Rectal Bleeding

Rectal bleeding-It’s embarrassing to talk about but more common than you think.Rectal bleeding is the observation of blood from the back passage when you go to the toilet. It may be bright or dark red in colour and is most often minimal with a few drops into the toilet water or the toilet paper. Occasionally, it may be heavier and particularly noticeable when you wipe yourself but thankfully rarely is it heavy.

Where has it come from?

Bright red rectal bleeding is generally painless and comes from the back passage itself. Blood mixed with the stool suggests it comes from higher in the bowel and is darker in colour. Bloody diarrhoea suggests it is due to an inflammation of the bowel due to infection or colitis.

How common is it?

Bright red rectal bleeding is very common and most often due to piles (haemorrhoids). This is often painless and associated with constipation and the feeling of a lump that comes out of the back passage when you open your bowels which may need pushing back. Most people by the age of 50 have had bleeding at some point in their lives.

Do I need to worry about it?

No, you do not need to get too worried. The commonest causes are haemorrhoids (piles) or a fissure (tear in the back passage). However it can be a symptom of bowel cancer in the lower bowel and you should therefore get yourself seen by your family doctor who will take a history, examine you and decide whether you need further investigations.

The risk of bowel cancer in patients less than 45 years is very low and if there is no family history of bowel cancer it is very unlikely that you have a tumour in your bowel.

When should I seek medical attention?
  1. Rectal bleeding WITH a change in bowel habit to looser stools and/or increased frequency of defecation persistent for 6 weeks.

  2. If you are 50 years and older* with rectal bleeding persistently WITHOUT any anal symptoms (Anal symptoms – soreness/discomfort/itching/lumps/prolapse and pain).

  3. If you are in your 40s or older and have never had rectal bleeding or haemorrhoids (piles) before.

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Leicester Bowel Clinic