Understanding Rectal Bleeding

Rectal bleeding is the passing of bright red blood through the rectum. It can be mild or severe and is caused by various gastrointestinal conditions. Persistent or recurrent rectal bleeding requires medical evaluation for treatment.

Looking down the toilet and seeing blood can be alarming. Your mind can go to many places when the alarm bells are ringing, and something is wrong. It is often rectal bleeding.

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What is Rectal Bleeding?

Rectal bleeding or blood in stool generally refers to bleeding from the anus, rectum, or colon, which are all the last parts of the digestive tract. In most cases, bright red blood indicates bleeding in the lower colon or rectum. In contrast, dark red blood is a sign of bleeding in the small intestine or upper colon.

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What Are the Symptoms of Rectal Bleeding?

Blood in stool or rectal bleeding is a symptom of many medical conditions. It can range from mild to a sign of a severe illness, such as colorectal cancer. If you have rectal bleeding symptoms, you may see blood in different ways. It can be of different colors, ranging from bright red to dark brown to black. The color of the blood you see can indicate where the bleeding is coming from:

Sometimes, rectal bleeding is not visible to the naked eye and can only be seen under a microscope. This type of bleeding is usually found during a lab test of a stool sample.

What Causes Rectal Bleeding?

A wide range of conditions and health factors can cause or worsen rectal bleeding or blood in the stool.

Hemorrhoids

Hemorrhoids are inflamed anal blood vessels, which are extremely common. They can develop on the outside or inside of the anus, appearing as small bumps that sometimes bleed during bowel movements or when wiping.

Hemorrhoids, also called piles, can affect anyone of any age but are associated with a few risk factors, including:

These generally respond well to over-the-counter creams and suppositories that contain hydrocortisone. Frequent warm baths, a diet high in fibre, and the use of stool softeners can also help reduce the discomfort of haemorrhoids. If the initial treatments fail, a doctor may perform minor surgery to remove the haemorrhoids.

Fistulas

A fistula occurs when an abnormal opening or pocket develops between two nearby organs. Fistulas that appear between the anus and the rectum, or the anus and the skin, can cause a discharge of white fluid and blood.

Fistulas are sometimes treated with antibiotics, but they may require surgery if they progress.

Cracks

Cracks occur when the tissue lining the anus, colon, or rectum is torn, causing rectal pain and bleeding. Warm baths, a diet high in fibre, and stool softeners can all help reduce crack symptoms. In severe cases, the cracks may require prescription creams or surgery.

Diverticulitis

Diverticulosis occurs when small pockets called diverticula develop on the walls of the colon around weakened muscle layers in the organ. These pouches, or diverticula, are extremely common. Sometimes, the diverticula can start to bleed, but the bleeding usually stops on its own.

Usually, these pockets do not cause symptoms or require treatment unless they are infected. That is when a condition called diverticulitis occurs. Infected and inflamed diverticula are often painful and can cause rectal bleeding, usually a moderate rush of blood that flows for a few seconds. Diverticulitis is treated with antibiotics and, if severe, surgery.

Proctitis or Colitis

Proctitis, or colitis, occurs when the tissues that make up the rectum become inflamed, often causing pain and bleeding. Colitis occurs when the tissues lining the colon become inflamed. A type of Colitis called ulcerative Colitis can also cause ulcers, or open, progressive sores that are prone to bleeding.

Treatments for proctitis and colitis vary depending on the cause and range from antibiotics to surgery. Common causes of proctitis and Colitis include:

Gastroenteritis

Bacterial infections can cause inflammation of the colon and stomach, causing diarrhoea, which may contain mucus and blood spots. Viral gastroenteritis usually does not cause bloody diarrhoea. Treatment for gastroenteritis usually involves fluids, rest, and antibiotics or antivirals, depending on the cause.

Treatment for gastroenteritis usually involves fluids, rest, and antibiotics or antivirals, depending on the cause.

Sexually Transmitted Infections (STIs)

Unprotected sex that involves the anal area can spread a wide range of viral and bacterial diseases. These can cause inflammation of the anus and rectum. Inflammation, if it occurs, increases the likelihood of bleeding. Treatment for STIs usually involves antibiotic, antiviral, or antifungal medication, depending on whether the cause is bacterial, viral, or fungal.

Prolapse

Weakened rectal tissue can allow part of the rectum to push forward or swell outside the anus, usually causing pain and, almost always, bleeding. Prolapse is more common in older people than in young people. Some people with this condition may require surgery to correct it.

Polyps

Polyps are abnormal, non-cancerous growths. When polyps grow on the lining of the rectum or colon, they can cause irritation, inflammation, and minor bleeding. In many cases, a doctor will remove the polyps so that they can be tested for signs of cancer and to prevent them from becoming cancerous.

Colon or Rectal Cancer

Cancer that affects the colon or rectum can cause irritation, inflammation, and bleeding. Up to 48% of people with colorectal cancer have had rectal bleeding. Colon cancer is a prevalent form of cancer and tends to grow slowly, so it's often treatable if caught early. 

Rectal cancer, although much rarer than colon cancer, is also usually curable if caught and treated in time. Some cases of colon and rectal cancer develop from initially benign polyps. All cases of gastrointestinal cancer require treatment, which usually involves a combination of chemotherapy, radiation therapy, and surgery.

Rectal cancer, although much rarer than colon cancer, is also usually curable if caught and treated in time. Some cases of colon and rectal cancer develop from initially benign polyps. All cases of gastrointestinal cancer require treatment, which usually involves a combination of chemotherapy, radiation therapy, and surgery.

Internal Bleeding

Serious injury to any of the gastrointestinal organs can lead to internal bleeding that passes through the rectum. Severe gastrointestinal illness can also lead to internal bleeding, which always requires hospitalization and surgery.

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How to Diagnose Rectal Bleeding (Blood in Stool)?

Several tests allow a provider to examine the inside of the colon, rectum, and anus. These procedures are performed using specialized instruments called oscilloscopes:

While the recommended tests may be different for different people, the important thing is to see a healthcare provider for an evaluation. The only way to know for sure what the cause of your rectal bleeding is to get the care and treatment you need.

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How to Treated Blood in Stool (Rectal Bleeding)?

Rectal bleeding treatment depends on the cause and severity. Hot baths and creams can help with haemorrhoids. Severe haemorrhoids may require rubber band ligation, laser treatments, or surgery. Anal fissures can resolve on their own or with stool softeners. Infections may need antibiotics. Colon cancer may require surgery, chemotherapy, or radiation therapy to rule out cancer and reduce the risk of recurrence.

When to Visit a Doctor?

Here are conditions in which it's advisable to check with a doctor if you experience rectal bleeding:

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How to Prevent Blood in Stool?

Rectal bleeding can be prevented by making changes in your regular lifestyle and food habits. Find the list of changes that help in the prevention of blood in stool: