11 Common Causes Of Rectal Bleeding

By: GI Alliance


Why is there blood in my stool? It’s a question we never want to ask, but it’s one in vital need of an answer. Even a slight presence of blood in your stool or on the toilet tissue hints that bleeding is occurring in the digestive tract. The darker the appearance of the blood, the higher up on the digestive tract the blood entered the stool. Bright red blood can be the result of anal bleeding or problems in the lower intestinal tract. But this is not an absolute rule by which you can make decisions. Although bright red blood may suggest that it is from hemorrhoids, sometimes there may be another serious underlying problem. If the physician performs the necessary evaluation and decides that the bleeding is from hemorrhoids, that is acceptable. Assuming that the bleeding is from hemorrhoids because is it a small amount or because it is bright red in color, or based on someone else’s experience is somewhat risky. There are some patients who may have colon cancer and have minimal or NO  bleeding. The most common symptom of colon cancer is …no symptom! So please don’t ignore, postpone or assume something when a serious symptom like blood in the stool occurs. Appropriate evaluation gives you peace of mind and relief from your symptoms. Most of these underlying causes have effective management and there is no need to suffer. The 11 most common causes of rectal bleeding are
  1. Anal fissures, which are small cuts or tears in the lining of the anus, can appear after passing a particularly hard stool.
  2. Hemorrhoids are swollen veins in the lower rectum, which can cause pain, itching, and difficulty sitting, as well as the appearance of bright red blood. The good news is that there is no need for painful surgery in most cases due to recent developments in non-surgical techniques which are easy, pain-free, in-office and very effective.
  3. An anal fistula is a small channel that forms between the anal canal and the skin surrounding the anus. Along with minor bleeding, it can cause swelling, tenderness, and persistent discharge/drainage. Currently, the only remedy for an anal fistula is surgery.
  4. Gastroenteritis is a sudden-onset intestinal infection, which can be viral, bacterial, or parasitic. In addition to blood in the stool, gastroenteritis is characterized by diarrhea, abdominal cramps, nausea, vomiting, fever, and body aches. If gastroenteritis recurs or lasts longer than 2 days, we recommend further evaluation by a trained digestive specialist.
  5. Peptic ulcers are sores in the esophagus, stomach, or the lining of the upper part of the small intestine. Depending on the location of the sores, the blood in the stool may appear darker, possibly even black. In addition, you may experience burning pain in the stomach, which worsens as the stomach empties, heartburn, nausea and vomiting, bloating, appetite changes, and weight loss. If left untreated peptic ulcers can cause severe damage to the lining of your digestive system, so please seek help immediately if symptoms of peptic ulcers persist.
  6. Diverticular disease is defined by the development of small bulges—or diverticula—in the lining of the colon. Along with rectal bleeding, diverticular disease—and diverticulitis—include severe abdominal pain, bloating, high fever, and frequent diarrheal bowel movements.
  7. Angiodysplasia occurs more often in older adults and is defined by swollen, fragile blood vessels in the colon. If the swelling worsens, small passages ways can form between the artery and vein, resulting in bleeding from the colon wall, which can manifest as bright red or black blood in the stool. Angiodysplasia is also characterized by weakness, fatigue, shortness of breath, and anemia.
  8. Inflammatory Bowel Diseases, such as Crohn’s disease or ulcerative colitis, can cause ulcers, abscesses, and scarring in the intestinal lining over time. Blood in the stool is often accompanied by diarrhea, fever, weight loss, and abdominal pain.
  9. Bleeding varicesWhen dilated blood vessels (varices) in the esophagus and stomach rupture and bleed, they can be life-threatening. If your black, tarry or bloody stool is accompanied by vomiting blood, low blood pressure, lightheadedness, or rapid heart rate, seek medical attention immediately. If not addressed, the sufferer can go into shock.
  10. Colon polyps are noncancerous growths in the colon or rectal lining. Though colon polyps are normally asymptomatic, they can cause rectal bleeding, sudden changes in bowel habits, and constipation or diarrhea that lasts for more than a week. Though colon polyps are not necessarily cancerous, they can develop into colon or colorectal cancer, so it’s vital to get screened by a skilled gastroenterologist immediately.
  11. Colon cancer may cause blood in the stool, anywhere from minimal bleeding to a significant amount. Sometimes it may not cause any bleeding at all and be completely asymptomatic. Everyone 50 years and above needs SCREENING COLONOSCOPY (done in the absence of symptoms as a prevention/ wellness check) to identify precancerous polyps and remove them before they could become cancer. Sometimes cancer may cause abdominal pain, weight loss or anemia.
While rectal bleeding can be the result of many intestinal or anal issues that are not life-threatening and can resolve themselves, it can also be an early indication of a more severe digestive tract issue. If you are experiencing rectal bleeding, you may want to take the next step in protecting your future with preventative screenings, like a colonoscopy.  The gastroenterologists with GI Alliance are specialized and highly experienced in screening for, detecting, and treating colorectal cancer and the precursors to colorectal cancer (ie polyps).  Contact a GI Alliance gastroenterologist today.