Rectal Bleeding: Symptoms, Causes, and When to Seek Help - Surgery

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Rectal bleeding can be a concerning symptom, and it's understandable that you're feeling anxious about it. Let's break down the potential causes, symptoms, and when to seek medical help.


Symptoms of Rectal Bleeding
The symptoms you've described include:
- Bright red blood on toilet paper after wiping.

- Pain during bowel movements.

- Blood in the toilet bowl, possibly mixed with stool.

- Changes in stool consistency, such as having hard, pellet-like stools.


Possible Causes
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 you're straining or have hard stools.

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 during bowel movements and may cause bleeding.

3. Diverticular Disease: Diverticulosis involves small pouches that can form in the walls of the colon. If these pouches become inflamed or infected (diverticulitis), they can cause bleeding.

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

5. Colorectal Cancer: Although less common, rectal bleeding can be a symptom of colorectal cancer, especially if accompanied by other symptoms such as unexplained weight loss, changes in bowel habits, or abdominal pain.

6. Gastrointestinal Infections: Infections can cause diarrhea and may lead to bleeding, especially if the intestinal lining is inflamed.


When to Seek Help
It's crucial to consult a healthcare professional if you experience any of the following:
- Persistent rectal bleeding, especially if it increases in frequency or amount.

- Blood mixed with stool or dark, tarry stools.

- Severe pain during bowel movements.

- Changes in bowel habits, such as diarrhea or constipation lasting more than a few days.

- Unexplained weight loss or fatigue.


Diagnostic Approach
When you visit a healthcare provider, they may perform several evaluations:
- Physical Examination: A thorough examination, including a digital rectal exam, to check for hemorrhoids or fissures.

- Anoscopy or Sigmoidoscopy: These procedures allow the doctor to visualize the rectum and lower colon.

- Colonoscopy: If necessary, a colonoscopy may be performed to examine the entire colon and possibly take biopsies of any suspicious areas.

- Imaging Studies: In some cases, imaging studies like CT scans may be used to assess for diverticulitis or other conditions.


Management and Treatment
Treatment will depend on the underlying cause of the bleeding:
- For Hemorrhoids: Lifestyle changes, topical treatments, or procedures like rubber band ligation may be recommended.

- For Anal Fissures: Increasing fiber intake, hydration, and topical anesthetics can help. In some cases, surgical intervention may be necessary.

- For Diverticulitis: Antibiotics and dietary changes are often the first line of treatment.

- For Polyps or Cancer: Surgical removal and further treatment may be required based on pathology results.


Conclusion
While rectal bleeding can be alarming, many causes are treatable. It's essential to seek medical advice to determine the underlying cause and appropriate treatment. Early intervention can significantly improve outcomes, especially if there are concerns about more serious conditions like colorectal cancer. Don't hesitate to reach out to a healthcare provider for a thorough evaluation and peace of mind.