Health Topics for Digestive System

James A. Clifton Center for Digestive Diseases

Cancers of the Digestive System

Liver Failure Clinic

Liver Service

Rectal bleeding

Rectal bleeding can be a sign of many different problems. Some causes can be serious. All rectal bleeding requires a medical check- up.

Bright red blood may be seen only on toilet paper or in the toilet bowl after a bowel movement. This is usually from a hemorrhoid or anal fissure. A hemorrhoid is a swollen vein in the anal area. A fissure is a split in the anal mucosal surface. Both cause difficult and painful bowel movements.

Blood in the stool may also indicate an inflamed rectum or colon. These could become serious conditions. They usually are present with other symptoms. An inflamed rectum is usually caused by an infection. The cause of an inflamed colon is usually unknown.

Other symptoms may include:

• sharp rectal pain
• mucus and pus in the stools
• constipation
• abdominal pain
• cramping
• fever
• diarrhea and
• anemia

Colon cancer is the second leading cause of cancer death. It can cause rectal bleeding. Polyps are often found before the cancer is diagnosed. Polyps are small growths from the inner lining of the colon. They may cause minor bleeding. This makes screening for blood in the stool a useful tool for early detection of colon cancer. The test can detect small amounts of blood that would typically go unnoticed.

Bleeding that occurs higher in the intestine than the colon may be maroon or black. Peptic ulcers cause black or tarry stools. Other causes include problems with blood vessels and overuse of alcohol or aspirin. Iron pills cause black stools, but do not cause bleeding.

If you notice rectal bleeding, consult your healthcare provider. If your bleeding is nonstop or in large amounts, you should seek emergency care. Tests to find the source of the blood may include x- ray or endoscopic procedure. A colonoscopy is the passage of a long, flexible tube through the colon.

For all men and women 50 years of age or older, who are at average risk of colon cancer, the American Cancer Society recommends the following screening tests for colon cancer:

• fecal occult blood test every year OR
• flexible sigmoidoscopy every 5 years OR
• fecal occult blood test every year with a flexible sigmoidoscopy every 5 years OR
• colonoscopy every 10 years OR
• double contrast barium enema every 5 years

Of the first three options, the American Cancer Society recommends the third option of the fecal occult blood test every year with a flexible sigmoidoscopy every 5 years. If the fecal occult blood test is positive, a colonoscopy should be done instead of the sigmoidoscopy. The take-home multiple sample method of fecal occult blood test is the one that should be done.

If any of these tests (except colonoscopy) are positive, they should be followed up with a colonoscopy. Anyone who has a relative in the immediate family who has had colon cancer, or has a history of polyps is considered at higher risk. These higher risk people need to have the tests more often as recommended by their healthcare provider.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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