Rectal Bleeding: Causes and When to Seek Help - Gastroenterology and Hepatology

Q: Rectal Bleeding: Causes and When to Seek Help

Hello： The pattern of rectal bleeding (bright red blood or black stools, frequency, volume, chronic or acute) and whether the stools themselves are mixed with blood can help differentiate between upper and lower gastrointestinal bleeding. <br>Your upper gastrointestinal endoscopy

Rectal bleeding

In June, I frequently experienced rectal bleeding, but it stopped after about a week.
In July, I underwent a full-body check-up and was diagnosed with superficial gastritis and tested positive for Helicobacter pylori.
After that, I occasionally experienced rectal bleeding again over the course of one to two weeks.
I initially planned to see a doctor, but the bleeding subsided.
However, I noticed some mild pain in the left side of my abdomen, and I also found that after exercising, such as walking for 40 minutes or cycling for 20 kilometers, the bleeding would reoccur.
What could this condition be?

Zhutou, 20~29 year old female. Ask Date: 2003/09/09

Dr. Liang Jiade reply Gastroenterology and Hepatology

Hello: The pattern of rectal bleeding (bright red blood or black stools, frequency, volume, chronic or acute) and whether the stools themselves are mixed with blood can help differentiate between upper and lower gastrointestinal bleeding.
Your upper gastrointestinal endoscopy results from July only showed superficial gastritis without any other bleeding lesions, making it more likely that the bleeding originates from the lower gastrointestinal tract.
To assess lower gastrointestinal bleeding, it is essential to know if there is a history of similar bleeding, inflammatory bowel disease, etc.
Additionally, it is important to consider whether you have taken medications such as aspirin or anticoagulants, as well as any weight loss, loss of appetite, or changes in bowel habits.
The medical history mentions left abdominal pain and the occurrence of bleeding after exercise, which raises the possibility of vascular abnormalities, diverticula, or tumor bleeding.
Furthermore, hemorrhoids or hemorrhagic colitis could also be potential causes.
To further differentiate the cause of the bleeding, a more detailed medical history, stool examination, and lower gastrointestinal endoscopy may be necessary.

Reply Date: 2003/09/09

More Info

Rectal bleeding can be a concerning symptom and may arise from various causes, ranging from benign to serious conditions. Given your history of gastrointestinal issues, including superficial gastritis and a positive test for Helicobacter pylori, it's essential to consider several potential causes for your rectal bleeding.

Possible Causes of Rectal Bleeding
1. Hemorrhoids: One of the most common causes of rectal bleeding, hemorrhoids are swollen veins in the lower rectum or anus. They can cause bright red blood during bowel movements, especially if there is straining involved.

2. Anal Fissures: These are small tears in the lining of the anus, often resulting from passing hard stools. They can cause sharp pain and bleeding during bowel movements.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can lead to diverticulitis, an inflammation that may cause bleeding.

4. Colorectal Polyps or Cancer: Polyps are growths on the inner lining of the colon or rectum, some of which can become cancerous over time. Rectal bleeding can be a symptom of colorectal cancer, especially if it is accompanied by changes in bowel habits or unexplained weight loss.

5. Gastrointestinal Infections: Infections can cause inflammation and bleeding in the gastrointestinal tract. Given your history of gastritis, it’s possible that an infection could also be affecting your lower GI tract.

6. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause inflammation in the intestines, leading to symptoms such as abdominal pain, diarrhea, and rectal bleeding.

When to Seek Medical Help
You should seek medical attention if you experience any of the following:
- Persistent Bleeding: If the rectal bleeding continues or recurs, it is essential to consult a healthcare provider.

- Significant Blood Loss: If you notice large amounts of blood or if the blood is dark or tarry, this could indicate a more serious condition.

- Associated Symptoms: If you experience severe abdominal pain, changes in bowel habits, weight loss, or fever, these could be signs of a more serious underlying issue.

- Pain: Since you mentioned experiencing pain in your left flank, this could be related to your gastrointestinal issues and warrants further investigation.

Recommended Actions
1. Consult a Gastroenterologist: Given your symptoms and history, it would be prudent to see a gastroenterologist. They may recommend further diagnostic tests, such as a colonoscopy, to visualize the colon and rectum directly.

2. Monitor Symptoms: Keep a detailed record of your symptoms, including the frequency and amount of bleeding, any associated pain, and changes in your bowel habits. This information will be valuable for your healthcare provider.

3. Dietary Adjustments: Consider making dietary changes to promote digestive health. Increasing fiber intake can help prevent constipation and reduce straining during bowel movements, which may alleviate hemorrhoids or fissures.

4. Hydration: Ensure you are well-hydrated, as this can help maintain regular bowel movements and prevent constipation.

5. Avoid Straining: If you have hemorrhoids or anal fissures, avoiding straining during bowel movements can help reduce bleeding and pain.

In conclusion, while rectal bleeding can sometimes be benign, it is crucial to take it seriously, especially given your medical history. Seeking timely medical advice will help ensure that any underlying issues are addressed appropriately.

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