Rectal Bleeding: Causes and When to Seek Help - Internal Medicine

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Rectal bleeding can be a concerning symptom, and understanding its potential causes is crucial for determining the appropriate course of action. The fact that you are experiencing bright red blood with soft stools suggests that the bleeding is likely originating from the lower gastrointestinal tract, such as the rectum or anus, rather than from higher up in the digestive system. Here are some common causes of rectal bleeding:
1. Hemorrhoids: These are swollen blood vessels in the rectal area that can bleed, especially during bowel movements. They are often associated with straining, constipation, or prolonged sitting.

2. Anal Fissures: Small tears in the lining of the anus can occur due to passing hard stools. This can cause sharp pain and bright red bleeding during bowel movements.

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

4. Polyps: These are growths on the lining of the colon or rectum that can bleed. Some polyps can be precursors to colorectal cancer, so they should be monitored.

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

6. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause inflammation and bleeding in the gastrointestinal tract.

Given that you have experienced intermittent rectal bleeding over the past few days, it is essential to seek medical attention, especially since the bleeding has persisted for three days this time. Here are some recommendations on when to seek help:
- If the bleeding is persistent: Since you mentioned that the bleeding has lasted for three days, it is advisable to consult a healthcare professional for further evaluation.

- If you experience significant pain: Severe pain accompanying rectal bleeding may indicate a more serious condition that requires immediate attention.

- If there are changes in bowel habits: Any significant changes, such as diarrhea or constipation, along with bleeding should be evaluated.

- If you notice other symptoms: Symptoms such as weight loss, fatigue, or changes in appetite should prompt a visit to the doctor.

In terms of management, your doctor may recommend a thorough evaluation, which could include a physical examination, a digital rectal exam, and possibly further diagnostic tests such as a colonoscopy. A colonoscopy allows for direct visualization of the colon and rectum, and it can help identify the source of bleeding, as well as allow for potential treatment of any identified issues.

In the meantime, maintaining a high-fiber diet, staying hydrated, and avoiding straining during bowel movements can help reduce the risk of hemorrhoids and anal fissures. If you are prescribed medication to manage bleeding, it is essential to follow your doctor's instructions and report any new or worsening symptoms.

In summary, while rectal bleeding can have various causes, it is essential to seek medical evaluation, especially given the duration and recurrence of your symptoms. Early diagnosis and treatment can help prevent complications and ensure better health outcomes.