Index
Rectal bleeding has many causes and can result from a weaker or abnormal area along your digestive tract.
If you stop going to the bathroom and notice a small amount of bright red to black blood in the toilet bowl, toilet paper, or the stool, you are experiencing rectal bleeding.
According to the Cleveland Clinic, hemorrhoids are the most common cause of rectal bleeding.
While these and other causes of rectal bleeding can be minor inconveniences, rectal bleeding can be a genuine concern if you lose blood.
Symptoms of Blood in the Year
The most apparent sign of rectal bleeding is red blood on toilet paper, or visible blood or stools dyed red in the toilet bowl.
However, you must pay attention to the coloring of the blood (and the color of your stool) as it may indicate different things:
- Bright red blood: indicates bleeding somewhere in the lower gastrointestinal tract, such as the colon or rectum.
- Dark red or wine-colored blood: may indicate bleeding in the small intestine or the early portion of the colon.
- Black, tarry stools: may indicate bleeding from the stomach or upper part of the small intestine.
Additional symptoms associated with rectal bleeding include:
- Confusion.
- Fainting.
- Dizziness
- Rectal pain.
- Abdominal pain or cramps.
Causes
Some of the associated diseases that can cause rectal bleeding include:
Anal fissure:
An anal fissure is a small cut or tears in the lining of the anus. The crack in the skin causes severe pain and some bright red blood during and after bowel movements.
Sometimes, the fissure is deep enough to expose the underlying muscle tissue.
An anal fissure can occur due to labor, the effort during bowel movements, or prolonged episodes of constipation or diarrhea.
Anal fissures can also result from certain medical conditions, such as inflammatory bowel disease (IBD), infections, and cancer.
An anal fissure can affect people of all ages and is often seen in infants and young children.
An anal fissure is usually not a severe condition. In most cases, the fissure heals within four to six weeks.
In cases where the fissure persists beyond eight weeks, it is considered chronic or long-term.
Specific treatments can promote healing and help relieve discomfort, including stool softeners and topical pain relievers.
Surgery may be required if an anal fissure does not improve with these treatments. Alternatively, your doctor may need to look for other underlying disorders that can cause anal fissures.
Ulcerative colitis:
Ulcerative colitis is an inflammatory bowel disease (IBD). IBD includes a group of diseases that affect the gastrointestinal tract.
Ulcerative colitis occurs when the lining of the large intestine (also called the colon) and rectum are inflamed.
This inflammation produces small sores called ulcers on the lining of your colon.
It usually starts in the rectum and extends upwards. It can involve your entire colon.
Inflammation causes your bowel to move its contents quickly and empty frequently.
As the cells on the surface of the lining of the intestine die, ulcers form. Ulcers can cause bleeding and discharge of mucus and pus.
Although this disease affects people of all ages, most people are diagnosed between 15 and 35 years.
After 50 years, another slight increase in the diagnosis of this disease is observed, generally in men.
Anal cancer:
Cancer cells that form in benign or malignant tumors in the tissues of the anus are anal cancer.
The anus is the opening in the lower part of the intestines where the stool leaves the body.
Some non-cancerous forms of anal cancer can become cancerous over time. Anal cancer is rare and can spread to other parts of the body.
Colorectal cancer:
Colorectal cancer is a type of cancer that begins in the rectum or colon, sections that belong to the large intestine.
Both organs are in the lower part of your digestive system. The colon is also known as the large intestine, and the rectum is at the end of the colon.
According to the American Cancer Society (SAC), it is estimated that one in 20 people will develop colorectal cancer during their lifetime.
Your doctor can use staging as a guide to determine your cancer’s advanced.
Your doctor must know the stage of your cancer so that they can devise the best treatment plan for you and also so that they can give you an estimate of the long-term prognosis.
Necrotizing enterocolitis:
It is a disease that develops when the tissue in the inner lining of the small or large intestine becomes damaged and begins to die.
This causes the intestine to become inflamed. The condition usually affects only the inner lining of the intestine, but the total thickness of the intestine may eventually be affected.
In severe cases of NEC, a hole can be formed in the wall of the intestine.
If this happens, the bacteria usually found inside the intestine can leak into the abdomen and cause a generalized infection.
This is considered a medical emergency. NEC can develop in any newborn within two weeks after birth.
NEC is a severe disease that can progress very quickly. It is essential to get treatment immediately if you or your baby shows symptoms of NEC.
Crohn’s disease :
Crohn’s disease is a very recurrent chronic intestinal disease that causes severe digestive tract inflammation and affects your quality of life.
Crohn’s disease is included in a larger group of inflammatory bowel diseases.
It can appear anywhere along the gastrointestinal tract, from the mouth to the anus. It is usually found in the distal small intestine and colon.
Crohn’s disease can also develop in any part of the intestinal tract, making it difficult to diagnose and treat.
Over time, ulcerations or small sores can develop and spread through the layers of your intestinal tract.
Colonic polyps :
Colonic polyps, also known as colorectal polyps, are lumps that appear on the surface of the colon.
The colon or large intestine is where the body makes and stores stool.
Polyps in the colon may vary in size and number. There are three types of polyps in the colon:
- Hyperplastic polyps: they are harmless and do not turn into cancer.
- The adenomatous polyps are the most common most have the potential to become colon cancer.
- Malignant polyps: they are polyps that are observed in the microscopic examination to observe if in them cancer cells exist.
Hemorrhoids:
Hemorrhoids are swollen veins located around the anus or in the lower rectum.
About 50 percent of adults experience the symptoms of hemorrhoids at the age of 50.
Hemorrhoids can be internal or external. External hemorrhoids are the most common and problematic because they cause pain, severe itching, and difficulty sitting.
Fortunately, they are treatable.
Bacterial gastroenteritis:
Bacterial gastroenteritis occurs when bacteria cause an infection in the intestine.
This causes inflammation in your stomach and intestines.
You may also experience vomiting, severe abdominal cramping, and diarrhea.
While viruses cause many gastrointestinal infections, bacterial infections are also common.
Some people call this infection “food poisoning.” Bacterial gastroenteritis can be the result of poor hygiene.
Infection can also occur after close contact with animals or consuming food or water contaminated with bacteria (or the toxic substances that bacteria produce).
Ischemic colitis:
Ischemic colitis (IC) is an inflammatory condition of the large intestine or colon, which occurs when the blood flow to your colon is suddenly interrupted or restricted.
Blood clots can be a reason for the sudden blockage.
CI can occur at any age, but it is more common among those over 60.
An accumulation of plaque inside the arteries ( atherosclerosis ) can cause chronic or long-term IC.
This condition can also disappear with a mild treatment, such as a short-term liquid diet and antibiotics.
It is also known as mesenteric artery ischemia, mesenteric vascular disease, or colonic ischemia.
A blood clot usually causes acute IC (sudden and short-term). Acute IC is a medical emergency and requires treatment quickly.
The mortality rate is high if gangrene or tissue death occurs in the colon.
When should I seek medical help?
Severe rectal bleeding can be a medical emergency.
Go to the emergency room if you experience the following additional symptoms:
- Cold and damp skin.
- Confusion.
- Continuous rectal bleeding.
- Fainting.
- Painful abdominal cramps.
- Fast breathing.
- Severe anal pain
- Severe nausea
Make an appointment to see your doctor if you experience less severe rectal bleeding, such as tiny drops of blood from the rectum.
However, because a small amount of rectal bleeding can quickly become a large amount, it is essential to seek treatment in the early stages.
Diagnosis of Blood in the Year
Some of the tests used to find the cause of anal bleeding include:
Anoscopy:
An anoscope is a hollow tube three inches long, made of metal or clear plastic, and about an inch in diameter at its most comprehensive end.
The anoscope is lubricated, and the conical end is inserted into the anus through the anal canal and rectum.
As the anoscope is removed, the area where internal hemorrhoids and anal fissures are found is well observed.
The patient’s efforts, as if they were evacuating, can make the hemorrhoids more prominent.
If there has been rectal bleeding, it is necessary to examine the colon above the rectum to exclude other important causes of hemorrhage.
Colonoscopy :
It is a procedure that allows an examiner (usually a gastroenterologist) to evaluate the interior of the entire colon.
This is accomplished by inserting a flexible observation tube (the colonoscope) into the anus and then advancing slowly under direct vision through the rectum and the entire colon.
The colonoscope can often reach the part of the small intestine adjacent to the right colon.
Colonoscopy is the most commonly used procedure to evaluate rectal and occult bleeding.
It can detect polyps, cancers, diverticulosis, ulcerative colitis, proctitis, Crohn’s colitis, ischemic colitis, and angiodysplasias throughout the colon and rectum.
Sigmoidoscopia flexible:
It uses a flexible sigmoidoscope, a fiber optic display tube with a light at its tip. It is a shorter version of a colonoscopy.
It is inserted through the anus and is used by the doctor to examine the rectum, the sigmoid colon, and part or all of the descending colon.
It is helpful to detect diverticula, colon polyps, and cancers located in the rectum, the sigmoid colon, and the descending colon.
Flexible sigmoidoscopy can also diagnose ulcerative colitis, ulcerative proctitis, and sometimes Crohn’s colitis and ischemic colitis.
Despite its value, flexible sigmoidoscopy can not detect cancers, polyps, or angiodysplasias in the transverse and right colon.
Video capsule and small intestine endoscopy:
If an upper or lower gastrointestinal source of blood is not found in the stool, the small intestine becomes suspicious as the source of the hemorrhage.
There are two ways to examine the small intestine.
The first is the video capsule, a large pill that contains a miniature camera, a battery, and a transmitter that swallows and retransmits photos of the small intestine wirelessly to a recorder that is placed on the abdomen.
The second way to examine the small intestine is with a specialized endoscope similar to the endoscopes used for upper gastrointestinal and colonoscopies.
The advantage of these endoscopes over the video capsule is that hemorrhagic lesions can be biopsied and treated, which can not be done with the capsule.
Radionuclide scans:
Two types of radionuclide scans are used to determine the site of gastrointestinal hemorrhage; a Meckel scanner and a red blood cell scanner labeled.
The Meckel scan is an exploration to detect a Meckel’s diverticulum.
A radioactive chemical is injected into the patient’s vein, and a nuclear chamber is used to scan the patient’s abdomen.
The radioactive chemical will be captured and concentrated by the tissue that secretes acid into the Meckel’s diverticulum and will appear as a “hot” area in the lower right abdomen on examination.
The labeled red blood cell scans are used to determine the location of the gastrointestinal hemorrhage.
After extracting blood from the bleeding patient, a radioactive chemical is attached to the patient’s red blood cells, and the “marked” red blood cells are injected back into the patient’s vein.
If there is an active gastrointestinal hemorrhage, the radioactive red blood cells are filtered to the intestine where the hemorrhage occurs and will appear as a hot area with a nuclear chamber.
Visceral Angiogram:
A visceral angiogram is an X-ray study of the blood vessels of the gastrointestinal tract.
The doctor will insert a long thin catheter into a blood vessel in the groin and, under X-ray guidance, advance the tip of the catheter into one of the mesenteric arteries (arteries that supply blood to the gastrointestinal tract).
A radio-opaque dye is injected through the catheter and into the mesenteric artery.
If there is an active hemorrhage, the dye can seep into the gastrointestinal tract on the x-ray film.
Visceral angiograms are accurate in locating rapid hemorrhages in the gastrointestinal tract but are not helpful if the bleeding is slow or stopped at the time of the angiogram.
The visceral angiogram is not widely used due to its possible complications, such as renal damage by dye, allergic reactions to the dye, and the formation of blood clots in the mesenteric arteries.
It is reserved for patients with severe and continuous bleeding and in patients in whom colonoscopy can not locate the site of bleeding.
MRI and computed tomographic angiography:
Magnetic resonance imaging (MRI) and computed tomography can be used similarly to X-rays in visceral angiography, a diagnostic procedure that has been discussed previously.
The use of magnetic resonance imaging and CT angiography for diagnosing gastrointestinal bleeding is a relatively recent development, and its value has not been clearly defined.
They could be considered experimental.
Nasogastric tube aspiration:
If there is concern about bleeding from the stomach or duodenum, nasogastric tube aspiration can be performed.
Thin, flexible rubber or plastic tube is passed through the nose and into the stomach.
The liquid content of the stomach is then aspirated and examined for visible blood. (The content can also be analyzed for hidden blood).
If the bleeding comes from the stomach, there may be visible blood in the aspirate.
There may also be visible blood if the bleeding comes from the duodenum and if part of the blood leaks back into the stomach.
Esofagogastroduodenoscopia:
If there is great concern about bleeding from the esophagus, stomach, or duodenum, an esophageal duodenoscopy (EGD) can be performed with an endoscope similar to the endoscope used for colonoscopy.
Blood test:
Blood tests, such as a complete blood count (CBC) and iron levels in the blood do not play any role in the location of the gastrointestinal hemorrhage site.
However, the levels of CSC and iron in the blood can help determine if the bleeding is acute or chronic. Anemia (low red blood cell count) associated with iron deficiency suggests chronic bleeding for several weeks or months.
The colon conditions that commonly cause iron deficiency anemia include colon polyps, colon cancers, angiodysplasias, and chronic colitis.
When a patient suddenly loses a large amount of blood, such as with moderate or severe acute rectal bleeding, the blood loss is replaced by fluid from the body’s tissues.
This fluid influx dilutes the blood and leads to anemia (a reduced concentration of red blood cells).
However, it takes time for the tissue fluid to replace the blood lost within the blood vessels.
Therefore, shortly after a sudden episode of significant hemorrhage, there may be no anemia.
Anemia can develop for several hours and even a day or more while the tissue fluid slowly dilutes the blood.
For this reason, a red blood cell count early after bleeding is unreliable for estimating the severity of bleeding.
Treatment
Rectal bleeding treatments depend on the cause and severity.
You can relieve the pain and discomfort of hemorrhoids by taking warm water baths. The application of over-the-counter or prescription creams can also reduce irritation.
Your doctor can perform more invasive treatments if your hemorrhoids pain is severe or if the hemorrhoids are enormous.
These include elastic band ligation, laser treatments, or surgical removal of hemorrhoids.
Like hemorrhoids, anal fissures can resolve on their own.
Using stool softeners can address problems with constipation and help anal fissures heal.
Infections may require antibiotic therapy to kill the bacteria.
Colon cancers may require more invasive and long-term treatments, such as surgery, chemotherapy, and radiation, to eliminate cancer and reduce the risk of recurrence.
Home treatments to prevent constipation can reduce the risk of rectal bleeding. These include:
- Eat foods rich in fiber (unless your doctor tells you otherwise).
- Exercise regularly to prevent constipation.
- Keep the rectal area clean.
- Stay well hydrated.
Blood Forecast In The Year
The prognosis depends on the underlying cause of the hemorrhage. Fortunately, the cause of rectal bleeding is often benign and due to hemorrhoids or an anal fissure.
It is essential never to ignore blood in the stool or rectal bleeding.
