Rectal Prolapse

Understanding Rectal Bleeding

Understanding Rectal Bleeding

Outline of man showing gastrointestinal system. Rectal bleeding is when blood passes through your rectum and anus. It can happen with or without a bowel movement. Rectal bleeding may be a sign of a serious problem in your rectum, colon, or upper GI tract. Call your healthcare provider right away if you have any rectal bleeding.

The GI Tract

The gastrointestinal (GI) tract includes the mouth, esophagus, stomach, small intestine, large intestine (colon), rectum, and anus. The food you eat is digested as it passes through the GI tract. Solid waste leaves the body through the rectum.

Rectal bleeding and GI problems

The cause of rectal bleeding may be found in any region of the GI tract. The colon or rectum may be the site of your bleeding problem. Or, bleeding may be due to problems farther up the GI tract, such as in the small intestine, duodenum, or stomach.

Causes of rectal bleeding

Rectal bleeding causes include the following:

  • Hemorrhoids (swollen veins in the rectum and anus)

  • Fissures (tears in or near the anus)

  • Diverticulosis (inflamed pockets in the colon wall)

  • Infection

  • Ischemia (low blood flow)

  • Radiation damage

  • Inflammatory bowel disease (Crohn's disease or ulcerative colitis)

  • Ulcers in the upper GI tract and inflammation of the large intestine

  • Abnormal tissue growths (tumors or polyps) in the GI tract

  • A bulging rectum (also called a rectal prolapse)

  • Abnormal blood vessels in the small intestine or in the colon

Common symptoms

Common symptoms include the following:

  • Rectal pain, itching, or soreness

  • Belly pain or epigastric pain

  • Minor occasional drops of blood that appear on the stool or toilet paper, to greater amounts of stool that appear black or tarry 

Rectal bleeding can also happen without pain.

Evaluating and Treating Rectal Bleeding

Evaluating and Treating Rectal Bleeding

Man lying on exam table on side. Health care provider is holding end of colonoscope and looking at pictures on monitor. Another healthcare provider is standing next to table.To find the site and cause of your bleeding, you will have a physical exam. You will be asked about your health history. Tests may be done to help confirm the diagnosis and plan your treatment.

Tests you may have

Any of these procedures may be done:

  • Stool sample. A small amount of your stool will be checked for blood.

  • Anoscopy. This test uses a small tube (anoscope) to examine the anus. It checks for problems such as hemorrhoids.

  • Sigmoidoscopy. This test uses a lighted tube to check your rectum and the part of the large intestine that is closest to the rectum (the sigmoid colon).

  • Colonoscopy. This test looks at your rectum and entire colon. You may be given medicine through an IV to help you relax.

  • Lower GI (gastrointestinal) series, or barium enema. This is an X-ray test to view your colon. A milky liquid containing barium is passed through your rectum and into the colon. This liquid makes it easy to see your colon on the X-ray.

  • Upper endoscopy. This test checks your esophagus, stomach, and upper small intestine. It is done in cases of rectal bleeding along with other symptoms like low blood pressure and rapid heartbeat. This test may also be done if your stools are dark black and tarry.

  • Capsule endoscopy. For this test, you swallow a pill that has a tiny camera inside. The camera takes pictures of your small intestine. It can get to areas that are hard to reach with colonoscopy and upper endoscopy.

  • Balloon enteroscopy. This test uses a special tube (scope) to get deep into the small intestine.

  • Tagged red blood cell scan. This test marks (tags) red blood cells with very small amounts of radioactive material. The cells can then be seen and tracked on a scan.

  • Angiography. This test threads a tube (catheter) through a vein, often in the leg. The tube injects dye into your blood vessels to see where the bleeding is taking place.

Your treatment plan

Your treatment will depend on the cause of your rectal bleeding. Your healthcare provider will create a treatment plan that’s right for you. Sometimes rectal bleeding stops on its own. If it does, be sure to see your provider to check that the problem wasn’t serious.

What you can do

Follow all your doctor’s instructions. Keep working with your doctor after your treatment. Make and keep your follow-up visits. If you have more rectal bleeding, call your doctor. It may be a sign of the same or another health problem.

Understanding Colon and Rectal Polyps

Understanding Colon and Rectal Polyps

Cross section of segment of colon showing polyp.The colon (also called the large intestine) is a muscular tube that forms the last part of the digestive tract. It absorbs water and stores food waste. The colon is about 4 to 6 feet long. The rectum is the last 6 inches of the colon. The colon and rectum have a smooth lining composed of millions of cells. Changes in these cells can lead to growths in the colon that can become cancerous and should be removed. Multiple tests are available to screen for colon cancer, but the colonoscopy is the most recommended test. During colonoscopy, these polyps can be removed. How often you need this test depends on many things including your condition, your family history, symptoms, and what the findings were at the previous colonoscopy. 

When the colon lining changes

Changes that happen in the cells that line the colon or rectum can lead to growths called polyps. Over a period of years, polyps can turn cancerous. Removing polyps early may prevent cancer from ever forming.

Polyps

Polyps are fleshy clumps of tissue that form on the lining of the colon or rectum. Small polyps are usually benign (not cancerous). However, over time, cells in a polyp can change and become cancerous. Certain types of polyps known as adenomatous polyps are premalignant. The risk for invasive cancer increases with the size of the polyp and certain cell and gene features. This means that they can become cancerous if they're not removed. Hyperplastic polyps are benign. They can grow quite large and not turn cancerous. 

Cancer

Almost all colorectal cancers start when polyp cells begin growing abnormally. As a cancerous tumor grows, it may involve more and more of the colon or rectum. In time, cancer can also grow beyond the colon or rectum and spread to nearby organs or to glands called lymph nodes. The cells can also travel to other parts of the body. This is known as metastasis. The earlier a cancerous tumor is removed, the better the chance of preventing its spread.

Cross section of segment of colon showing cancer.

Providers

Robert C Amajoyi, MD

Colon and Rectal Surgery, Surgery (General)