Rectal bleeding refers to any blood that passes from the anus, often mixed with stool and/or urine. It’s estimated that 1 in 20 people will experience an episode of rectal bleeding at some point in their lives. While rectal bleeding is often caused by a minor problem like hemorrhoids, it can also be a sign of a more serious underlying condition. That’s why it’s important to see a doctor any time you notice blood in your stool. This article will examine five of the most common causes of rectal bleeding.
What Is Rectal Bleeding?
Rectal bleeding, also called hematochezia, occurs when blood passes from the large intestine and out through the anus. Blood in the stool can appear bright red, maroon in color, or black and tarry. The color and consistency of the blood can signify different types of bleeding somewhere along the digestive tract.
Bright red blood usually indicates bleeding low in the colon or rectum, while darker blood can mean bleeding in the small intestine or upper colon. Bleeding higher up in the digestive tract, like in the stomach, can turn stool completely black and tarry with a foul odor. Seeing any amount or color of blood after a bowel movement is not normal and should prompt a call to your doctor.
What Are The Five Common Causes Of Rectal Bleeding?
Hemorrhoids are swollen, inflamed veins around the anus or in the lower rectum. They are extremely common, affecting nearly 50% of people over age 50. The exact cause is unknown, but potential factors include strained bowel movements, constipation, obesity, pregnancy, aging, and genetics.
Internal hemorrhoids lie inside the rectum and usually aren’t painful. They can prolapse and bleed painlessly during bowel movements. External hemorrhoids develop under the skin around the anus. They can itch, bleed, and cause pain when sitting or passing stools.
Hemorrhoid bleeding is typically bright red and painless. Seeing a few small streaks of bright red blood on toilet paper is common. Hemorrhoids usually clear up on their own or with over-the-counter treatments. However recurrent bleeding or prolapsed internal hemorrhoids may require medical procedures.
🔹 Anal Fissures
Anal fissures are tiny tears or splits in the thin tissue lining of the anus. They affect all age groups but are most common in infants and young children. The exact cause is unknown, but passing hard or large stools, chronic diarrhea, inflammation, or trauma can damage the anal tissue. Anal fissures usually cause pain and bleeding with bowel movements.
Bleeding from an anal fissure is also typically bright red and minimal. Application of creams, sitz baths, and stool softeners can help anal fissures heal within a few weeks. Chronic fissures may require prescription medication or minor surgery. See a doctor if the fissure fails to heal or bleeds frequently.
Diverticulosis occurs when small pouches or sacs called diverticula bulge outward through weak spots in the colon wall. It’s estimated that over half of all people older than 60 have diverticulosis. The pouches themselves don’t cause problems, but they can bleed or become inflamed or infected (diverticulitis).
Rectal bleeding with diverticulosis is usually minimal and painless. But the diverticula can erode into blood vessels in the colon wall and cause delayed bleeding that turns stool maroon, red, and tarry. Avoiding constipation and taking fiber supplements can help prevent diverticular bleeding. More serious cases may require hospitalization, blood transfusions, or surgery.
Colitis refers to inflammation in the colon and can have several underlying causes:
– Infectious colitis is often caused by bacteria, viruses, or parasites. Common symptoms include abdominal pain, diarrhea, and bloody stools.
– Ischemic colitis results from reduced blood flow to part of the large intestine, usually in older adults. It causes abdominal pain, cramping, and bloody diarrhea.
– Ulcerative colitis is a type of inflammatory bowel disease that causes long-lasting inflammation and ulcers in the colon or rectum. Symptoms include bloody diarrhea, rectal pain, and abdominal cramps.
Colitis causes inflammation that can damage the colon lining and cause bleeding. Treatment depends on the specific cause but may include antibiotics, medications, and avoiding trigger foods. Severe cases may require hospitalization or surgery.
🔹 Colon Polyps or Cancer
Colon polyps are abnormal growths that form on the lining of the colon and rectum. Most are noncancerous (benign), but some polyps can become cancerous over time. Rectal bleeding is one of the most common warning signs of colon polyps and colorectal cancer.
Polyps and colorectal tumors can bleed as they grow and erode the tissue. Cancerous growths also trigger inflammation that makes the tissue more prone to bleeding. Blood from polyps or cancer is often darker red or maroon as the bleeding is slower.
All rectal bleeding should prompt a medical evaluation. Polyps can often be removed during a colonoscopy before turning cancerous. Detecting colorectal cancer in its early stages greatly improves treatment success.
How Can Rectal Bleeding Be Prevented?
While rectal bleeding has many potential causes, there are things you can do to lower your risk:
- Eat a high-fiber diet and stay hydrated to avoid constipation and straining during bowel movements. This helps prevent hemorrhoids and anal tears.
- Don’t delay going to the bathroom as holding in stool also strains the rectum and anus.
- Practice gentle hygiene and don’t scrub aggressively after bowel movements. Gently pat clean with moist toilet paper or unscented wipes.
- Don’t use dry toilet paper alone as this can further irritate hemorrhoids or anal fissures.
- Avoid prolonged heavy lifting and strenuous exercise which increase intra-abdominal pressure.
- Lose weight if overweight or obese and don’t smoke, as these increase hemorrhoid risk.
- See a doctor for persistent diarrhea or constipation, which can chafe and damage the rectum.
- Get screened for colon polyps and cancer regularly after age 50. Removing precancerous polyps early is key.
Seeing blood in the toilet bowl or on toilet paper can be alarming. But rectal bleeding has many causes, most of which are benign and treatable. Hemorrhoids, anal fissures, diverticulosis, and colitis account for most cases and rarely lead to serious outcomes when properly managed. Still, certain symptoms like darker blood or bleeding accompanied by severe pain or dizziness warrant prompt medical care.
Don’t hesitate to call your doctor for proper diagnosis and treatment if you experience any rectal bleeding. Catching conditions like cancerous polyps early vastly improves prognosis. With an accurate diagnosis, rectal bleeding can often be controlled and prevented from recurring.
A: Increasing fiber with fruits, vegetables, whole grains, beans, nuts, and seeds can help regulate bowel movements and prevent constipation. Staying hydrated helps soften stool. Avoiding spicy foods, alcohol, and NSAIDs may also help prevent rectal irritation.
A: No, while bright red blood is often caused by hemorrhoids, it can also result from anal fissures, ulcerative colitis, Crohn’s disease, rectal ulcers, or cancer growth. It’s important to see a doctor to determine the exact cause of any rectal bleeding.
A: Seek emergency care if you experience dizziness, rapid heartbeat, confusion, or fainting along with rectal bleeding. Also go if bleeding is persistent or you pass many large, bright red clots. Signs of severe blood loss like rectal pain, swelling, or black tarry stool also warrant an ER visit.
A: While they don’t directly cause bleeding, stress, and anxiety can increase your risk by leading to behaviors that strain digestion. Tension can trigger IBS constipation, frequent diarrhea, and abdominal discomfort that chafe the rectum. Managing stress is key.
A: No, recurrent bleeding with each bowel movement is not normal even with hemorrhoids. Chronic bleeding can lead to anemia. See your doctor to stop frequent bleeding, which may require medical treatment or surgery if hemorrhoids are severe.