Medical Article

Reasons for rectal bleeding

Rectal bleeding means any blood that is passed out when you go to the toilet to pass stools. There are many causes of rectal bleeding. The severity can vary from mild bleeding to severe life threatening bleeding. In this regard, here are some of the terms used to describe blood in stools.

Fecal occult blood: Fecal occult blood (FOB) refers to small amount of blood in the feces that is not visible apparently, but detected on chemical testing of stools. The bleeding can be a sign of problem in any part of the digestive system, such as a growth, or polyp, or cancer to the colon or rectum. Sometimes, despite the absence of any bleeding, the fecal occult blood test may give a positive result. The use of food like meat creates such dilemma. Therefore, dietary precautions are necessary before going to this test.

Hematochezia: Hematochezia is the passage of fresh blood through the anus, usually in or with stools. It indicates problem in the lower part of the digestive tract.

Causes of Hematochezia

Piles or Hemorrhoids: Piles or hemorrhoids that become inflamed. They are swollen blood vessels in or around the anus and rectum caused due to straining at stool, pregnancy, diarrhea etc. Sometimes they swell so that the veins walls become stretched which result in painless bleeding while passing stools.
Anal fissure or fistula: Anal fissure are crack or tear in the anal skin. They may be acute or chronic. Besides minor bleeding, they are accompanied with itching and malodorous discharge.
Diverticulosis: Diverticula are small pouches that bulge outward through the colon, or large intestine. Bleeding can arise due to a burst of blood vessel in the wall of the diverticulum.  It results in painless, but significant blood loss. If the pouches become inflamed or infected, result in a condition called diverticulitis. The serious diverticulitis cases can lead to bleeding.
Colorectal cancer:  The colon and rectum are part of the large intestine. Colorectal cancer occurs when tumors form in the lining of the large intestine. It causes bleeding from the anus. Colorectal cancer often begins as a growth called a polyp, which may form on the inner wall of the colon or rectum.Colorectal cancer can be diagnosed with the help of colonoscopy or sigmoidoscopy and fecal occult blood tests.
Intussusception: Instussusception is the sliding of one part of the intestine to another. This condition results in obstruction and requires immediate medical attention. Infants who have abdominal pain may pull their knees to their chests when they cry. The pain of instussception comes and goes, usually every 15 to 20 minutes first. They pass stools mixed with blood and mucus.
Inflammatory bowel disease:  Inflammatory bowel disease (IBD) represents a group of intestinal disorders that cause prolonged inflammation of the digestive tract. IBD primarily include ulcerative colitis and Crohn’s disease. While ulcerative colitis causes long lasting inflammation and sores(ulcers) in the innermost lining of your large intestine(colon) and rectum, Crohn’s affects any part from mouth to anus. Besides hematochezia, it may induce melena.
Ischemic colitis: Ischemic colitics (IC) is an inflammatory condition of the large intestine, or colon, which develops when there isn’t enough blood flow to the colon. It is often accompanied with severe abdominal pain and bloody stools.
Melena: This is the passage of dark tarry stools containing decomposing blood that is usually an indication of bleeding in the upper part of the digestive tract like esophagus and stomach. The black colour caused by the hemoglobin in the blood being attracted by digestive chemicals and intestinal bacteria.
Usually the patient reports presence of blood in stools or detected on stool tests. To understand the cause of bleeding tests like endoscopy, colonoscopy, CT scan etc., are recommended. The treatment is decided in accordance with the underlying cause. Depending on the blood loss anemic condition may also have to be treated.

Causes of Melena

Peptic ulcer disease: Peptic ulcer disease refers to painful sores or ulcers in the lining of the stomach or upper intestine. A burning stomach pain is the most common symptom. Patient may have the history of taking pain killers on a regular basis.
Stomach cancer:  Stomach cancer begins when cancer cells form in the inner lining of stomach. These cells can grow in to tumor. The disease usually grows slowly over many years. Weight loss and vomiting are main symptoms. Helicobacter pylori is the most common cause of

stomach cancer.
Esophageal varices : Esophageal varices are abnormal enlarged veins in the tube that connects the throat and stomach (esophagus). This condition most often occurs in people with serious liver disease. It is a common consequence of alcoholism. The veins often rupture resulting in vomiting of blood; it may also be accompanied by melena.
Other causes of bleeding in stools are:
Blood disorders:  A blood cell disorder is a condition in which there is a problem in red blood cells, white blood cells, circulating cells called platelets. The blood disorder like leukemia and polycythemia may result in blood in stools.
Infection of the intestine : Gastrointestinal infections are viral, bacterial or parasitic infections that cause gastroenteritis. The infection of the intestine due to typhoid, tuberculosis and food poisoning may cause blood in stools. Often these patients suffer with pain, fever, diarrhea and sometimes mucus in stools.
Radiation: Exposure to radiation creates side effects like inflammation of the intestine, also known as radiation enteritis.
Food allergy: Food allergy symptoms are most common in babies and children, but they can appear at any age. Allergy to milk in infants could cause passage of small amounts of blood in stools.
Angiodysplasia: Angiodysplasia is a small vascular malformation of the gut. This can result in gastrointestinal bleeding in to the stools. These include angioma, hemangioma and arteriovenous abnormalities. Using endoscopic methods has been employed to identify the problem.

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