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Rectal Bleeding

Monday, October 2nd 2017. | Rectal Bleeding

Rectal bleeding means any blood that is passed from the rectum. The blood may be mixed with the stools or there may be clots present. The bleed indicates that there is some problem in the gastro-intestinal system. It could be in the anus, rectum or sigmoid colon if the blood is bright red in colour, dark red or maroon if the problem is higher up and black and tarry if it is from the stomach. Blood that is present in the stools but not visible to the naked eye is known as occult blood and can only be confirmed by a laboratory test.
The causes of blood in the stool can be quite harmless as in polyps, hemorrhoids and anal tears or can be indicative of a more serious conditions such as cancer. The presence of blood in the stool must always be checked out by a doctor.

Causes of bleeding from the rectal and anal area include piles or haemorrhoids, an anal tear or fissure due to passage of hard stools. These are the most common causes of rectal bleeding.

Hemorrhoids or piles are the swollen rectal veins in the anal and rectal area. They can cause pain, burning, discomfort and bleeding. An anal fissure or tear is caused by the passage of hard stools or straining in constipation. The blood is usually seen as a linear smear on the stool. There may also be drops of fresh, red blood. It usually heals on its own. Stool softeners and warm immersive baths help both the conditions.Rectal Bleeding

Rectal bleeding from a trauma such as a from a gunshot wound or foreign body impalement can cause rapid and fatal blood loss. Emergency treatment becomes necessary in such cases.

Infection, inflammation (IBD or irritable bowel disease, Crohn’s disease, ulcerative colitis), angiodysplasia, ischaemic colitis, diverticulosis, rectal trauma, colon cancers, polyps, tumours and radiation can all cause bleeding from higher up in the GI tract.

Bacterial diarrhoea from infection with Clostridia, Campylobacter, Salmonella, Shigella, EColi or amoebic dysentery commonly cause loose stools with blood.

Diverticula are pouch like structures that project from the intestinal wall. When these become inflamed and infected it is called diverticulitis. It usually occurs in older people because of lack of fibre in the diet. The stools are dark red or maroon. Pain if present, typically occurs in the left lower part of the abdomen.

Polyps are bulges of tissue from the lining of the colon. It is a hereditary condition. They are usually harmless. Sometimes they may bleed when enlarged. Some types can be precancerous.

Both benign and malignant tumours are frequently found in the colon and rectum. Usually occur in those above the age of 50 years. Bleeding if it occurs is usually slow, chronic, and minimal.

In cancer symptoms such as weight loss, a change in the caliber of stools, a sense of rectal fullness, or constipation may be experienced.

Inflammatory bowel disease (IBD) like Crohn’s disease and ulcerative colitis is a common cause of rectal bleeding in adults under 50 years of age. There is bright red blood in the stool along with mucus. There may be fever, cramping and stomach pain.

Angiodysplasia is a vascular problem. Enlarged veins and capillaries in the wall of the right colon in elderly people become fragile and can bleed. The bleeding may be slow and not noticeable. There may be weakness, fatigue and shortness of breath. Or there may be massive, painless, rectal bleeding.

If the blood is black in colour resulting in tarry and foul smelling stools it is called melena. It indicates bleeding from the upper gastrointestinal tract for example, bleeding from ulcers in the stomach or the duodenum or from the small intestine. Alcohol consumption can cause ulcers and gastritis.

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