevent constipation and promote regular bowel movements.
Stay hydrated: Drink plenty of water to keep stools soft and easier to pass.
Exercise regularly: Physical activity can help prevent constipation.
Avoid straining: If you have hemorrhoids or anal fissures, avoid prolonged sitting on the toilet and straining during bowel movements.
Screening for colorectal cancer: If you are over 45 (or earlier if you have a family history of colorectal cancer), talk to your doctor about colorectal cancer screening options, such as colonoscopies.