Areas of Expertise
About Rectal Bleeding
Rectal bleeding is a symptom that may represent a variety of underlying problems. While hemorrhoids are commonly blamed as the cause of bleeding, a number of other problems such as cancer, polyps, fissures, infections, inflammatory bowel disease, and more may in fact be the cause. Differentiation between these entities can only be made after an appropriate evaluation. Rectal bleeding requires further investigation regardless of age. Failure to investigate properly is the most common reason for missed cancers that may be discovered at a treatable stage.
There may be other warning signs associated with rectal bleeding that are more worrisome. These include:
- change in bowel habits or size of stools.
- recurring stomach discomfort such as gas, cramping, or pain
- weakness or fatigue
- unexplained weight loss
- low blood counts
Diagnosis and Further Investigations:
As stated above, all forms of rectal bleeding require further investigation. This is most commonly done in the form of a flexible endoscope or fiberoptic camera. The extent of evaluation may vary depending on the severity of symptoms. These instruments allow biopsy of any suspicious area to make the correct diagnosis. Possible options for endoscopy include:
A colonoscopy uses a colonoscope to visually examine the colon and rectum for polyps and tumors. A colonoscope is a thin, flexible tube, with a tiny fiber-optic video camera and a light inside its tip. It is about the thickness of an adult finger. The tube is flexible and can be maneuvered to investigate the interior surface of the colon. The camera sends magnified images of the colon to a television screen.
The colonoscope can be used to perform treatment as well as viewing the colon. Small surgical instruments, inserted through the colonoscope, can be used to remove small polyps that are discovered during the examination, without having to perform major surgery.
To prepare for a colonoscopy, a patient is usually required to drink a liquid or perform bowel cleansing using laxatives and sometimes enemas. This eliminates all fecal matter (stool) from the colon so that the person conducting the test will have a clear view.
A sigmoidoscopy is similar to a colonoscopy in that it uses a flexible tube with a fiber-optic camera and light, but examines only the last two feet of the intestine, called the sigmoid colon, and rectum.
A proctoscope is an office-based special plastic scope that allows your doctor to examine the lining of the rectum. It may require an enema to clean out the stool at the end of the digestive tract and allow improved visualization to detect problems in the rectum.
The treatment of rectal bleeding depends on the diagnosis. For more information: