Blood in the Stool (Rectal Bleeding) (cont.)
Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)
Dr. Anand received MBBS degree from Medical College Amritsar, University of Punjab. He completed his Internal Medicine residency at the Postgraduate Institute of medical Education and Research, Chandigarh, India. He was trained in the field of Gastroenterology and obtained the DPhil degree. Dr. Anand is board-certified in Internal Medicine and Gastroenterology.
In this Article
- Rectal bleeding (blood in stool) definition and facts
- What does rectal bleeding (blood in stool) mean?
- What are causes of blood in the stool (rectal bleeding)?
- What diseases and conditions can cause blood in the stool (rectal bleeding)?
- Anal fissures
- Colon cancer and polyps
- Meckel's diverticulum
- Colitis and proctitis
- Rare causes of rectal bleeding
- What kind of doctor treats rectal bleeding?
- When should I call a doctor for blood in the stool (rectal bleeding)?
- How is the cause of blood in the stool (rectal bleeding) diagnosed?
- History and physical examination
- Flexible sigmoidoscopy
- Video capsule and small intestine endoscopy
- Radionuclide scans
- Visceral angiogram
- MRI and CT tomographic angiography
- Nasogastric tube aspiration
- Blood tests
- What is the treatment for rectal bleeding (blood in the stool)?
- Can rectal bleeding (blood in the stool) be prevented?
- What is the prognosis of rectal bleeding (blood in the stool)?
- Find a local Gastroenterologist in your town
What diseases and conditions can cause blood in the stool (rectal bleeding)?
Many diseases and conditions can cause rectal bleeding. Common causes include:
- Anal fissures
- Cancers and polyps of the rectum and colon
- Abnormal blood vessels in the lining of the intestines (angiodysplasia)
- Ulcerative colitis
- Ulcerative proctitis
- Crohn's colitis
- Infectious colitis
- Ischemic colitis
- Meckel's diverticula
As discussed previously, it also is possible for "rectal bleeding" to be coming from the stomach and duodenum, primarily from ulcers, cancers, and angiodysplasias.
An anal fissure is a fairly common, painful condition in which the lining of the anal canal is torn. An anal fissure usually is caused by physical trauma due to constipation or a forceful bowel movement through a tight anal muscle or physical trauma also may be contributing factors. Once the skin is torn, each subsequent bowel movement can be painful, and the pain often is severe. The amount of bleeding that occurs with an anal fissure is small and usually is noticed in the toilet bowl or on the toilet paper as bright red in color. The symptoms of an anal fissure are commonly mistaken for hemorrhoids, but hemorrhoids generally do not cause pain with bowel movements.
Hemorrhoids are masses or clumps ("cushions") of tissue within the anal canal that contain blood vessels. Although most people think hemorrhoids are abnormal, they are present in everyone. It is only when the hemorrhoidal cushions enlarge that hemorrhoids become susceptible to trauma from passing stool and cause problems (such as bleeding or anal discomfort) and are considered abnormal or a disease. Like anal fissures, bleeding from hemorrhoids usually is mild and does not cause anemia or low blood pressure. Rarely, a person may develop iron deficiency anemia as a result of repeated hemorrhoidal bleeding over several months to years, especially if the dietary intake of iron is low.
Colon cancer and polyps
Tumors of the colon and rectum are growths (masses) arising from the wall of the large intestine. Benign tumors of the large intestine usually are called polyps because of their shape. Malignant tumors of the large intestine are cancers, and most are believed to have developed from polyps. Bleeding from colon polyps and cancers tends to be mild (the amount of blood loss is small), intermittent, and usually does not cause low blood pressure or shock.
Cancers and polyps of the colon and rectum can cause bright red rectal bleeding, maroon colored stools, and sometimes melena. The colon cancers and polyps located near the rectum and the sigmoid colon are more likely to cause mild intermittent bright red rectal bleeding, while colon cancers located in the right colon are more likely to cause occult bleeding that over time can lead to moderate or severe iron deficiency anemia.
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