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What causes rectal bleeding?

Rectal bleeding can be bright red (hematochezia) to dark, maroon colored (melena). The most common cause of rectal bleeding is hemorrhoids, which cause bright red bleeding and are generally not painful although occasionally associated with pain that dissipates.

Possible causes of rectal bleeding

  • Hemorrhoids (most common)
  • Fissures
  • Proctitis
  • Colitis
  • Polyps

Colonic tumorsBlood mixed within the stool can be seen with hemorrhoids and fissures, but may be associated with proctitis, colitis, polyps and colonic tumors. The age at which patients bleed is also important. Younger patients tend to have benign pathology more often than a serious disease such as cancer. At your appointment, we’d take into account your family history of colon cancer or inflammatory bowel disease so that we could rule out these diseases. While a colonoscopy is important, a good digital rectal exam and anoscopy with your office visit is the most important step in seeking the appropriate treatment.

Another cause of rectal bleeding can be anal fissures. Painful bowel movements associated with bright red rectal bleeding is usually caused by an anal fissure. An anal fissure is a cut or tear occurring in the anus that extends upwards into the anal canal. Pain can last minutes to hours. Anal fissures tend to take weeks to heal and treatment options include fiber, stool softeners, sitz baths and analgesic cream. Surgery is required for refractory fissures.

The majority of rectal bleeding cases are no cause for alarm and respond to non-surgical treatment. However, that doesn’t mean it should be ignored. It is important to get an accurate diagnosis to rule out something that could be more serious.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.