Rectal bleeding is also known as hematochezia. It is the passage of blood from the rectum during or after a bowel movement. The blood may appear as bright red streaks, drops in the toilet, or dark, mixed-in stool, or syringing, depending on the source. While it can be frightening, not all causes are serious. Yet some conditions do require timely medical attention.
In a busy urban environment like Bengaluru, factors such as sedentary work patterns, stress, low-fibre diets, and delayed medical consultations often contribute to anorectal and gastrointestinal problems. Early evaluation helps identify the cause, prevent complications, and ensure effective treatment.
This article explains the common causes of rectal bleeding, how doctors diagnose it, when to seek urgent care, and what treatment and prevention options are available.
Common Causes of Rectal Bleeding
Rectal bleeding can originate from the anus, rectum, or anywhere else in the colon, and may also be due to systemic conditions. Below are the most frequent diagnoses.
Hemorrhoids (Piles)
Hemorrhoids are swollen blood vessels in the anus or lower rectum and are one of the most common causes of rectal bleeding.
Symptoms
- Bright red blood on toilet paper or in the toilet
- Syringing of blood
- Anal itching
- Soft lumps near the anus
- Mild discomfort
Risk factors include chronic constipation, strain, prolonged sitting, pregnancy, and low-fibre food habits. Severe or persistent bleeding should be evaluated by a specialist.
Anal Fissures
Anal fissures are small tears in the lining of the anal canal and usually occur when passing hard or large stools.
Symptoms
- Sharp pain during or after bowel movements
- Small amounts of bright red blood
- Streak of blood on the stools
- A feeling of spasm in the anal area
They often heal with dietary and lifestyle changes, but recurrent fissures may need medical attention.
Inflammatory Bowel Disease (IBD)
Crohn’s disease and ulcerative colitis are chronic inflammatory disorders affecting the digestive tract.
Symptoms
- Bloody diarrhea
- Abdominal pain
- Weight loss
- Fatigue
- Mucus in stool
Untreated IBD may lead to severe inflammation, anaemia, or complications such as strictures or fistulas.
Gastroenteritis
Infections caused by bacteria, viruses, or parasites may inflame the intestines and occasionally lead to bloody stools.
Other symptoms include diarrhoea, fever, cramping, nausea, and dehydration. Persistent symptoms or signs of dehydration require prompt care.
Colorectal Polyps
Polyps are growths on the inner colon lining. Most are benign, but some can progress to cancer if not removed.
Symptoms may be subtle, such as blood mixed with stool, anaemia, or changes in bowel habits. Screening colonoscopy is recommended after age 45 or earlier for high-risk individuals.
Diverticulosis and Diverticulitis
Diverticulosis involves small pouches in the colon wall. When these bleed, the bleeding may be sudden and painless.
Diverticulitis occurs when these pouches become infected or inflamed and can cause fever, abdominal pain, and nausea.
Large-volume bleeding or symptoms of infection need urgent evaluation.
Proctitis
Proctitis is inflammation of the rectal lining due to infections, autoimmune disorders, radiation therapy, or inflammatory bowel disease. Patients often experience rectal bleeding along with urgency and mucus discharge.
Colorectal Cancer
Rectal bleeding can sometimes indicate colorectal cancer, particularly in older adults or those with a family history.
Warning signs include:
- Blood mixed with stool
- Unexplained weight loss
- Persistent constipation or diarrhoea
- Fatigue or anaemia
- A frequent urge to pass stool without relief
Rates of colorectal cancer are increasing in metropolitan areas, making early detection crucial.
Systemic Causes
Bleeding disorders, liver disease, and certain medications (e.g., blood thinners) can predispose to rectal bleeding and require comprehensive evaluation.
How Hospitals Diagnose Rectal Bleeding
A systematic approach ensures accurate identification of the cause. At centres like Chirag Global Hospitals Bengaluru, evaluation includes the following steps.
Clinical History
Doctors assess the colour and pattern of bleeding, bowel movement habits, pain, diet, medications, and family history of gastrointestinal conditions.
Physical Examination
A general and anorectal exam helps identify external hemorrhoids, fissures, or visible inflammation.
Digital Rectal Examination (DRE)
This quick, simple exam checks for internal hemorrhoids, tenderness, blood in the rectum, or growth.
Video rectoscopy
These tools allow direct visualisation of the anal canal and lower rectum and help detect fissures, internal hemorrhoids, or proctitis. And tumours in the lower rectum.
Colonoscopy
A colonoscopy examines the entire colon, helps detect polyps, tumours, inflammation, and bleeding sources, and allows for biopsy or removal of polyps during the same procedure.
Stool Tests
Used to detect infections, inflammation, parasites, or hidden blood.
Imaging
CT scans, MRI, or ultrasound are used when complications, diverticulitis, or systemic causes are suspected.
When to Seek Immediate Medical Care
Seek urgent medical attention if you experience:
- Bleeding persists for more than 2-3 days
- Heavy or continuous bleeding
- Dizziness, fainting, or symptoms of low hemoglobin
- Severe abdominal or rectal pain
- Fever with bloody stools
- Black or tarry stools
- Unexplained weight loss
- Change in bowel habits lasting more than two weeks
- A family history of colorectal cancer or polyps
Residents can benefit from timely access to gastroenterologists and colorectal specialists, ensuring early diagnosis and intervention.
Treatment Options for Rectal Bleeding
Treatment depends on the underlying cause, and doctors follow evidence-based, stepwise care.
Lifestyle and Dietary Management
- A high-fibre diet
- Adequate hydration
- Regular physical activity
- Avoiding prolonged sitting or straining
- Establishing a healthy bowel routine
These foundational steps help treat and prevent hemorrhoids and fissures.
Medications
Depending on the diagnosis, treatment may include:
- Topical creams and suppositories
- Stool softeners
- Anti-inflammatory medicines for IBD
- Antibiotics for infections
- Supplements for anaemia
Endoscopic & Minimally Invasive Alternatives
For persistent bleeding or severe symptoms, many minimally invasive procedures, such as polyp removal or thermal coagulation, are available in general gastroenterology practices. Even though such endoscopic procedures exist, proctology-focused treatments at Chirag Global Hospitals are far more specialised and targeted.
At Chirag Global Hospitals, patients receive a complete, advanced treatment package designed specifically for anorectal conditions:
1. Infrared Coagulation (IRC)
A non-surgical technique that uses infrared light to shrink internal hemorrhoids. Ideal for early-stage hemorrhoids with bleeding.
2. Laser Hemorrhoidoplasty
A modern, minimally invasive outpatient laser procedure that reduces hemorrhoidal tissue with minimal pain, faster recovery, and excellent long-term results.
3. DG-HAL (Doppler-Guided Hemorrhoidal Artery Ligation)
Uses Doppler ultrasound to locate and ligate the arteries supplying hemorrhoids. This reduces bleeding and swelling with high precision.
4. Ultrasonic Shears Hemorrhoidectomy
In selected cases, hemorrhoids can be removed using ultrasonic shears that cut and seal simultaneously, resulting in:
- Less bleeding
- Reduced pain
- Shorter operating time
- Faster recovery
Surgery
Surgery is reserved for severe hemorrhoids, chronic fissures, complicated diverticulitis, or colorectal cancer.
Doctors clearly explain indications and expected outcomes without unnecessary intervention.
Preventive Measures for Colorectal Health
- Drink sufficient water daily
- Consume fibre-rich foods
- Avoid excessive straining
- Maintain a healthy body weight
- Limit processed foods and red meat
- Prioritise regular screenings after age 45
- Manage stress
- Seek early care for chronic digestive symptoms
Take Charge of Your Colorectal Health
Rectal bleeding is a symptom that should never be ignored. While some causes are mild, others require timely medical attention. Early evaluation ensures accurate diagnosis, prevents complications, and provides peace of mind.
If you’re in Bangalore and experiencing rectal bleeding or related symptoms, the expert team offers comprehensive, patient-focused gastroenterology and colorectal care.
Schedule your consultation today. Early diagnosis leads to better outcomes, taking the first step toward your health.
