Rectal Bleeding: Causes from Hemorrhoids to Cancer

Rectal bleeding is the passing of bright red blood through the rectum. It can be mild or severe and is caused by various gastrointestinal conditions. Persistent or recurrent rectal bleeding requires medical treatment.

Looking down the toilet and seeing blood can be alarming. Your mind can go to many places when the alarm bells are ringing and something is wrong. It is often rectal bleeding.

What Causes Rectal Bleeding?

Various health conditions can cause or worsen rectal bleeding or blood in the stool.

Hemorrhoids

Hemorrhoids are inflamed anal blood vessels, which are extremely common. They can develop on the outside or inside of the anus, appearing as small bumps that sometimes bleed during bowel movements or when wiping.

Hemorrhoids, also called piles, can affect anyone of any age but are associated with a few risk factors, including:

• Pregnancy
• Chronic constipation and tension
• Chronic diarrhoea
• Straining during a bowel movement or sitting on the toilet for too long
• Obesity
• Low-fiber or unbalanced diet
• Ageing

These generally respond well to creams and suppositories that contain hydrocortisone. Frequent warm baths, a diet high in fibre and stool softeners can also help reduce the discomfort of hemorrhoids. If the initial treatments fail, a doctor may perform minor surgery to remove the haemorrhoids.

Fistulas

A fistula occurs when an abnormal opening or pocket develops between two nearby organs. Fistulas that appear between the anus and the rectum, or the anus and the skin, can cause a discharge of white fluid and blood.

Fistulas are sometimes treated with antibiotics, but they may require surgery if they progress.

Cracks

Cracks occur when the tissue lining the anus, colon, or rectum is torn, causing rectal pain and bleeding. Warm baths, a diet high in fibre, and stool softeners can all help reduce crack symptoms. In severe cases, the cracks may require prescription creams or surgery.

Diverticulitis

Diverticulosis occurs when small pockets called diverticula develop on the walls of the colon around weakened muscle layers in the organ. These pouches, or diverticula, are extremely common. Sometimes, the diverticula can start to bleed, but the bleeding usually stops independently.

Usually, these pockets do not cause symptoms or require treatment unless infected. That is when a condition called diverticulitis occurs. Infected and inflamed diverticula are often painful and can cause rectal bleeding, usually a moderate rush of blood that flows for a few seconds. Diverticulitis is treated with antibiotics and, if severe, surgery.

Proctitis or Colitis

Proctitis, or colitis, occurs when the tissues that make up the rectum become inflamed, often causing pain and bleeding. Colitis occurs when the tissues lining the colon become inflamed. Colitis called ulcerative Colitis can also cause ulcers or open, progressive sores prone to bleeding.

Treatments for proctitis and colitis vary depending on the cause and range from antibiotics to surgery. Common causes of proctitis and Colitis include:

• Infection
• Some conditions that cause digestive problems like irritable bowel syndrome (IBS) and Crohn's disease
• Some medicines such as blood thinners
• Radiotherapy or chemotherapy
• Anal sex
• Decreased blood flow to the colon or rectum
• A blockage in the colon or rectum

Gastroenteritis

Bacterial infections can cause inflammation of the colon and stomach, causing diarrhoea, which may contain mucus and blood spots. Viral gastroenteritis usually does not cause bloody diarrhea. Treatment for gastroenteritis usually involves fluids, rest and antibiotics or antivirals, depending on the cause.

Sexually Transmitted Infections (STIs)

Unprotected sex that involves the anal area can spread a wide range of viral and bacterial diseases. These can cause inflammation of the anus and rectum. Inflammation, if it occurs, increases the likelihood of bleeding. Treatment for STIs usually involves antibiotic, antiviral or antifungal medication, depending on whether the cause is bacterial, viral or fungal.

Prolapse

Weakened rectal tissue can allow part of the rectum to push forward or swell outside the anus, usually causing pain and, almost always, bleeding. Prolapse is more common in older people than in young people. Some people with this condition may require surgery to correct it.

Polyps

Polyps are abnormal, non-cancerous growths. When polyps grow on the lining of the rectum or colon, they can cause irritation, inflammation, and minor bleeding. In many cases, a doctor will remove the polyps so that they can be tested for signs of cancer and to prevent them from becoming cancerous.

Colon or Rectal Cancer

Cancer that affects the colon or rectum can cause irritation, inflammation, and bleeding. Up to 48% of people with colorectal cancer have had rectal bleeding. Colon cancer is a prevalent form of cancer and tends to grow slowly, so it's often treatable if caught early.

Rectal cancer, although much rarer than colon cancer, is also usually curable if caught and treated in time. Some cases of colon and rectal cancer develop from initially benign polyps. All cases of gastrointestinal cancer require treatment, which usually involves a combination of chemotherapy, radiation therapy, and surgery.

Internal Bleeding

Serious injury to any of the gastrointestinal organs can lead to internal bleeding that passes through the rectum. Severe gastrointestinal illness can also lead to internal bleeding, which always requires hospitalization and surgery.

What Are the Symptoms of Rectal Bleeding?

Blood in stool or rectal bleeding is a symptom of many medical conditions. It can range from mild to a sign of a severe illness, such as colorectal cancer. You may see blood in different ways if you have rectal bleeding symptoms. It can be of different colors, ranging from bright red to dark brown to black. The color of the blood you see can indicate where the bleeding is coming from:

• Bright red blood usually means weak bleeding in the colon or rectum.
• Dark red or brown blood may mean you must bleed higher up in the colon or small intestine.
• Melena (dark, tar-like stools) often indicates bleeding in the stomach, such as from ulcers.

Sometimes, rectal bleeding is invisible to the naked eye and can only be seen under a microscope. This type of bleeding is usually found during a lab test of a stool sample.

When to Visit a Doctor?

Here are conditions in which it's advisable to check with a doctor if you experience rectal bleeding:

• Rapid, shallow breathing
• Dizziness or lightheadedness after standing up
• Blurred vision
• Fainting
• Confusion
• Nausea
• Cold, clammy, pale skin
• Low urine output

How to Diagnose Rectal Bleeding?

Several tests allow a doctor to examine the inside of the colon, rectum and anus. These procedures are performed using specialized instruments called oscilloscopes.

• Sigmoidoscopy: A clinician may examine the rectum and most of the lower large intestine.
• Colonoscopy: A procedure in which a clinician examines the entire colon.

While the recommended tests may differ for different people, the important thing is to see a doctor for an evaluation.

Rectal Bleeding Treatment

Rectal bleeding depends on the cause and severity. Hot baths and creams can help with hemorrhoids. Severe hemorrhoids may require rubber band ligation, laser treatments, or surgery. Anal fissures can resolve on their own or with stool softeners. Infections may need antibiotics. Colon cancer may require surgery, chemotherapy, or radiation therapy to rule out cancer and reduce the risk of recurrence.

Home Remedies For Rectal Bleeding

• High-Fiber Diet: A fiber-rich diet helps soften stools and supports easy bowel movements, reducing the need to strain. This prevents irritation and bleeding caused by hemorrhoids or anal fissures.
• Drink Plenty of Water: Staying well-hydrated keeps the digestive system functioning smoothly and the stools soft. This helps prevent constipation and minimizes rectal pressure during bowel movements.
• Sitz Baths: Soaking the anal area in warm water for 10-15 minutes eases pain and reduces swelling. It also promotes the healing of minor tears and soothes irritation.
• Aloe Vera Gel: Applying pure aloe vera around the anus helps soothe inflammation and promote skin healing. Its natural cooling effect also provides relief from itching or burning.
• Coconut Oil: Coconut oil acts as a natural moisturizer and has mild antibacterial properties. It reduces irritation and keeps the anal area soft and protected.
• Witch Hazel: Witch hazel is a natural astringent that can reduce bleeding and swelling. Applying it gently helps relieve discomfort and inflammation in the rectal area.
• Avoid Straining: Avoiding straining during bowel movements prevents added pressure on rectal veins. This helps reduce the risk of bleeding and irritation in the anal tissues.
• Ice Packs: A cold compress or ice pack can quickly reduce swelling and numb pain. It provides relief from discomfort caused by hemorrhoids or inflammation.
• Probiotics: Probiotics support gut health and encourage regular, strain-free bowel movements. They help reduce constipation, which is a common cause of rectal bleeding.
• Exercise Regularly: Light physical activity like walking or yoga improves digestion and stimulates bowel function. Regular movement helps prevent constipation and straining.

How to Prevent Blood in Stool?

Rectal bleeding can be prevented by changing your regular lifestyle and food habits. Find the list of changes that help in the prevention of blood in stool:

• Eating high-fibre foods
• Exercise regularly to prevent constipation
• Keeping the rectal area clean
• Staying well hydrated