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

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Rectal bleeding can be a concerning symptom, and it's important to understand its potential causes and when to seek medical help. The presence of blood in your stool or on toilet paper after a bowel movement can arise from various conditions, some of which are benign, while others may require more serious attention.

Common 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. Hemorrhoids can be internal (inside the rectum) or external (under the skin around the anus).

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain and bleeding during or after bowel movements.

3. Diverticular Disease: Diverticulosis, which involves the formation of small pouches in the colon wall, can lead to diverticulitis when these pouches become inflamed or infected. This condition can cause bleeding as well.

4. Colorectal Polyps: These are growths on the lining of the colon or rectum that can sometimes bleed. While most polyps are benign, some can develop into colorectal cancer over time.

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

6. Gastrointestinal Infections: Certain infections can cause inflammation and bleeding in the intestines, leading to blood in the stool.

7. Cancer: While less common, rectal bleeding can be a sign of colorectal cancer, especially in older adults or those with a family history of the disease.

When to Seek Help:
You should seek medical attention if you experience any of the following:
- Persistent Bleeding: If the bleeding continues over several days or is recurrent.

- Large Amounts of Blood: If you notice a significant amount of blood, especially if it is dark or mixed with stool.

- Accompanying Symptoms: If you experience severe abdominal pain, changes in bowel habits, weight loss, or fatigue.

- Age Considerations: If you are over 50 or have a family history of colorectal cancer, it is advisable to consult a healthcare provider sooner rather than later.

What to Expect at the Doctor's Office:
When you visit a healthcare provider for rectal bleeding, they will likely perform a thorough history and physical examination. They may recommend tests such as:
- Digital Rectal Exam (DRE): To check for hemorrhoids, fissures, or other abnormalities.

- Colonoscopy: A procedure that allows the doctor to view the inside of your colon and rectum, which can help identify polyps, tumors, or areas of inflammation.

- Blood Tests: To check for anemia or signs of infection.

Conclusion:
While rectal bleeding can often be attributed to benign conditions like hemorrhoids or anal fissures, it is essential to take it seriously, especially if it is recurrent or accompanied by other concerning symptoms. Early evaluation and diagnosis can lead to effective treatment and management of any underlying issues. If you find yourself experiencing this symptom, do not hesitate to reach out to a healthcare professional for guidance and support.