Since I’ve received so many questions on my previous blog article on having blood in stool or toilet, I have decided to provide an updated blog post on this topic and answer some the more frequent questions and provide further detail on some related topics as well. I know that most writers format their content with the conclusion at the end, but I thought I would save people some time and give you the bottom line answer regarding rectal bleeding at the onset.
What do I do if I experience Rectal Bleeding?
Since all bleeding is abnormal, you need to be evaluated by a medical professional if you experience rectal bleeding. It doesn’t matter if it is infrequent or a regular occurrence. You need to be evaluated by a medical professional to ensure that it is not an indicator of a larger issue.
Most of us tend to think of worst case scenarios, which would be colon cancer when dealing with rectal bleeding. However, the American Society for Gastroenterology Endoscopy notes that colon cancer is caused by rectal bleeding with an occurrence of less than 2%. I just wanted to point this out, so that you don’t think since you are seeing blood in the toilet that you must have colon cancer.
Does the Color of the Blood in Toilet mean anything?
Generally speaking, if there is bright red blood it usually is from somewhere in the last part of the colon called the rectum. This type of bleeding is most often from hemorrhoids or an anal fissure. If there is a lot of blood with clots, then it can be from anywhere in the colon and can be a medical emergency. Finally if you see jet black tarry like stools, this can be bleeding from the right side of the colon or even up in the stomach or small bowel and is also an emergency that needs to be worked up.
Does the amount of Blood in Toilet indicate a more severe Issue?
A little bit of blood can look like a lot once it hits the water. That being said, if there are clots of blood and significant frank blood with the stool it can be a very significant bleed and needs to be seen asap.
Does the frequency of Rectal Bleeding mean the cause is more or less severe?
Unfortunately the frequency of rectal bleeding does not help all that much. All causes of bleeding can come and go including even cancer. So just get it checked out if there is intermittent or frequent bleeding.
If I don’t experience any pain during bowel movement, does that mean the cause of bleeding is less severe?
Usually, the only cause of rectal bleeding associated with pain is an anal fissure or anything effecting the anal canal. All the other causes of bleeding are above the dentate line, which means there are no pain fibers.
What are common causes of rectal bleeding?
Seeing blood in the toilet or on toilet paper can be a very alarming thing to occur. It’s important to remember that most causes of rectal bleeding are not severe and can be treated by your physician or a gastroenterologist. Common causes of rectal bleeding are:
- Hemorrhoids – Internal hemorrhoids are painless and external hemorrhoids can cause some pain or discomfort.
- Anal fissure (skin tears in the anus or anal canal)
- Hard stools
Seeing a Doctor for Rectal Bleeding
If you experience rectal bleeding it is important that you schedule an appointment with a medical professional to ensure that you are properly evaluated and treated. While the sight of blood is always alarming, the cause of rectal bleeding typically is not representative of a severe medical issue so don’t stress if this bleeding occurs. Also, many people have commented that they are embarrassed by this occurrence of blood and don’t feel comfortable discussing this even with their doctor. As a gastroenterologist, I can ensure you that we completely understand that some symptoms are difficult to discuss even with your doctor. Don’t let something like embarrassment prevent you from getting rectal bleeding or any health event evaluated.
When preparing to see a physician there are a few things that I would recommend that you do to assist your doctor in their evaluation.
- Document the frequency and amount of blood that you are experiencing.
- Document any changes in your bowel movements along with a date timeline.
- Document any changes in your diet or if you have had stressful events in your life. These should be noted with a date timeline.
- Let your doctor know if you have a family history of colon cancer or colon polyps.
Is a Colonoscopy always required when seeing a Doctor for Rectal Bleeding?
No. A colonoscopy is not always required by a physician when diagnosing rectal bleeding. The first step a good physical exam. If there is no cause during the physical exam then a colonoscopy may be needed.
Should I go to the ER if I experience Rectal Bleeding?
Since all bleeding is abnormal, it needs to be evaluated by your doctor. Unfortunately, I can’t speak to the urgency that you should seek treatment.
Note: I frequently receive comments/questions regarding treatment recommendations for different symptoms like rectal bleeding. I will not respond to these questions due to HIPAA guidelines. Also, I would like to point out that the Internet can be a great resource for researching various health symptoms and available treatments. However, it should not be used to seek health advise or replace the care and expertise that a medical professional can offer.