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
Diverticulosis is a condition in which the colon contains outpouchings (little sacks). Diverticula are present in a majority of people who reach the age of 50-60 years. The cause of colonic diverticula is not entirely known, but may be contributed by years of high pressure within the colon or a weakness in the wall of the colon. Diverticula are permanent, and no diet will cause them to disappear. The only way to rid a person of diverticula is to surgically remove the part of the colon that contains the diverticula. A person with diverticulosis typically has many diverticula scattered throughout the colon, but diverticula are most common in the sigmoid and descending colon.
Most people with diverticulosis have few or no symptoms. Diverticulosis is not a problem unless a diverticulum ruptures and an infection (abscess) results, a condition called diverticulitis. Diverticulitis causes abdominal pain, fever and tenderness usually in the left lower abdomen. Rarely, bleeding can occur from a diverticulum when a blood vessel inside the diverticulum is weakened by the infection and ruptures.
Bleeding from diverticulosis (diverticular bleeding) without the presence of diverticulitis is painless. Bleeding from diverticulosis is generally more severe and brisker than bleeding from anal fissures, hemorrhoids, and colon tumors. Diverticular bleeding is the most common cause of moderate to severe rectal bleeding that requires hospitalization and blood transfusions among the elderly population in the Western world.
When bleeding occurs in a diverticulum located in the sigmoid colon, the bleeding tends to be bright red. When bleeding occurs in a diverticulum located in the right or ascending colon, the bleeding may also be bright red if the bleeding is brisk and the transit through the colon is rapid; however, the color is more likely to be dark red, maroon, or, sometimes, even black (melena).
Bleeding from diverticulosis is usually brief (it stops on its own). However, diverticular bleeding tends to recur. For example, a patient may experience several episodes of rectal bleeding from diverticula during the same hospitalization. Even after discharge from the hospital, some patients who do not have the diverticula-containing part of their colon surgically removed will experience another episode of diverticular bleeding within 4-5 years.
A Meckel's diverticulum is an out-pouching (sack) that protrudes from the small intestine near the junction of the small intestine and the colon. It is present from birth and occurs in a small percentage of the population. Some Meckel's diverticula can secrete acid, like the stomach, and the acid can cause ulcerations in the inner lining of the diverticulum or the tissues of the small intestine adjacent to the diverticulum. These ulcers can bleed. Bleeding from a Meckel's diverticulum is the most common cause of gastrointestinal bleeding in children and young adults. Bleeding from a Meckel's diverticulum is painless but can be brisk and can cause bright red, dark red, or maroon stools.
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