Rectal bleeding is the expulsion of blood through the rectum or anus, which may or may not occur in association with defecation. It is a sign that may reflect the presence of a major or minor problem in the rectum, colon or small bowel, so it is necessary to consult a physician as soon as it is detected.
Most frequent symptoms of rectorrhagia:
- Rectal pain, rectal itching or rectal inflammation.
- Abdominal pain
- Diarrhea with blood clots
- Rectal bleeding may occur before or after defecation, and may be painless.
Causes of rectorrhagia:
- Hemorrhoids
- Fissures
- Diverticulosis
- Inflammatory bowel disease
- Ulcers in the digestive tract
- Intestinal angiomas (abnormal vascular structures in the digestive tract)
- Abnormal growths in the digestive tract (polyps or tumors)
- Rectal prolapse
The gastrointestinal tract
The gastrointestinal tract includes:
- Mouth
- Esophagus
- Stomach
- Small intestine
- Large intestine (colon)
- Rectum
- Anus
After food is ingested, it is digested as it passes through the digestive tract, with the absorption of liquids and different nutrients occurring in the different sections of the gastrointestinal tract; solid waste is collected in the rectum.
Rectorrhagia and gastrointestinal problems
The cause of rectorrhagia can be found anywhere in the gastrointestinal tract; most often it occurs in the rectum or colon, but if after an adequate analysis of these areas we do not find the lesion, we should extend it to the rest of the digestive tract (small intestine, duodenum and stomach).
Diagnosis of rectorrhagia
Your coloproctologist should perform a complete clinical review in order to find the cause of the rectorrhagia, including anamnesis or clinical interview and physical examination.
In the anamnesis the specialist will ask the patient a series of questions related to his symptomatology, such as if he has ever had the same problem, associated symptoms, etc.; and questions about his health.
The examination will consist of a visual inspection of the anus, followed by a manual examination by means of a digital rectal examination. The introduction of a small tube into the anus (anuscope) will allow visualization of the interior of the anus.
Complementary examinations can also be performed: the simplest test consists of the observation of the stool, which the patient performs at home, constituting the reason for consultation; the rest of the complementary tests will be performed in a medical center:
- Rigid sigmoidoscope: allows examination of about 20-25 cm. of colon from the anus. The bowel must be prepared with an irrigation or enema.
- Colonoscopy: it is performed with a long and flexible instrument that can allow the exploration of the entire colon. It requires prior bowel preparation. It may cause discomfort and discomfort during its performance.
- Opaque enema: also requires bowel preparation. It is a special radiological test in which a contrast material is introduced through the anus to fill the colon and draw its surface (mucosa); X-rays are taken in different projections to obtain a complete diagnosis of the colon and rectum. Sometimes air is also introduced to improve the interpretation of the test (double contrast enema).
- Endoscopy: examination of the esophagus and stomach with a flexible tube inserted through the mouth. This technique is performed on the rare occasions when the above tests have failed to provide a definitive diagnosis.
Treatment of rectorrhagia
Treatment depends on the cause. Depending on the data found during the analysis, your doctor will propose a specific plan of action for each case. Sometimes rectal bleeding stops spontaneously, but even in these cases a diagnosis must be made to rule out the presence of a serious underlying problem.