Rectal Bleeding: Getting to the Bottom of it!!!

Written by Dr. Sherwin Ng, BSN, RN, MD, GMC on 17 May 2021

Medically Reviewed by Dr. K on 18 May 2021

Rectal Bleeding

The passage of fresh blood via the rectum is known as rectal bleeding (or haematochezia). It is mostly affected by bleeding from the lower gastrointestinal (GI) tract, although it may also occur in patients that have massive upper GI bleeds or minor bowel lesions.

Rectal bleeding may be caused by a variety of conditions ranging from benign to life-threatening, and if not treated properly, it may induce severe haemodynamic instability.

The first time people see blood in the toilet bowl can be a daunting experience. It is often difficult to measure the amount of blood passed due to the fact that the blood will mix with water and a few drops of blood can stain the whole bowl red.

Causes

Common causes of rectal bleeding can be broadly categorized into two sources: upper GI tract and lower GI tract. The chart below generally indicates the common causes of rectal bleeding.

Symptoms

It is worth noting the characteristic of this bleed. Try answering the following questions:

  1. Is it bright red, dark red, a mixture of both, or black in color
  2. Is it mixed with stool or on its own
  3. Is it mixed with clots
  4. Any symptoms of light-headedness or dizziness?

Pitfalls

What keeps people from seeking medical advice is a mixture of being ashamed and financial circumstances. It is therefore important to ask the following questions:

  1. Is it worth saving a few dollars now by disregarding your symptoms or saving a fortune from a more serious condition that could have been prevented if you sought help earlier.
  2. Doctor-patient confidentiality is adhered to internationally and they cannot tell anyone you don’t give permission for them to tell. This is only if you are no longer a minor and do not lack the capacity to make decisions.

Red Flag Symptoms

Best practice in primary care will include careful attention to a patient’s history: presence or absence of perianal symptoms, red-flag symptoms including weight loss, altered bowel habit, symptoms of anaemia (shortness of breath, pale skin), and family history of colorectal cancer. (1)

Seeking Help

Googling and resorting to Doctor Internet is very common but will only scare you and won’t help you fix your problem properly.

Get help, get checked, and get to the “bottom” of it!!!

Source:

Referenced on 17.5.2021

  1. Walsh, C.J., Delaney, S., Rowlands, A. 2018, ‘Rectal bleeding in general practice: new guidance on commissioning’, British Journal of General Practice, 68 (676): 514-515. Available from: https://doi.org/10.3399/bjgp18X699485 

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