Speciality
Blood in stool
Rectal bleeding refers to bleeding from one's bottom after the passing of a stool and can range from a small amount on toilet paper to large-volume blood loss.
It may present as bright red blood (haematochezia), maroon stools, or black tarry stools (melaena) and causes range from benign anorectal conditions to serious gastrointestinal disease. Prompt evaluation helps identify the source and guide appropriate treatment.
Blood in your stool can typically be noticed as blood mixed in with your stool — whether that be diarrhoea or hard and dry stool, light bleeding on the toilet paper, heavier bleeding to change the colour of the water in your toilet bowl, or, usually if coming from higher up in the gut, it can make the stool black and sticky.
Blood in your stool can signal that there is an issue somewhere along the gastrointestinal tract, and is most commonly a sign of non-cancerous conditions such as:
However, it can also be a symptom of bowel or rectal cancer, and that is why it is so important to report this to your GP or a specialist when it first occurs.
Usually, it's caused by non-cancerous conditions and isn't a cause for worry. However, visiting a doctor is necessary to rule out more serious conditions.
The initial assessment will consist of a history and physical exam, including abdominal and a digital rectal examination.
Depending on the findings of the above, a sigmoidoscopy or colonoscopy will usually be recommended to determine the cause of the bleeding. In some cases, a CT scan may be a valid alternative, and which investigation is chosen depends on several factors which become apparent at the time of your initial consultation.
Treatment for rectal bleeding really depends on the underlying cause that has been detected and depends on the duration and severity of the bleeding.
Is rectal bleeding always serious?
Not always. Many causes, such as haemorrhoids or anal fissures, are benign. However, any rectal bleeding requires evaluation to exclude serious conditions like colorectal cancer.
When should I see a doctor for rectal bleeding?
See a doctor promptly for any new, recurrent, or unexplained rectal bleeding. Seek emergency care for heavy bleeding, fainting, or signs of shock.
Do I need a colonoscopy?
Colonoscopy is commonly recommended for evaluation of lower gastrointestinal bleeding, especially in patients over 50, those with risk factors for colorectal cancer, or when the bleeding source is not identified on anorectal exam.
Can haemorrhoids be treated without surgery?
Yes — many haemorrhoids respond to lifestyle changes and minor clinic-based procedures. Surgery is reserved for persistent, large, or complicated haemorrhoids.
Could rectal bleeding mean cancer?
Rectal bleeding can be a sign of colorectal cancer, particularly in older adults or those with weight loss, appetite loss, or a family history. Timely diagnostic testing is important.
If you have concerns or would like to discuss treatment options, Mr Lamah is available for consultation.
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