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Occasional minor to mild rectal bleeding is extremely common and will often not need medical attention or treatment. Severe, chronic, or painful rectal bleeding may be a sign of a more serious underlying condition and should be assessed by a doctor. People normally notice rectal bleeding when they see streaks or drips of blood in their stool, the toilet bowl, or when wiping. Some people might also find blood in their underwear, or the toilet water may appear reddish-pink after they go to the bathroom.
Common cause:
Other common causes, but can be life threatening conditions like
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A wide range of health conditions and factors can cause or add to rectal bleeding. Some of the most common causes include:
Hemorrhoids are inflamed anal blood vessels, and they are extremely common. They can develop on the outside or inside of the anus, appearing as small bumps that occasionally bleed during bowel movements or when wiping.
Hemorrhoids, which are also referred to as piles, can impact anyone of any age but are associated with a few risk factors, including:
Hemorrhoids usually respond well to over-the-counter creams and suppositories that contain hydrocortisone. Taking warm baths frequently, eating a high-fiber diet, and using stool softeners can also help reduce the discomfort of hemorrhoids.
If initial treatments fail, a doctor may perform minor surgery to remove the hemorrhoids.
A fistula occurs when an abnormal opening or pocket develops between two neighboring organs. Fistulas that appear between the anus and rectum, or anus and skin, can cause a discharge of white fluid and blood.
Fistulas are sometimes treated with antibiotics, but they may require surgery if they progress.
Fissures occur when tissues lining the anus, colon, or rectum are torn, resulting in pain and rectal bleeding.
Warm baths, a high-fiber diet, and stool softeners can all help reduce symptoms of fissures. In severe cases, fissures may require prescription creams or surgery.
Diverticulosis is when small pockets called diverticula develop on the walls of the colon around a weakness in the organ’s muscular layers.
These pockets or diverticula are extremely common. Sometimes diverticula can start bleeding, but this bleeding usually stops on its own.
Usually, these pockets do not cause symptoms or require treatment unless they become infected, which 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 occurs when the tissues that make up the rectum become inflamed, often resulting in pain and bleeding.
Colitis occurs when the tissues lining the colon become inflamed. A type of colitis called ulcerative colitis can also cause ulcers, or open, progressive sores, that are prone to bleeding.
Treatments for proctitis and colitis vary, depending on the causes and range from antibiotics to surgery.
Common causes of proctitis and colitis include:
Bacterial infections can cause inflammation of the colon and stomach, causing diarrhea that may contain mucus and spots of blood. Viral gastroenteritis does not typically cause bloody diarrhea.
Treatment for gastroenteritis usually involves fluids, rest, and antibiotics or antivirals, depending on the cause.
Unprotected sexual intercourse 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 either an antibiotic, antiviral, or antifungal medication, depending if the cause is bacterial, viral, or fungal.
Weakened rectal tissues can allow a portion of the rectum to push forward or bulge outside of the anus, usually resulting in pain and, almost always, bleeding.
Prolapse is more common in older adults than in younger people. Some people with this condition may require surgery to correct it.
Polyps are noncancerous, abnormal 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 polyps so they can be tested for signs of cancer and to avoid the risk of them becoming cancerous.
Cancer that impacts the colon or rectum can cause irritation, inflammation, and bleeding. As many as 48 percent of people with colorectal cancer have experienced rectal bleeding.
Colon cancer is a very common form of cancer and tends to progress slowly, so it is often treatable if caught early.
Rectal cancer, while far rarer than colon cancer, is also usually curable if detected 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.
Major injury to any of the gastrointestinal organs can result in internal bleeding that passes through the rectum. Severe gastrointestinal disease can also lead to internal bleeding.
Internal bleeding almost always requires hospitalization and surgery.
A few occasional drops or streaks of blood in the toilet, when wiping, or in the stool, is usually not a worry.
Some people may avoid talking with their doctor about rectal bleeding out of embarrassment and anxiety, even in moderate or severe cases. While rare, heavy or chronic rectal bleeding can cause serious blood loss or be a sign of an underlying condition that requires treatment.
People should see a doctor about rectal bleeding that is chronic or noticeable, abnormal growths around the anus. It is also a good idea to talk with a doctor about rectal bleeding that does not respond to home remedies.
People should seek emergency medical attention for rectal bleeding or stool that is very dark, especially if they are also vomiting or coughing up blood. It is also vital to seek immediate help for bleeding that lasts for more than a few minutes or is accompanied by other symptoms, such as severe pain, fever, or weakness.
People may wish to talk to a doctor about gastrointestinal symptoms that may be a sign of underlying conditions, including infections, digestive conditions, or abnormal growths.
Common prevention tips for rectal, colon, and anal bleeding include:
FRCP Edin, MRCP Gastro UK, MRCP, MBBS
