If you notice blood in the stool or the toilet bowl, it could be a case of rectal bleeding. There are many reasons why rectal bleeding can occur, the most common one being haemorrhoids. If the rectal bleeding is not significant then it is not a cause for concern. But if you lose a lot of blood then it can be a major problem.
What are the signs?
The most obvious one, in this case, is the presence of blood in your stool. But it's not just the presence of blood that is important here, the colour of the blood is also a very important indicator of what is wrong.
Black colour indicates that you are bleeding from the upper region of the small intestine
A bright red colour is an indication of the blood loss from the lower part of the gastrointestinal tract – rectum or colon
Dark red indicates that the bleeding is taking place at the initial region of the colon
Some other symptoms you may experience are –
Causes of rectal bleeding
Causes of rectal bleeding can be divided into mild and serious.
Mild causes –
Small tears in the anal lining (anal fissures)
Small growths of tissue in the rectum or colon
Serious causes –
Cancer of the colon and anus
An infection of the intestine such as salmonella
How is it treated?
If you lose a lot of blood, then it is a medical emergency. You should rush to the doctor if you experience the following – fainting, intense pain in the stomach, confusion, and rapid breathing.
The doctor will prescribe treatment based on the cause of your rectal bleeding. For example, if the cause is haemorrhoids then warm baths will help soothe the pain. If the haemorrhoids are large then invasive methods such as laser treatments and surgery are prescribed.
Or if it is constipation then stool softeners are a good option. In addition, you may have to eat a high fibre diet and exercise regularly to normalize your bowel movements.
Rectal bleeding can be a minor inconvenience or a major problem depending on the cause. So it is best to consult a doctor and seek immediate treatment.
Diseases that plague the anal and the rectum area are categorized as anorectal disorders. Some common forms of anorectal disorders are haemorrhoids, fissures, and fistulas. Most of these conditions manifest through symptoms like burning, itching, pain, and bleeding. If you have any of these disorders, consult a specialist to rule out anal cancer or other severe problems.
Let us look at some of the most common types of anorectal disorders and their treatments –
1. Anal Fissure - An anal fissure occurs when there are tears in the anal canal lining. If you are constipated or strain while passing bowels, you become vulnerable to this disorder. The symptoms are sharp pain during bowel movements that may be followed by blood loss from the anal area. If you have anal fissures, opt for warm baths to soothe the affected area. Not only that, it will also improve blood flow. Medications include fibre therapy, which changes the texture of the stool and allows that area to heal. You may also be prescribed sphincter relaxants if the above measures do not work. The last resort is surgery.
2. Haemorrhoids - Haemorrhoids are a part of your body. They allow you to control your bowel movements. There are two types of haemorrhoids – internal and external. The internal ones may lead to a feeling of incomplete bowel movement, bleeding, leakage of bowel and tissue prolapse. In the case of external haemorrhoids, you will feel a bulge near the anal outlet. You may also have bleeding and itching in the anal region. For this condition, the primary goal is to tackle the symptoms and not getting rid of the hemorrhoidal tissue.
3. Fistulas - If the skin and the anal canal are connected abnormally, then you have a fistula. It can also be a result of an abscess. An abscess occurs when one of the glands in the anal canal gets blocked. An infection ensues, which left untreated can turn into a fistula. Symptoms of fistula include fever, redness, pain, and bloody discharge. Controlling bowel movements also becomes difficult. For fistulas, the treatment begins with a careful examination of the affected area. If an abscess is found, it is drained. If abscesses are not the reason, then antibiotics are prescribed. Sometimes, a colonoscopy may be required for a better diagnosis. If all measures fail, doctors resort to surgery.
4. Pruritus ani - It is intense chronic itching, affecting peri-anal skin. It affects around 5% of the population, is four times more common in men. It is frequent between fourth and sixth decades of life.
5. Constipation - It refers to bowel movements that are hard to pass. The stool is often dry. Other symptoms include abdominal bloating, pain and feeling as if one has not completely passed the bowel movement.
6. Prolapse - It is often associated with prolapse of other pelvic organs. The weakness of connective tissue separating the bladder and the vagina can cause the bladder to bulge into the vagina.
7. Proctalgia fugax - It is a functional anorectal problem characterized by severe, intermittent episodes of rectal pain that are self-limited. Its diagnosis requires exclusion of other causes of rectal or anal pain.
Make sure to consult a doctor as soon as you experience any of these symptoms.
It is important to remember that, rectal bleeding or blood in the stool is never normal and while it may come from a relatively benign cause like hemorrhoids, more serious causes like colon cancer can be life-threatening. Rectal bleeding may be painful or painless. Fresh blood may come out before, during and/or after passing stool or it may be mixed with the stool. Sometimes one may have black color stool which indicates high up bleeding source.
The common causes of painful rectal bleeding are :
The common causes of painless rectal bleeding:
* Hemorrhoidal diseases (Piles)
* Cancer in the rectum and anal canal
* Anal or rectal polyp
* Rectal prolapse
* Ulcerative colitis
* Crohn’s disease
Rectal prolapse means complete rectal prolapse where the rectal walls have prolapsed to a degree where they protrude out of the anus and are visible outside the body.
The different types of prolapse are as-Internal prolapse (internal intussusception). Full thickness or a partial rectal wall is affected but the prolapsed tissue does not pass out of the anus.
Grades of Prolapse
Grade I: Non-relaxation of the sphincter mechanism
Grade II: Mild intussusception
Grade III: Moderate intussusception
Grade IV: Severe intussusception
Grade V: Rectal prolapse
Symptoms of Rectal Prolapse
History of a protruding mass- Initially, the mass protrudes from the anus only after a bowel movement and usually retracts when the patient stands up. As the disease process progresses, the mass protrudes more often, especially with straining and valsalva maneuvers such as sneezing or coughing.
Signs of Rectal Prolapse
How will you Diagnose?
A perineal approach refers to surgical access to the rectum and sigmoid colon via an incision around the anus and perineum. Abdominal approach (trans-abdominal approach) involves the surgeon cutting into the abdomen and gaining surgical access to the pelvic cavity.
Rectal cancer is the growth of cancerous cells in the rectum, which is the colon’s lower part of the colon, connecting the large bowel and the anus. The basic function of the rectum is to collect the stool that is formed inside the human body before it is eliminated from the body. The cancer starts as a polyp, which is precancerous, and slowly develops and turns cancerous. This cancer will start spreading and penetrates into the walls of the rectum causing rectal cancer.
Surgery is the most common treatment available for rectal cancer. Depending on the location of the cancer and the type of cancer, there are different types of rectal cancer surgeries available. One of the important things that are considered before deciding which kind of surgery is required is the location of the tumor from the anus.
Types of Surgeries for Rectal Cancer:
Here are different types of surgeries available for different stages of rectal cancer.
In case you have a concern or query you can always consult an expert & get answers to your questions!