meaning
Rectal bleeding is when blood flows out of the rectum or anus. There may be blood in the stool or blood on the toilet paper or toilet. The blood may turn bright red. The term “hematochezia” is used to describe this finding.
alias
Rectal bleeding; blood in the stool.Blood in the stool; lower gastrointestinal bleeding
considerations
The color of blood in the stool may indicate the source of the bleeding.
Black or tarry stools can be caused by bleeding in the upper part of the digestive tract, such as the esophagus, stomach, or first part of the small intestine. In this case, the blood is most often black because it is digested on its way through the gastrointestinal tract. Although less common, this type of bleeding can be active enough to cause bright red bleeding from the rectum.
Bleeding from the rectum may be red or fresh. This usually means that the source of the bleeding is the lower gastrointestinal tract (colon and rectum).
Eating beets or foods with red food coloring may cause your stool to appear red. In these cases, doctors can test the stool with chemicals to rule out the presence of blood.
cause
Causes of rectal bleeding include:
- Anal fissures (cuts or tears in the lining of the anus, often caused by straining hard stools or frequent diarrhea). May cause sudden rectal bleeding. Most often, pain occurs at the entrance to the anus.
- Hemorrhoids are a common cause of bright red blood. It may or may not be painful.
- Proctitis (inflammation or swelling of the rectum and anus).
- Rectal prolapse (a condition in which the rectum protrudes from the anus).
- Trauma or foreign body.
- Colorectal polyps.
- Colon, rectal, or anal cancer.
- Ulcerative colitis.
- Infection in the intestines.
- Diverticulosis (abnormal sacs in the colon).
When to contact a medical professional
Contact your health care provider if:
- fresh blood in the stool
- change in stool color
- Pain in the anal area when sitting or defecating
- Incontinence or inability to control stool evacuation
- Unexplained weight loss
- Dizziness and fainting occur due to drop in blood pressure
Even if you think hemorrhoids are the cause of your bloody stools, you should see your doctor and get tested.
In children, a small amount of blood in the stool is most often not serious. The most common cause is constipation. If you notice this issue, you should notify your child’s provider.
What to expect from an office visit
Your health care provider will take your medical history and perform a physical exam. The examination will focus on the abdomen and rectum.
You may be asked questions such as:
- Have you had any trauma to your abdomen or rectum?
- Have you ever had blood in your stool more than once? Does every stool look like this?
- Have you lost any weight recently?
- Is it just blood on the toilet paper?
- What color is the stool?
- When did the problem occur?
- What other symptoms do you have (abdominal pain, vomiting blood, bloating, excess gas, diarrhea, or fever)?
One or more tests or tests may be needed to determine the cause.
You may have previously had one or more of the following laboratory tests:
References
DeGeorge LM, Nable JV. Gastrointestinal bleeding.Source: Edited by Walls RM Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th edition Philadelphia, PA: Elsevier. 2023: Chapter 26
Kaplan GG, Ng SC. Epidemiology, pathogenesis, and diagnosis of inflammatory bowel disease. Author: Feldman M, Friedman LS, Brandt LJ, eds. Gastrointestinal and liver diseases in Slizenger and Ford Tran. 11th edition Philadelphia, PA: Elsevier. 2021: Chapter 115.
Kwan MR. Hemorrhoids, anal fissures, anorectal abscesses and anal fistulas. Source: Kellerman RD, Raquel DP, eds. Conn’s current treatment 2022. Philadelphia, PA: Elsevier. 2022:219-222.
Lamp LW. anus. Starring: Goldblum JR, Lumps LW, McKechnie JK, Myers JL, eds. Rosai and Ackerman Surgical Pathology. 11th edition Philadelphia, PA: Elsevier. 2018: Chapter 18.
Swartz MH. Abdomen. Source: Swartz MH, ed. Textbook of Physical Diagnosis: History and Examination. 8th edition Philadelphia, PA: Elsevier. 2021:Chapter 17
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