Rectal Bleeding

Rectal Bleeding Treatment

It can be quite alarming when you find blood on toilet paper after wiping or you see blood in your stool. Rectal bleeding isn’t uncommon—it can be something as simple and treatable as hemorrhoids, or it can be indicative of a more serious condition. Read on to learn more about rectal bleeding treatment and causes and when you should seek medical attention.

What Is Rectal Bleeding?

Rectal bleeding is blood that comes from the GI tract. It can present as blood in the stool or can appear on toilet paper. It can have many different causes. Some are less severe, while others are more serious, such as colorectal cancer, so it’s important to consult a gastroenterologist if you discover blood in the stool or on toilet paper. Rectal bleeding can be very worrisome, but if you can gauge the color of the blood, it may be an early indicator of where the bleeding is occurring. Color may indicate:

• Bright, red blood may indicate that the bleeding is low in your rectum or colon.
• Black, tarry stools (melena) may suggest you have a bleeding ulcer in the stomach.
• Maroon or dark, red blood may be bleeding in the small intestine or the higher portion of the colon.

However, sometimes rectal bleeding is not visible to the naked eye and a stool test must be taken in order to determine the presence of rectal bleeding. Minor rectal bleeding is referred to as occult bleeding and is very minute. Occult bleeding could be a sign of bleeding in the digestive tract, possibly from inflammation.

Sometimes, you may not notice rectal bleeding right away. Signs that you may have rectal bleeding include:

• Seeing blood on toilet paper after wiping
• Noticing a change in the color of your stool—black, bright red, or tarry; or bloody diarrhea
• Seeing blood in the bowl of the toilet before you flush

It is also possible that something you ate changed the color of your stool temporarily. If you think you notice bloody bowel movements, keep an eye on your stool for several days.

What Are the Symptoms of Rectal Bleeding?

The primary symptoms of rectal bleeding are blood in the stool or the toilet paper or bowl. However, because rectal bleeding is a sign of an underlying condition, you may experience other symptoms as well, depending on what is causing the bleeding. These symptoms may include:

• Feeling dizzy or lightheaded
• Fainting
• Mental confusion or “brain fog”
• Rectal pain or pressure 

Any case of rectal bleeding should prompt you to consult your gastroenterologist, but if you experience these symptoms also, it may be more of an urgent nature.

Common Causes of Rectal Bleeding

There are many different causes of rectal bleeding—some benign and others quite serious. Some of the most common causes of rectal bleeding include:

• Anal fissures. This is a split or tear in the lining of the skin surrounding the anus. These often occur after straining while having a bowel movement that’s difficult to pass.
• Colon cancer. Colon and colorectal cancer present as polyps in the colon. Large polyps can bleed and usually appear as bright, red blood. Polyps can be benign at first, however, they can become colon cancer if left untreated.
• Diverticular disease. If your intestine is weakened, small pouches can grow. These porches, known as diverticuli, can press through the wall of the bowel, which can cause bleeding. Diverticular disease can also cause an infection, which may cause abdominal pain and fever.
• Hemorrhoids. Hemorrhoids are the most common cause of rectal bleeding and often disappear on their own. Hemorrhoids are swollen blood vessels and veins either in the rectum or anus. They can be caused by straining while having a bowel movement, anal intercourse, heavy lifting, and obesity. Pregnant women are also very susceptible to hemorrhoids during pregnancy. Rectal bleeding treatment is often not needed for hemorrhoids.
• Inflammatory bowel disease (IBD). Rectal bleeding can indicate the presence of IBD, which is a swelling of the small intestine, large intestine, or both. There are two types of IBD—Crohn’s disease and ulcerative colitis (UC). Crohn’s involves patches of swelling and inflammation of the digestive tract, while UC is inflammation of the colon. Other symptoms of IBD may include abdominal pain, cramping, and diarrhea.
• Ulcers. Damage to the lining of the digestive tract can cause ulcers. A bleeding ulcer will cause a black, tarry stool.

When to Seek Medical Help for Rectal Bleeding

Any time you experience rectal bleeding, you should consult a gastroenterologist. While it’s likely not serious with hemorrhoids being the most common cause, rectal bleeding can be a symptom of an underlying condition that requires immediate intervention, such as colon cancer.

Rectal bleeding treatment can differ depending on the underlying condition that’s causing the bleeding. Those with anal fissures or hemorrhoids can use home remedies, such as warm baths (or sitz bats) and stool softeners to help relieve symptoms. Hemorrhoids are also commonly treated with over-the-counter medications.

To determine the underlying cause, your gastroenterologist will likely perform a series of diagnostic tests, such as colonoscopy or sigmoidoscopy and a stool test. Your provider will also perform a physical exam of the anus and rectum.

Rectal bleeding treatment very much depends on the underlying cause. For example, if you have an ulcer, you may have a course of antibiotics combined with antacids. However, colorectal cancer would require a full treatment plan if it is diagnosed. Your gastroenterologist will be able to walk you through any rectal bleeding treatment options with you.