Rectal bleeding causes can include several health conditions, such as hemorrhoids, anal fissures, infections, polyps, or even cancer. Rectal bleeding can sometimes occur without the person noticing it. This is called occult, or hidden, bleeding. Most rectal bleeding causes are not serious; however, others are potentially life threatening, so rectal bleeding should always be reported to your doctor.
Rectal Bleeding Causes: An Overview
The most common cause of
rectal bleeding is
hemorrhoids. However, more serious rectal bleeding causes can occur. So while the causes of rectal bleeding may or may not turn out to be serious, it is still important to locate the source of the bleeding.
It is important that you see your doctor if you have rectal bleeding and:
- You are older than 50
- You have a family history of colon or rectal cancer
- Bleeding occurs between bowel movements
- The blood is dark red or maroon
- You have tar-like, black stools.
How Anatomy Affects Rectal Bleeding Causes
The digestive or gastrointestinal (GI) tract includes the:
- Esophagus
- Stomach
- Small intestine
- Large intestine (colon)
- Rectum
- Anus.
Rectal bleeding can come from one or more of these areas. For example, bleeding may come from a small area, such as an ulcer on the lining of the stomach, or from a large surface, such as an inflammation of the colon.
Rectal bleeding can sometimes occur without the person noticing it. This type of bleeding is called occult, or hidden, bleeding. Fortunately, simple tests can detect occult blood in the stool.
Common Rectal Bleeding Causes
Common rectal bleeding causes can include:
- Hemorrhoids
- Anal fissures
- Infections
- Inflammation (ulcerative colitis or irritable bowel disease)
- Colorectal polyps
- Colorectal cancer
- Diverticular disease
- Angiodysplasia
- Any upper gastrointestinal or small bowel lesion, if the bleeding is brisk.
In the lower digestive tract, the large intestine and rectum are frequent sites of gastrointestinal bleeding. Hemorrhoids are the most common cause of visible blood in the digestive tract, especially blood that appears bright red. Hemorrhoids are enlarged veins in the anal area that can rupture and produce bright red blood, which can then show up in the toilet or on toilet paper. If red blood is seen, however, it is essential to exclude other rectal bleeding causes, since the anal area may also be the site of cuts (fissures), inflammation, or cancer.
Benign growths or polyps of the colon are common, and are thought to be forerunners of cancer. These growths can cause either bright red blood or occult bleeding (hidden bleeding). Colorectal cancer is the third most common of all cancers in the United States, and often causes occult bleeding at some point, but not necessarily visible bleeding.
Inflammation from various causes can produce extensive bleeding from the colon. Different intestinal infections can cause inflammation and bloody
diarrhea. Ulcerative colitis can produce inflammation and extensive surface bleeding from tiny ulcerations.
Crohn's disease of the large intestine can also produce GI bleeding.
Diverticular disease caused by pouches in the colon wall can result in massive bleeding, too.
Finally, as a person gets older, abnormalities may develop in the blood vessels of the large intestine (a condition called angiodysplasia). This may result in recurrent bleeding.
Patients taking blood-thinning medications (such as warfarin) may have gastrointestinal bleeding, especially if they take drugs like aspirin.
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