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Rectal Bleeding

Comprehensive care for digestive disorders by Dr. Akeel Alisa

Understanding Rectal Bleeding

Rectal bleeding is the presence of blood in or around the stool. While it can be alarming, it is not always a sign of something serious. In many cases, rectal bleeding is caused by minor issues such as haemorrhoids (piles) or anal fissures. However, it can also be a symptom of more significant conditions like inflammatory bowel disease (IBD), diverticular disease, or bowel cancer.

Because the causes of rectal bleeding range from mild to serious, it is always important to have the symptom properly assessed by a specialist gastroenterologist.

How Rectal Bleeding Appears

The colour, amount, and timing of the blood can sometimes help indicate the cause:

  • Bright red blood on toilet paper or in the bowl usually comes from the lower rectum or anus, often due to haemorrhoids or fissures.
  • Dark red or maroon blood may suggest bleeding higher up in the colon.
  • Black, tarry stools (known as melaena) indicate bleeding from the stomach or upper digestive tract.

Regardless of appearance, any persistent or unexplained bleeding should not be ignored.

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Common Causes of Rectal Bleeding

  • Haemorrhoids: Swollen veins in the rectum or anus, often causing painless bright red bleeding.
  • Anal fissures: Small tears in the lining of the anus, usually associated with pain.
  • Diverticular disease: Small pouches in the bowel wall that can sometimes bleed.
  • Inflammatory bowel disease (Crohn’s disease, ulcerative colitis): Ongoing inflammation may cause bleeding.
  • Polyps: Growths in the bowel that may bleed and, in some cases, turn cancerous over time.
  • Bowel cancer: An important cause to rule out, especially in older patients or those with risk factors.
  • Gastrointestinal ulcers: Ulcers in the stomach or duodenum may lead to black, tarry stools.

When to See a Gastroenterologist

You should seek medical advice if you experience:

  • Persistent or recurrent rectal bleeding
  • Bleeding accompanied by changes in bowel habit
  • Unexplained weight loss or fatigue
  • Abdominal pain or bloating
  • Mucus in the stool
  • A family history of bowel disease or bowel cancer

If rectal bleeding is heavy or accompanied by dizziness, fainting, or black stools, it may be an emergency and requires immediate medical attention.

Diagnosis

A gastroenterologist will carry out a thorough assessment, which may include:

  • Medical history and examination to assess symptoms and risk factors.
  • Blood tests to check for anaemia or inflammation.
  • Stool tests to detect hidden blood or infection.
  • Endoscopy (colonoscopy, sigmoidoscopy, or gastroscopy): A camera test to directly examine the digestive tract and identify the source of bleeding.
  • Imaging scans (CT or MRI) if required.

Treatment Options

Treatment depends on the underlying cause of the bleeding:

  • Haemorrhoids and fissures: Often treated with lifestyle changes, topical creams, or minor procedures.
  • Diverticular disease: Managed with dietary changes, antibiotics, or in rare cases, surgery.
  • Inflammatory bowel disease: Controlled with anti-inflammatory medications, immunosuppressants, or biologics.
  • Polyps: Can be removed during a colonoscopy to prevent future complications.
  • Bowel cancer: Requires a combination of surgery, chemotherapy, or radiotherapy, depending on stage.

Why Early Evaluation is Important

While many causes of rectal bleeding are benign, some are serious and potentially life-threatening. Early detection means:

  • Polyps can be removed before they turn into cancer.
  • IBD can be treated early to prevent complications.
  • Bowel cancer can be detected at an early, highly treatable stage.

Why See a Specialist?

A gastroenterologist provides:

  • Accurate diagnosis through advanced endoscopy and testing.
  • Peace of mind by ruling out serious conditions.
  • Targeted treatment based on the exact cause.
  • Ongoing care to manage long-term bowel health.
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My consultation with Dr Akeel Alisa was highly satisfactory and he was very thorough. The Gastroscopy procedure was performed satisfactorily with no pain or discomfort at all. I am very pleased with treatment received so far.

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I was fully vaccinated investigated by Dr Akeel Alisa and I was reassured. My endoscopy and colonoscopy were straight forward and painless. I am very happy with the care I received.

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