Rectal Bleeding

What is rectal bleeding?

The term rectal bleeding is often used to mean any blood that is passed out when going to the toilet to pass faeces. However, not all bleeding that is passed out actually comes from the rectum. The blood can come from anywhere in the gut (the gastrointestinal tract). The severity can vary from mild bleeding (very common) to a severe life-threatening bleeding (uncommon).

Where does the bleeding come from?

Bleeding can come from anywhere in the gut. As a general rule, with bleeding from the anus or low down in the rectum, the blood tends to be bright red and fresh. It may not be mixed in with faeces but instead blood may be noticed as spots in the toilet pan or streaks of blood on the surface of the stools, as for example, with an anal fissure or haemorrhoids. With bleeding from the colon, the blood is often mixed up with the motions and darker in colour e.g. as can occur with colitis, diverticular disease or from a bowel tumour. However, sometimes, if the bleeding is brisk, blood from higher up in the colon may still be bright red and not mixed up too much with faeces.

What are the causes of rectal bleeding?

There are many possible causes of rectal bleeding. Here is a list of the more common causes:

  • Haemorrhoids (‘Piles’)
  • Anal Fissure
  • Diverticular Disease
  • Angiodysplasia
  • Colonic Polyps
  • Bowel Cancer
  • Ulcerative Colitis
  • Crohn's Disease
  • Meckel's Diverticulum
  • Stomach an Duodenal Ulcers
  • Gut Infections

What should you do if you have rectal bleeding?

With mild rectal bleeding, you should make an appointment to see your GP who will arrange an appointment for you to see a colorectal surgeon. Some people assume that their rectal bleeding is due to haemorrhoids and do not get it checked out. Haemorrhoids are perhaps the most common cause of rectal bleeding. However, you should not assume the bleeding is coming from a haemorrhoid unless you have been properly assessed by a specialist, as it is important to exclude potentially serious causes for the bleeding. This may entail undergoing further tests such as a colonoscopy.