RECTAL BLEEDING

Rectal bleeding can manifest with various symptoms, which may include:

• Pain or pressure in the rectum: Individuals with rectal bleeding may experience discomfort or a sense of pressure in the rectal area.

• Black stools: Also known as melena, black or tarry stools can indicate bleeding from the upper gastrointestinal tract, such as the stomach or upper small intestine.

• Bloody stools: The presence of bright red blood in stools or on toilet tissue may suggest lower gastrointestinal bleeding, often originating from the rectum, colon, or anus.

• Weight loss: Unexplained weight loss can be a concerning symptom and may be associated with chronic bleeding or underlying medical conditions.

• Incontinence to defecate: Rectal bleeding, especially if accompanied by other symptoms, can sometimes lead to incontinence or difficulties with bowel movements.

• Dizziness: In cases of significant blood loss, individuals may experience dizziness or lightheadedness due to anaemia or low blood volume.

Categorised based on the location and severity of the bleeding, common types include: 

• Haematochezia: Haematochezia is the term used to describe bright red blood in the stool. It typically originates from the lower gastrointestinal tract, including the rectum, anus, or colon. Haematochezia is often visible in the stool or on toilet paper after wiping.

• Melena: Melena is the passage of dark, tarry stools, which occurs due to the partial digestion of blood in the upper gastrointestinal tract, such as the stomach or small intestine. The black colour results from the breakdown of haemoglobin during its passage through the digestive system.

• Occult Bleeding: Occult bleeding refers to small amounts of blood in the stool that are not visible to the naked eye. Occult bleeding can be detected through laboratory tests, such as faecal occult blood tests (FOBT) or faecal immunochemical tests (FIT).

• Lower Gastrointestinal Bleeding: Lower gastrointestinal bleeding refers to bleeding that originates from the lower part of the gastrointestinal tract, including the rectum, colon, and anus.

• Upper Gastrointestinal Bleeding: Upper gastrointestinal bleeding refers to bleeding that originates from the upper part of the gastrointestinal tract, such as the oesophagus, stomach, or duodenum.

• Anal Fissures: Anal fissures are small tears or cuts in the lining of the anus, which can cause bright red blood on the surface of stools or on toilet paper.

• Haemorrhoids: Haemorrhoids are swollen and inflamed veins in the rectum or anus, which can cause bright red blood during bowel movements.

• Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis, which are types of inflammatory bowel disease, can cause rectal bleeding along with other gastrointestinal symptoms.

• Colorectal Polyps or Cancer: Growths or tumours in the colon or rectum, such as polyps or colorectal cancer, can cause rectal bleeding, especially if they are located close to the anus.

• Diverticular Disease: Diverticular disease involves the formation of small pouches (diverticula) in the colon, which can become inflamed or infected and cause bleeding.

Rectal bleeding can have various common causes, including:

• Haemorrhoids: Swollen and inflamed blood vessels in the rectum or anus are a frequent cause of rectal bleeding. External haemorrhoids can cause bleeding during bowel movements.

• Anal Fissures: Small tears or cracks in the lining of the anus, known as anal fissures, can lead to bright red rectal bleeding, especially during or after bowel movements.

• Anal Ulcers: Ulcers in the anal region can result from various conditions and may lead to rectal bleeding.

• Colitis: Inflammation of the colon (colitis) can be associated with rectal bleeding. Conditions like ulcerative colitis or infectious colitis may cause this symptom.

• Inflammatory Bowel Disease (IBD): Chronic conditions such as Crohn's disease and ulcerative colitis, collectively known as inflammatory bowel disease (IBD), can lead to rectal bleeding due to inflammation and damage to the intestinal lining.

• Hard Stools: Constipation or the passage of hard, dry stools can cause strain during bowel movements, potentially leading to rectal bleeding.

Medical treatment for rectal bleeding will depend on the underlying cause. Here are some common medical treatments that may be employed based on the specific diagnosis:

• Topical Analgesics: Topical medications like lidocaine can help relieve pain and discomfort associated with anal fissures and haemorrhoids.

• Hydrocortisone Suppositories: Hydrocortisone suppositories or creams containing corticosteroids may be prescribed to reduce inflammation and itching, particularly for conditions like haemorrhoids and anal fissures.

• Ointments: Various ointments or creams, such as antibiotic ointments or medicated ointments, may be recommended to address specific causes of rectal bleeding, such as infection or inflammation.

• Antibiotics: In cases where rectal bleeding is caused by infections, such as bacterial or sexually transmitted infections, antibiotics may be prescribed to treat the underlying infection.

• Anti-inflammatories: Anti-inflammatory medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), may be used to manage conditions associated with rectal bleeding and inflammation, such as inflammatory bowel disease (IBD) or colitis.

• Other Medications: Depending on the diagnosis, other medications or treatments may be necessary. For example, if rectal bleeding is due to IBD, medications to manage and control the condition may be prescribed.

Natural approaches can complement medical treatments and help manage rectal bleeding or related conditions. Here are some natural treatment options:

• Fibre-Based Diet: Consuming a high-fibre diet with plenty of fruits, vegetables, whole grains, and legumes can promote regular bowel movements and prevent constipation, which may contribute to rectal bleeding.

• Adequate Hydration: Drinking sufficient water helps soften stools and prevent constipation, reducing strain during bowel movements.

• Natural Laxatives: Some natural laxatives, such as prunes or prune juice, can help alleviate constipation and promote regular bowel movements.

• Probiotics: Probiotic supplements or probiotic-rich foods like yoghurt can help maintain gut health and promote balanced digestion.

• Comfortable Underwear: Wearing loose-fitting, cotton underwear can reduce friction and irritation in the anal area, which may be beneficial for conditions like haemorrhoids or anal fissures.

• Mind-Body Practices: Stress reduction techniques like meditation and yoga can help manage stress, which can exacerbate digestive issues and contribute to rectal bleeding.

• Avoid Irritants: Avoid using harsh soaps or scented wipes in the anal area, as these can irritate sensitive skin and worsen symptoms.

• Sitz Baths: Soaking in a warm sitz bath for 15-20 minutes can provide relief from anal discomfort and promote healing, especially for conditions like haemorrhoids and anal fissures.