Several other methods are available to locate the source of anal bleeding. These can include:
- Barium x-rays
- A CT scan
- Radionuclide scanning.
Barium x-rays are generally less accurate than endoscopy in locating bleeding sites. Some drawbacks of barium x-rays include the following:
- They may interfere with other diagnostic techniques if used for detecting acute anal bleeding
- They expose the person to x-rays
- They do not offer the capabilities of biopsy or treatment.
Another type of x-ray, called a CT scan, is particularly useful for inflammatory conditions and cancer.
Angiography is a technique that uses dye to highlight blood vessels. This procedure is most useful in situations when the person is acutely bleeding. When this happens, the dye leaks out of the blood vessel and identifies the site of bleeding. In some situations, angiography allows medicine to be injected into the arteries that may stop the anal bleeding.
Radionuclide scanning is a noninvasive screening technique used for locating sites of acute anal bleeding, especially in the lower GI tract. This technique involves injection of small amounts of radioactive material. Then, a special camera produces pictures of organs, allowing the doctor to detect the site of a GI bleed.
Endoscopy is the primary diagnostic and therapeutic procedure for most causes of anal bleeding. Active bleeding from the upper GI tract can often be controlled by injecting chemicals directly into a bleeding site with a needle that is passed through the endoscope. A physician can also cauterize (treat with heat) a bleeding site and the surrounding tissue with a heater probe or electrocoagulation device. These devices are also passed through the endoscope. Laser therapy is useful in certain specialized situations.
Once anal bleeding is controlled, medicines are often prescribed to prevent the bleeding from coming back. Medicines are useful for things like H. pylori infections, esophagitis, ulcers, other infections, and inflammatory bowel disease (IBD). Medical treatment of ulcers -- including the elimination of H. pylori -- to ensure healing and maintenance therapy to prevent the return of ulcers can also lessen the chance of recurrent anal bleeding.
Removing polyps with an endoscope can control anal bleeding due to colon polyps. Removing hemorrhoids by banding or various heat or electrical devices is effective in people who suffer hemorrhoidal bleeding on a recurrent basis. Endoscopic injection or cauterization can be used to treat sites of anal bleeding throughout the lower intestinal tract.
Endoscopic techniques do not always control anal bleeding. Sometimes, angiography may be used. However, surgery is often needed to control active, severe, or recurrent bleeding when endoscopy is not successful.