Causes and Treatments for Rectal Bleeding

13th, November 2015

As part of his weekly health column, Dr. Roger Brown, Private GP at Kingsbridge Private Hospital, discusses the importance of seeking medical attention if something isn’t right.

If ever you go to the toilet and find blood in the pan or on the toilet paper it can be a bit of a shock.

In men and non-menstruating women it is not normal to find blood in the toilet. It may be coming from the waterworks or the bowel and should sound the alarm bells.

Bleeding can be painless or painful and contain bright fresh blood or darker older looking blood. Mostly, the cause is something very simple – but bleeding can also indicate a much more serious pathology.

If you find any blood coming from the back passage or mixed with faeces please ask your doctor to take a good look. This may lead to a hospital referral for more tests, but ignoring something like this could cost you dearly.

Bleeding from the upper bowel may actually turn faeces black or a dark plum colour - this is called Melaena and is often a sign of bleeding from a stomach or duodenal ulcer.

Piles (haemorrhoids), little leaking veins which are a bit like varicose veins, or a fissure - a tiny tear at the margin of the back passage - can also cause bleeding. Bleeding from a rectal polyp or internal inflammation (proctitis) is not common, but possible.

Abnormal blood vessel formations in the lining of the bowel can cause significant bleeding from higher up the bowel and things like diverticulitis or ulcers. Bleeding can also come from inflammatory bowel conditions like Ulcerative colitis and Crohn’s disease.

Cancer of the bowel can also present itself as rectal bleeding, which is why it is so important to get this presenting symptom checked out. Bowel cancer is curable, but only if caught in time, so please be sensible and don't take a chance on this!

Bright fresh blood usually comes from the very low end of the bowel, near the exit, and although alarming is not ordinarily a sign of cancer.

Older and darker blood, blood mixed in with the bowel motion, and blood which is altered and clotted, are worrying signs of something possibly sinister.

Heavy or excessive bleeding  from the back passage is not common, but this and Melaena are surgical emergencies which should take you straight to the nearest A&E. Call an ambulance if you feel faint or that you might pass out.

Itching and pain at the back passage usually accompanies things like piles or fissures, but can also be a sign of an anal tumour. Again, lumps at the back passage which bleed can be piles, but this must be confirmed by a doctor.

A UK-wide national screening programme for bowel cancer is based on detecting microscopic traces of blood in the faeces. This operates in Northern Ireland every two years for 60 to 71-year-olds.

A positive result does not automatically mean bowel cancer, but does mean the person must be checked out by a Colorectal Surgeon using a camera to inspect the inside of the bowel.

An examination of the colon is called a colonoscopy and an examination of the lower bowel only, including the rectum and sigmoid colon, is called a sigmoidoscopy. These are vital in diagnosing or refuting the diagnosis of bowel cancer.

If you are sent a small package and asked to produce and send of a smear of your faeces to this screening programme, please respond by doing so. It could save your life.

If you are experiencing any of these symptoms, there are a number of  specialist Consultants available privately at Kingsbridge Private Hospital, or alternatively, you can make an appointment with your local GP.

Dr. Brown is a Private GP at Kingsbridge Private Hospital Belfast, available from 9-8pm Monday to Friday and 9-5pm Saturday.

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