Seeing blood in the toilet or with wiping after a bowel movement can be alarming but it is actually quite common. Fortunately, most of the causes of rectal bleeding are not life-threatening, but the only way to be certain it is not serious is to be evaluated by a doctor. Rectal bleeding can be a sign of something very serious such cancer or inflammatory bowel disease, but most often it is caused by hemorrhoids or anal fissures. Because there is no way to tell the difference an examination is needed in all cases of rectal bleeding.
When do I see a doctor ?
The only way to be certain of the cause of rectal bleeding is to be evaluated by a doctor. As noted above, most people with rectal bleeding don’t have cancer or some other serious condition. However, it is not possible to know the cause of rectal bleeding without an examination. Therefore, anyone who notices rectal bleeding should make an appointment with our office to determine if an examination is needed.
What causes rectal bleeding?
There are many causes of rectal bleeding from life threatening to minor issues. The two most common causes are hemorrhoids and anal fissures. Hemorrhoids are swollen blood vessels in the rectum or anus that can become swollen and cause symptoms such as pain, itching and can sometimes bleed. Painless rectal bleeding with a bowel movement is a common symptom of hemorrhoids. An anal fissure is a tear in the lining of the anus, and these tears also cause bleeding; but with fissures they also cause pain with bowel movements.
Other causes of rectal bleeding include IBD (inflammatory bowel disease) colon cancer, colon polyps, colitis and even diverticulosis.
In addition, bleeding from higher in the digestive tract such as the stomach or small bowel can produce black tarry bowel movements which is very serious as well and needs to be evaluated.
Why should I worry about rectal bleeding ?
While most rectal bleeding is caused by the non-serious causes already mentioned, bleeding can also be caused by very serious medical conditions like cancer or precancerous lesions. Precancerous polyps located lower in the colon can mimic the bleeding from hemorrhoids and they can be removed safely from the colon, preventing progression to cancer. Colon cancer frequently is diagnosed in patients who have ignored bleeding for years because they assume it was from hemorrhoids.
What are the test for a rectal bleeding?
There are several tests for rectal bleeding and the best one depends on your age, symptoms and medical and family history.
Rectal examination is the easiest test to perform and is done in the office and sometimes can detect the cause of bleeding with no further examination.
Anoscopy allows us to inspect the anus and lower rectum in the office. It is a quick procedure which requires no sedation and is very good to evaluate hemorrhoids.
Colonoscopy is the most thourough test to evaluate for rectal bleeding. A colonoscopy is a procedure in which we will examine the entire colon, while you are asleep. Please see our section on colonoscopy for full details on this examination.
If you would like to request an appointment with Dr. FEUHOUO call his clinic at 01 60 42 99 94
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