There are a few ways to notice the presence of blood in your faeces or stool – either it gets passed out together with the stool, staining the water in the toilet bowl red, or when wiping with tissues, you noticed the presence of red discolouration on it. Regardless, noticing the presence of blood in your faeces (also known as rectal bleeding) is something very alarming for most, if not all of us. As will be discussed in this article, there are non-life-threatening causes for bleeding through your rectum, and they make up the majority of cases but what you will also learn from this article is that there are serious, life-threatening causes of rectal bleeding that warrants urgent attention and investigation.

Less Serious Causes Of Blood In Your Faeces

Anal Fissure

We start this list with one of the commonest cause of rectal bleeding that you may have experienced before at some point of your life. Anal fissure refers to the tearing or a cut, on the lining of the mucosal surface of the anus. This delicate surface, when torn, leads to pain and bleeding. The pain may be severe when passing out motion and may last for several hours after that. Anal fissure can occur at any age albeit more common in infants and middle-aged adults. It can happen due to a few reasons which includes:

  • Passing large or hard stools
  • Constipation and straining during bowel movements
  • Chronic diarrhea
  • Anal intercourse
  • Childbirth

Hemorrhoids

Hemorrhoids or piles, are swollen blood vessels in the rectum or anus. In many cases, haemorrhoids don’t cause symptoms and some people don’t even realise they have them but when it does exhibit symtpoms and signs, it can be painful, itchy, and can sometimes bleed. Painless rectal bleeding with a bowel movement is a common symptom of hemorrhoids. Bright red blood typically coats the stool or blood may drip into the toilet or stain toilet paper. Typical features of haemorrhoids include:

  • Bleeding after passing a stool – the blood is usually bright red
  • Itchy anal opening
  • A lump hanging down outside of the anus, which may need to be pushed back in
  • A mucus discharge after passing a stool, leading to feeling of discomfort
  • Soreness, redness and swelling around your anus

More Serious Causes Of Blood In Your Faeces

Ulceration

Ulceration of the stomach usually do not result in the presence of obvious or frank blood in the stool because the relatively longer transit time and journey the blood has to go through before it passes out of the gastrointestinal system. Usually, because of the delay, blood from the ulceration of the lining of the stomach will already be oxidised within the stool, causing the colour of the stool to be very very dark, described as dark-tarry stool. Doctors describe this stool with the term ‘melena’ and it has an awful smell accompanying it as well. However, should the bleeding from the ulcer be overwhelming, some rank blood may be able to be seen.

Ulceration here can be caused by a number of reasons, most commonly from frequent act of meal skipping followed by consumption of spicy, hot and acidic food. Another cause of ulceration can be due to a form of gastrin secreting tumor, known as Zollinger-Ellison Syndrome. Regular consumption of NSAIDs analgesics can also cause bleeding tendency is it interferes with the protective mechanisms of the lining of the stomach.

Inflammatory Bowel Diseases (IBDs)

Inflammatory Bowel diseases includes condition such as Crohn’ disease and Ulcerative Colitis. This condition causes chronic relapsing inflammation of the bowel, the gastrointestinal system as well as some extra-intestinal manifestation. It is caused by a complex interaction between genetic predisposition, immune dysregulation targeted towards intestinal microbiota, and certain environmental factors.  IBDs can be very debilitating and because of the transmural inflammation or the surface ulceration of the bowel, bleeding can occur and lead to the presence of blood in your stool. IBDs also increases one’s risk to develop bowel cancer especially for Ulcerative Colitis.

Bowel Polyps

Bowel polyps, also known as colon polyps, are small growths of tissue on the wall of the colon (large bowel) or rectum. Most polyps are small, usually less than 1cm in size, although they can grow larger. Polyps can appear in many forms: they may look like a small raised lump, a wart, a grape or a mushroom on a stalk or a cluster of many small bumps. Some people have just one polyp, while others can have several. Most polyps are harmless and inn most cases, polyps do not cause any symptoms and are often discovered by accident, but over time some can develop into bowel cancer. That’s why they are usually removed if found. Because it grows into the lumen of the bowel and stands in the way of faecal movement, the process of passing out stool against the structure may cause it to bleed, leading to rectal bleeding.

Diverticular diseases

Diverticula are pouches which bulges out of weak areas along the lining of the wall of the the intestine. They are usually small and shaped like a balloon, and the contents of the bowel may mistakenly be trapped inside these pouches. Most diverticula don’t cause any symptoms (often referred as Diverticulosis) but when they do, Diverticular disease is typically associated with pain in the lower left side of the abdomen or, less commonly, the right side. It can also lead to bloating, constipation or diarrhea and especially for Divertuculitis (when the diverticula becomes inflammed), bleeding can occur.

Cancer

Last but not least, the most worrying and life-threatening explanation why there is blood in your faeces is none other than cancer. The suspicion of Bowel cancer (Colorectal cancer) should always be in one’s head especially if you also experiencing chronic unexplained weight loss and a chronic episode of alternating diarrhoea with constipation.

Presence of blood in your faeces is not something you see every day and if you have risk factors for the above condition or worried about what could be the underlying cause, go and see a doctor.

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

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