Rectal Bleeding Specialist

Where does the blood come from?

The blood you see from rectal bleeding normally comes from either your colon, rectum, or anus. Your colon is the large intestine, where food passes after being digested in your small intestine. The main job of your colon usually involves removing water from undigested food and storing it before it’s eliminated from your body.

At the end of your colon, the last seven inches or so, is your rectum. Your anus is the opening where stool passes out of your body. Together, your colon, rectum, and anus, make up a muscular tube called the large intestine (or lower gastrointestinal tract). Your large intestine is several feet long.

The color of blood you see in rectal bleeding is often a clue about its origin. For instance, the closer to your anus, the brighter red the blood will generally be. Blood from your anus, rectum, or end of your colon, is often bright red, while dark red or maroon blood often comes from higher up in your colon.

If the source of rectal bleeding is at the top of the colon, near where it connects to the small intestine, the blood can be in the system long enough to appear black. The color of blood you see is not definitive though. Massive bleeding from as far up as your stomach, can cause blood to speed through your colon and not stay in your system long enough to turn black.

What are the more common causes of rectal bleeding?

Anal Fissure:
This common, but painful, condition is a tear in the lining of your anal canal. It can be caused by passing hard stools, or by chronic diarrhea. After your lining is torn, any following bowel movements will be painful, but little blood is evident. This condition is frequently mistaken for hemorrhoids, which do not generally cause pain during a bowel movement.

Treatment is often as simple as frequent warm baths and the use of bulking agents to keep your stools soft. Dr. Shamsi can order specially formulated creams that are compounded at pharmacies, although you might surgery if these treatments don’t work.

Hemorrhoids"
Swollen or dilated blood vessels near your anus can occur inside or outside of your rectum. Problems occur when the cushion that holds your vessels, enlarges, causing anal bleeding or anal itching. Bleeding from hemorrhoids is usually mild, but you can have iron deficiency anemia if your hemorrhoidal bleeding is left untreated for several months, or years.

Diverticulosis:
This condition appears most often in men and women over age 50. It’s thought to be caused by years of high pressure spasms in your colon, or weaknesses in your colon wall. Diverticula are permanent pockets or sacs that stick out from your colon wall and can occasionally bleed. If bleeding is serious and consistent, hospitalization or surgery might be necessary to correct the condition.

Colon Cancers and Polyps:
The greatest fear whenever rectal bleeding is seen in Dr. Shamsi’s office, is cancer. Polyps are benign, but if they grow large enough, they can bleed. Certain types of polyps can turn into cancer. Bleeding from either is usually mild, ranging from bright red to black.

Proctitis and Colitis:
Colitis is an inflammation of your colon, and proctitis is inflammation in your rectum. If either of these becomes ulcerated, bleeding can happen. These conditions have a variety of causes, including bacterial and viral infections, as well as some diseases. Each cause has its own treatment. Diarrhea, cramps, and rectal urgency, may accompany either of these conditions.

How can the cause and location of my rectal bleeding be determined?

To properly treat rectal bleeding, you need to have an accurate diagnosis of its cause and source. This begins with a physical examination by your gastroenterologist, Dr. Shamsi, who will need your comprehensive medical history. He may order blood tests, and might want to perform an anoscopy, colonoscopy, angiogram, or other diagnostic procedure.