When blood passes from the rectum or anus, it is referred to as rectal bleeding. The bleeding could show up on the stool or visible as blood in the toilet or on toilet paper. Rectal bleeding could be the symptom of a clutch of conditions, some of which could be serious. Hence, it is critical to zero in on the cause of the bleed.

What are the possible causes of rectal bleeding?

Anal fissures: Tiny tears in the lining of the anus, often caused by constipation or during childbirth, can cause bleeding or pain while passing stools.
Angiodysplasia: These are inflamed or enlarged blood vessels that develop in the intestine and can disintegrate and bleed.
Haemorrhoids or piles: These are tissue masses formed of blood vessels and muscle fibres. While internal haemorrhoids may not be painful, these can sometimes cause bleeding, the blood passing through the anus.
Constipation: Straining during bowel movement to relieve constipation can cause anal fissures and haemorrhoids, which could lead to bleeding.
Colorectal or anal polyps: Polyps are growths which when developing in the intestine, can bleed. These growths aren’t necessarily cancerous, but going forward, might become malignant.
Ulcers: Erosion in the digestive track causes ulcers. If the bleeding ulcer is located in the upper GI tract, stools are likely to be black and tarry. When the bleeding is in the lower gut, the blood is likely to be bright red. However, your gastroenterologist will be the best judge.
Colon or anal cancer: The growth of tumours is propelled by blood vessels which are often delicate in the colon and prone to tear, leading to rectal bleeding.
IBD: Inflammatory bowel disease which includes both ulcerative colitis and Crohn’s disease, can also cause rectal bleeding along with pain and diarrhoea.
Diverticular disease: Little pouches or bulges in the colon are called diverticula. Over a period of time, blood vessels in these structures can burst and bleed. Sometimes, no symptoms manifest (diverticulosis), but sometimes, there is inflammation (diverticulitis). Collectively, these are known as diverticular disease.
Infections: Bleeding can also be caused by an intestinal infection or bacterial infections like salmonella.
Bleeding conditions: Certain conditions can lead to bleeding since they hamper blood coagulation. These could include vitamin K deficiency, haemophilia or a low platelet count.
Upper GI tract damage: Black, tarry stools could signify bleeding from the upper GI tract, like a tear in the stomach.

usual symptoms of rectal bleeding

What are the usual symptoms of rectal bleeding?

Bright red blood would indicate bleeding along the lower GI tract
Wine-coloured, darkish blood could be a pointer to bleeding in the small intestine or upper portion of the colon
Black, tarry stools might indicate bleeding from the stomach or the upper part of the small intestine
Some other symptoms could include: Confusion, fainting, dizziness, rectal pain or abdominal pain

How is rectal bleeding treated?

While there are some home remedies to address constipation and haemorrhoids, when these don’t work, medical and prescription options could include:

If the haemorrhoids are large and pain is intense, the patient might need laser treatments, rubber band ligation or surgical removal
While anal fissures often go away on their own, sometimes the doctor might advise a course of antibiotics if there is an infection
If the cause is colon cancer, the answer could be surgery, chemo or radiation therapy to remove the cancer
If there are multiple polyps and they are large in size or cell changes indicate a possible cancerous turn, the doctor might opt to remove the polyps during a colonoscopy