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What is Rectal Bleeding?

Rectal bleeding is essentially any bleeding seen before, during or after you have a bowel movement.

What are the signs of rectal bleeding?

The amount of blood seen with rectal bleeding varies from a few drops on toilet paper or in the toilet bowl to whole capfuls of blood. The blood seen is also variable in appearance from being bright red to dark red with associated blood clots.

What causes rectal bleeding?

The causes of rectal bleeding are numerous. Bleeding can occur from upper gastrointestinal sources such as the stomach and small bowel caused by conditions such as:

  • Peptic ulcer
  • Gastro-esophageal varices
  • Gastro-esophageal cancer
  • Small bowel tumors
  • Arterio-venous malformation
  • Crohn’s disease

Bleeding can also occur from lower gastrointestinal specifically the colon, rectum and anus caused by conditions such as:

  • Inflammatory bowel disease
  • Colorectal cancer
  • Anal cancer
  • Arteriovenous malformations
  • Diverticular disease
  • Hemorrhoids
  • Anal fissure

What are the possible complications of rectal bleeding?

The effects of rectal bleeding are dependent on the amount of blood loss and how long it has been going on for. It is possible to lose small amounts of blood and not have significant symptoms because your body can initially compensate for the loss. However, if you continue to lose blood persistently and continuously, it can ultimately result in symptoms of weakness, confusion, dizziness, faints and ultimately could be life-threatening.

How is rectal bleeding investigated?

When you are seen by a colorectal specialist, they normally assess where the bleeding is coming from firstly by taking a history and examining you for the possible source of bleeding. Examination may include endoscopic tests such as upper endoscopy (EGD) or lower endoscopy (anoscopy, flexible sigmoidoscopy or colonoscopy). The colorectal specialist may also perform x-ray tests as a guide to find the source of bleeding in addition to blood or stool examinations.

How is rectal bleeding treated?

The treatment of rectal bleeding is dependent on the source of the bleeding. Contacting a colorectal specialist will enable them to work out which of the possible causes is a source of your bleeding and what the best methods might be to stop the bleeding from continuing.

When to contact my doctor/see the specialist?

If you have persistent bleeding which is either occurring continuously or on multiple occasions, it is important to have that assessed by a colorectal specialist to prevent excessive blood loss which can ultimately be life threatening and to rule out the more serious causes of bleeding including colorectal cancer