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What are the most common causes of rectal bleeding?1159495174

Blood in the stool indicates rectal bleeding, and can have a number of causes. These causes range from hemorrhoids to ulcers to anal fissures. All kinds of rectal bleeds must be assessed by the Best General Surgeon in Lahore to rule out more serious conditions. Read on to know more about rectal bleeding and its most common cause: 

What are the common symptoms of rectal bleeding?

Rectal bleeding appears as blood in the stool, but the color and appearance of this blood tells us a lot:

  • In case of upper gastrointestinal bleed, such as the stomach or the upper part of the small intestine, the stool has a dark, tarry appearance as the blood oxidizes while passing through the GI tract. 
  • If the bleeding site is the lower gastrointestinal tract there is bright red blood in the stool. This blood is not oxidized as it passes through the GI tract, unlike that from the upper gastrointestinal tract and therefore has a bright red appearance. This lower GI tract includes rectum and colon. 
  • If the bleeding site is the lower part of small intestine or the first part of the large intestine, the blood is darker in color. 
  • If large amount of blood is lost, there may be additional symptoms like:
    • Dizziness
    • Confusion
    • Cramps and pain in the abdomen 
    • Rectal pain 

What are the common causes of rectal bleeding?

  • Hemorrhoids: these are amongst the most common cause of rectal bleeding, mainly in middle aged adults. In hemorrhoids, there are swollen blood vessels and muscle fibers in the rectum, secondary to exertion of pressure as seen in constipation, pregnancy, lifting heavy weight, obesity and straining during bowel movements. These hemorrhoids can be internal if the vessels are swollen in the rectum, or external, if they lie in the anal canal. Hemorrhoids are managed based on their cause and are not a medical emergency.
  • Anal fissure: this is the condition in which there is a tear or split in the anal skin around the sphincter causing extreme pain to the patient. Anal fissures occur secondary to childbirth, passage of hard stool and straining that can cause a tear in the skin. Anal fissures heal on their own and are managed with topical creams, and relief of constipation. 
  • Inflammatory bowel disease: ulcerative colitis and Crohn’s disease are inflammatory bowel diseases which cause ulcers along the GI tract that can bleed during exacerbations. With IBD, there is also fever, cramping pain, diarrhea and intestinal blockage. 
  • Polyps: these are growths along the wall of the large intestine which can bleed. Polyp growths are seen in a number of conditions and need monitoring if they are pre-cancerous. 
  • Diverticulitis: weakening in the wall of the GI tract can cause ballooning or outpouching of its walls and these pouches are called diverticuli. These diverticuli can become infected—called diverticulitis—and may bleed. In addition, they can cause fever in the patient, pain in the abdomen and change in the bowel habits. 
  • Angiodysplasia: enlarged blood vessels in the abdominal wall are called angiodysplasia. These newly grown blood vessels are fragile and tend to break easily. If these vessels break, rectal bleeding occurs. 
  • Colorectal cancer: the most dangerous cause of rectal bleeding is colorectal cancer. If these tumors are in the colon, they present with anemia due to occult bleeding and change in the bowel habits. For more distal tumors, located in the rectum, bleeding is more common. 

When to seek help?

Excessive rectal bleeding is a medical emergency, especially if the following symptoms are experienced: 

  • Severe nausea and vomiting 
  • Cold, clammy skin
  • Painful cramps in the abdomen 
  • Continuous fresh blood from the rectum
  • Blood in vomitus 
  • Dizziness and loss of consciousness 
  • Severe rectal pain 

Most patients with rectal bleeding get better on their own. However, complete workup by Best General Surgeon in Karachi to rule out colorectal cancer and other serious conditions needs to be done.