Rectal Bleeding Treatment, Causes, Symptoms & Remedies

Nov 8, 2019 | General Medical

There can be many causes of blood in the stool or rectal bleeding, some of which are more serious than others. In fact, the seriousness of rectal bleeding ranges all the way from mild to life-threatening, so it’s ideal to be aware of certain comorbid conditions or other problems that may precipitate a visit to your doctor or the emergency room. Read on to learn more about rectal bleeding and it causes, when you should be concerned, and diagnostics and treatment for this issue. 

What Is Rectal Bleeding (Hematochezia)?

The rectum is the very bottom of the large bowel and is located between this last portion of the bowel and the anus. This area is easily irritated by problems such as hemorrhoids and anal fissures; however, more serious complications of rectal bleeding can indicate that there is something wrong in another portion of the gastrointestinal tract. Rectal bleeding often occurs concurrently with blood in the stool, and blood in the stool may be a sure sign that there is rectal bleeding present. These are slightly different conditions but are very closely related. Many cases of rectal bleeding do not come directly from the rectum and can be actually located in the colon or anus. Rectal bleeding is often associated with diarrhea, as strong, uncontrollable diarrhea can lead to rectal and anal irritation and cause blood in the stool and rectal bleeding. 

What Are the Signs and Symptoms of Rectal Bleeding?

There are many signs and symptoms of rectal bleeding and blood in the stool. The first is seeing maroon-colored stools or blood left on toilet tissue paper after wiping. These can be concerning signs to see, but may not always be indicative that something is seriously wrong. You may also see bright red blood within the stool, or blood in the toilet bowl after using the bathroom. These are sure signs that there is rectal bleeding or blood in the stool, but there are other symptoms to watch out for that may point to a problem further up the digestive tract. You may see bloody stools comorbid with abdominal cramping, rectal pain, dizziness or fainting, vomiting, rapid heartbeat, low blood pressure, and confusion. If you experience rectal bleeding alongside any of these other symptoms, it’s imperative to see your physician as soon as possible. 

Children may experience blood in the stool and these types of symptoms if they are suffering from intussusception, which is a folding of the bowel. Pregnant women may also have rectal bleeding problems due to hemorrhoids, which are very common in the second and third trimesters. 

Causes of Blood in the Stool

There are many different causes for blood in the stool. Hemorrhoids and anal fissures are very common culprits. Other causes may include diverticulosis, infection, inflammation (such as inflammatory bowel disease or irritable bowel disease, Crohn’s disease, and colitis. Other gastrointestinal disturbances that can cause rectal bleeding include stomach ulcers, Meckel’s diverticulum, and ischemic colitis. Still, yet other serious causes may include colon polyps, tumors, or trauma to the area. 

Hemorrhoids are one of the primary culprits of blood in the stool or rectal bleeding, along with other anorectal disorders. There are two types of hemorrhoids: internal and external. External ones are easy to see with the naked eye and are often accompanied by anal itching. Internal hemorrhoids are on the inside of the anus and are not visible. Both types, without irritation, are quite painless. However, with the hemorrhoid is inflamed or swollen, it can cause pain and discomfort, as well as bleeding. Very often, this swelling is brought on by hard bowel movements or strenuous pushing during bowel movements. These are known as thrombosed hemorrhoids. A good rule of thumb is to take stool softeners often to prevent this from happening. If hemorrhoids become too thrombosed, a clot will form, which will be painful (and will cause more bleeding). At this juncture, minor surgery will be required for removal. 

Anal fissures are also created by the passage of hard stools or from too much pushing. These are conditions that are tears in the lining of the rectum. Anal fissures can cause bright, red blood from broken blood vessels, which can be disconcerting; but while anal fissures can be painful, from a medical standpoint they are not exceedingly serious. The best way to keep anal fissures at bay is to take warm baths, add fiber to the diet, and take daily stool softeners. 

Diverticulosis is another common cause of rectal bleeding. A diet that is too low in fiber can cause the diverticula to jut out from the bowel wall. When the diverticula are irritated or inflamed, it causes a condition known as diverticulitis. This condition usually occurs in people aged 40 and over and presents with dark, tarry stools or dark maroon stools. This condition is usually not painful; however, if patients experience pain or high fever with diverticulitis, they should seek help immediately. 

Infection and inflammation are also common causes of rectal bleeding. Infections from Campylobacter jejuni, Salmonella, Shigella, Escherichia coli, and Clostridium difficile are common culprits, as well as inflammation from gastrointestinal disorders, which can include inflammatory bowel disease (IBD), which is a collective term for both Crohn’s disease and ulcerative colitis (UC). These conditions can also independently cause blood in the stool or rectal bleeding. 

When to Seek Medical Care for Rectal Bleeding

Generally speaking, any type of rectal bleeding should be evaluated by a healthcare provider or medical professional. If you have blood in the stool or rectal bleeding, this is a marker that something is indeed wrong; it is the severity of the problem that needs to be diagnosed. Rectal bleeding may be caused by something as benign as hemorrhoids or as serious as late-stage colon cancer. If you have rectal bleeding accompanied by any of the symptoms mentioned several paragraphs above, you may want to seek help immediately. Irregular heartbeat, loss of blood, confusion, dizziness, or fainting along with rectal bleeding should prompt you to dial 9-1-1 or visit your closest walk-in urgent care.

Blood in Stool Diagnosis

To diagnose the cause of blood in the stool, your doctor will give you a thorough workup and physical exam, checking your abdomen and vital signs closely. An examination of the rectum and anus is also warranted to deem if the cause might be anal fissures or hemorrhoids. If your doctor suspects something more severe, you may have blood tests or a nasogastric tube, which is a quick procedure to check for blood in the digestive tract. 

Further diagnostics may be ordered to rule out certain conditions, such as colonoscopy, sigmoidoscopy, or anoscopy. Your physician may want you to have a barium enema X-ray or a CT scan. 

Blood in Stool Treatments

Treatment for blood in the stool or rectal bleeding depends heavily on the diagnosis. If you are suffering from anal fissures or hemorrhoids, the most common treatment is stool softeners and dietary changes. More serious problems require more aggressive treatment. Severe rectal bleeding may require a blood transfusion or IV fluids if there has been a great blood loss. Generally, however, rectal bleeding is most pronounced as small flecks in bowel movements and will not require hospital admission. To treat rectal bleeding, doctors must treat the underlying cause. IBD or IBS may require some medication and lifestyle changes, while E. coli infection may require aggressive treatment. Your doctor will best advise you on the course of action to treat the underlying cause of your bleeding.

If you need more information about blood in the stool or rectal bleeding or wish to be evaluated by a physician, contact Gastroenterology Consultants of Savannah, P.C. today. We have one South Carolina location and five Georgia locations for your convenience.