Rectal bleeding refers to bleeding in the rectum, thus a form of lower gastrointestinal bleeding. There are many causes of rectal hemorrhage, including inflamed (which are dilated vessels in the perianal fat pads), rectal varices, proctitis (of various causes), , and . Diagnosis is usually made by proctoscopy, which is an endoscopic test.
Signs and symptoms
Those with rectal bleeding may notice bright red blood in their stool. Symptoms associated with rectal bleeding include having several bowel movements in a day, feelings of incomplete rectal evacuation, straining, hard or lumpy stools, feelings of urgency, loose or watery stools, and leakage of bowel movement.
Causes
Bleeding from the rectal area could indicate premalignant polyps or colorectal cancer.
Compared to colorectal cancer,
anal lesions or benign colorectal conditions are far more common causes of rectal bleeding.
Other causes of rectal bleeding include
Hemorrhoid, full-thickness
rectal prolapse,
Anal fissure, sentinel tags,
Colonic ulcer,
rhagades, external
Thrombosis with extravasation of blood clot, prolapsed polyps or tags, anal trauma or anal-receptive intercourse,
abscess,
fistula opening, dermatologic conditions of the perianal region, hypertrophied papilla, and distal
proctitis. An ulcer could be caused by Crohn's disease,
anal cancer,
HIV, or another
STD. Inflammatory bowel diseases may also cause rectal bleeding.
Risk factors
Certain medications, such as calcium channel blockers or proton pump inhibitors, can exacerbate anorectal symptoms by causing
diarrhea or
constipation, or they can exacerbate bleeding (e.g.,
Coumadin, nonsteroidal anti-inflammatory drugs). A history of
hemorrhoidectomy, fissure surgery, fistula surgery,
polypectomy, or
colectomy may be relevant. Gastrointestinal symptoms can also result from other procedures like gastric bypass or
cholecystectomy. Any prior assessment, such as a
colonoscopy or flexible
sigmoidoscopy, may also be important, as well as any history of
polypectomy carried out in connection with one of these operations.
Diagnosis
Any complaint of bleeding should be followed up with a complete blood count (CBC) in order to determine the extent of the bleeding and guide treatment. The partial thromboplastin time (PTT) and the international normalized ratio (INR), which can be used to detect bleeding tendencies, are additional crucial lab tests to obtain.
Testing for STIs, such as gonorrhea and chlamydia, should be conducted on patients who engage in anal receptive sex.
If there is a significant amount of bleeding or the patient is too unstable to be put under anesthesia for an endoscopic procedure, CT angiography may be pursued. It could be challenging to pinpoint the precise location of the blood if there is a lot of blood in the stomach.
Tagged red blood cell Scintigraphy are a precise way to locate the bleeding vessels and pinpoint the area where they are bleeding. It can be applied to chronic and recurrent rectal bleeding with no apparent cause.
See also
-
Lower gastrointestinal bleeding
-
Blood in stool
Further reading
External links
