Rectal bleeding (or bleeding in or near the rectum) typically appears deep or bright red, and it may or may not be accompanied by pain. By contrast, bleeding that develops elsewhere in the gastrointestinal tract tends to cause dark stools that are sticky or tar-like in their consistency. Rectal bleeding can appear as blood in the stool, blood in the toilet or as a red smear on toilet paper used to wipe following a bowel movement. In some cases, it can cause reddish or rust-colored stains in underwear.
There are several issues that can cause rectal bleeding, including:
straining when moving the bowels
a rectal fissure or cut
Crohn’s disease or ulcerative colitis (inflammatory bowel disease or IBD)
rectal inflammation or irritation
rectal prolapse, a condition that causes the rectum to protrude from the anus
Because both benign (relatively harmless) and serious issues can cause rectal bleeding, any type of bleeding from the rectum should be reported to the doctor so it can be evaluated.
If bleeding occurs after a period of constipation or following a very hard stool, no further testing may be needed beyond routine monitoring to ensure the bleeding stops and does not recur. But when bleeding is recurrent, chronic or prolonged, or when it’s accompanied by other symptoms like significant abdominal pain or fever, additional testing usually will be ordered. Blood tests and stool sample evaluation both may be performed along with diagnostic imaging like CT scans or MRI. In some cases, minimally-invasive examinations like flexible sigmoidoscopy or colonoscopy may be recommended to see inside the colon and rectum to identify the source of bleeding. Treatment will depend on the underlying cause. Some issues may be treated with medication or simple procedures to remove polyps or hemorrhoids. Other issues like IBD or cancer may require surgery.
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