Rectal Bleeding

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Definition

What is rectal bleeding?

Rectal bleeding can refer to any blood that passes from your anus, although rectal bleeding is usually assumed to refer to bleeding from your lower colon or rectum. Your rectum makes up the last few inches of your large intestine.

Rectal bleeding may show up as blood in your stool, on the toilet paper or in the toilet bowl. Blood that results from rectal bleeding is usually bright red in color, but occasionally can be dark maroon.

Not all rectal bleeding is visible to the eye. In some cases, rectal bleeding can only be seen by looking at a stool sample through a microscope.

How common is rectal bleeding?

Rectal bleeding is common. It can occur in patients in any gender at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Which signs and symptoms can rectal bleeding usually be associated with?

Related signs and symptoms include:

  • Rectal pain and/or pressure
  • Bright red blood in/on the stool, on underwear, and/or in the toilet
  • Red, maroon, or black stool color
  • Stool that has a tar-like appearance
  • Confusion
  • Feeling lightheaded or dizzy
  • Fainting

Causes

What causes rectal bleeding?

Common causes of rectal bleeding can include:

  • Hemorrhoids. One very common cause of bleeding from the rectum is hemorrhoids. Hemorrhoids are actually veins in the rectum that have become swollen. They may cause pain, itching, and bright red blood on the stool or on the toilet paper, although many do not cause any symptoms at all. Hemorrhoids are typically not serious and can be treated at home. They should be investigated by a physician in the case that they are causing a large amount of bleeding or if they aren’t getting any better after being treated. Remember, when there is visible blood in the toilet, coating the stool or on the toilet paper, it should be investigated by a doctor. This is because there is a possibility of losing so much blood that the situation becomes dangerous, or that the bleeding is not from hemorrhoids at all, but from a more serious condition like inflammatory bowel disease (IBD) or colon cancer.
  • Diverticular disease (Diverticulitis). Diverticular disease is quite common; as many as half of all people over age 60 have signs of diverticular disease. Diverticulosis is the presence of weak spots on the wall of the large intestine that develop into pockets or outpouchings. These outpouchings are called diverticula (a singular outpouch is called a diverticulum), and they generally don’t produce any symptoms at all. People with diverticular disease might not know diverticula are there unless one or more of them get infected, which is then a condition called diverticulitis. Diverticulitis might make a person seriously sick and could also cause abdominal pain. In some cases, the diverticula might bleed. The blood could be found in or on the stool, or bleeding could happen even without a bowel movement. Diverticular disease could cause quite a bit of bleeding and might or might not need treatment, but people with this condition should always see a physician if there is bleeding, even if it has happened before.
  • Anal fissures. An anal fissure could be a complication of Crohn’s disease or of childbirth, or it could be caused by hemorrhoids that have ulcerated or straining from severe constipation. An anal fissure is a tear in the anal canal and could cause bright red blood in the stool or on the toilet paper. Fissures also may cause pain during bowel movements, which sometimes is severe. Most fissures are classified as acute and will respond to non-invasive therapies that can be done at home. In many cases, the fissure won’t come back, especially when care is taken to ensure that stools are kept soft and easy to pass (in other words, not too hard or too loose). A fissure that becomes chronic and is resistant to heal is not common but may need more intensive treatment, such as surgery.
  • Polyps and colon cancer. One uncommon source of bleeding from the rectum is colon cancer. Colon cancer starts with polyps—outcroppings on the inside wall of the colon. Bleeding from colon polyps might not be enough to be visible to the naked eye, and most polyps don’t bleed at all. Therefore, polyps could be growing in the colon without causing any signs or symptoms. Bleeding is a sign of colon cancer, but it might not appear until the cancer is in a more advanced stage. When polyps are removed during a colonoscopy, there is no chance of them developing into cancer. Screening for colon cancer with a colonoscopy, especially for those over the age of 50, is an important tool to remove polyps and prevent colon cancer.
  • Inflammatory bowel disease (IBD). Rectal bleeding due to IBD is more common with ulcerative colitis than it is with Crohn’s disease. Bleeding tends to be a hallmark sign of ulcerative colitis because, in this form of IBD, the inflammation begins at the end of the colon in the rectum. Inflammation from Crohn’s disease in the colon, particularly when it’s located in the rectum, could also lead to visible blood on or in the stool. The blood coming from the ulceration in the colon that is caused by these diseases is often fresh, so it tends to be a brighter red in color. In the case of ulcerative colitis, there might be bowel movements that are mainly just blood. Blood from higher up in the digestive tract tends to be darker in color and might not be as visible in the stool.​

Other possible causes include:

  • Constipation
  • Hard stools
  • Angiodysplasia (abnormalities in the blood vessels near the intestines)
  • Diarrhea
  • Ischemic colitis (colon inflammation caused by reduced blood flow)
  • Proctitis (inflammation of the lining of the rectum)
  • Pseudomembranous colitis (colon inflammation caused by an infection)
  • Radiation therapy
  • Rectal cancer
  • Solitary rectal ulcer syndrome (ulcer of the rectum)
  • Ulcerative colitis (a type of inflammatory bowel disease)

The conditions mentioned above are some common causes of rectal bleeding. Consult with your doctor for an accurate diagnosis.

Risk factors

What increases my risk for rectal bleeding?

You are more likely to experience rectal bleeding if you have any of the conditions mentioned above.

Please consult with your doctor for further information.

When to see your doctor

When should I see my doctor?

You should contact your doctor if you or your loved one has any of the following:

  • Rapid, shallow breathing
  • Dizziness or lightheadedness after standing up
  • Blurred vision
  • Fainting
  • Confusion
  • Nausea
  • Cold, clammy, pale skin
  • Low urine output
  • Rectal bleeding accompanied by severe abdominal pain or cramping
  • Continuous or heavy rectal bleeding

On noticing one of these symptoms or having any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor to get the best solutions for your situation.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage rectal bleeding?

These following lifestyles and home remedies might help you cope with rectal bleeding:

  • You may relieve the pain and discomfort of hemorrhoids by taking warm baths. Applying over-the-counter or prescription creams can also reduce irritation.
  • Using stool softeners can address issues with constipation and help anal fissures to heal.
  • Eating high-fiber foods (unless otherwise directed by your doctor)
  • Exercising regularly to prevent constipation
  • Keeping the rectal area clean
  • Staying well hydrated

If you have any questions, please consult with your doctor for the best solutions.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: January 16, 2019 | Last Modified: January 16, 2019

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