Rectal bleeding

March 2017


Definition


Rectal bleeding is a hemorrhaging of digestive origin that is discharged through the anus. When blood is blackish, it is digested blood called melena. In the case of rectal bleeding, the blood is bright red, because it is not digested. In case of rectal bleeding, it is important to discern whether the blood is mixed with the stool or if separated. In general, when blood is found inside the stool, the origin is rather in favor of a disease of the colon while when separated or identified on the toilet paper, the origin is more frequently terminal, suspected to be hemorrhoids. Rectal bleeding requires prompt consultation with an attending physician.

Symptoms


Rectal bleeding occurs as an externalization of red blood from the anus. This is a symptom that is usually reported by the patient, and less frequently objectified by the doctor, except in hospitalized patients.

Diagnosis


The diagnosis of rectal bleeding is made through an examination of the patient, who expresses the discovery of red blood coming from the anus. An examination of the anal margin is done to search for the presence of external or internal hemorrhoids. If no cause is found, blood may sometimes be found during a rectal exam. Additional tests are sometimes performed to confirm the source of bleeding such as a colonoscopy searching for internal hemorrhoids or lower rectal lesions. A sigmoidoscope will display the status of the walls of the rectum. It is usually coupled with a colonoscopy.

Treatment


The treatment of rectal bleeding depends on the degree of severity of this phenomenon. If rectal bleeding is severe, then hospitalization is required because of the risk of blood loss and hemorrhagic shock. If the bleeding is due to a drug such as aspirin or anticoagulants, the use will be terminated immediately. The treatment of the cause after identification can often eliminate the bleeding. Surgery is considered in certain conditions such as cancerous tumors, chronic inflammatory bowel disease (Crohn's disease and ulcerative colitis), ischemic colitis or certain disorders secondary to the interruption of blood supply to the intestinal wall.

Related

Original article published by . Translated by Jeff.
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