Hemorrhoids - These are dilated blood vessels or veins in the anal or
rectal area. They can occur on the outside where they are felt as small bumps
when wiping. Or they may be on the inside where they are usually painless.
They develop quite commonly with chronic constipation and especially with
pregnancy. Hemorrhoids are usually treated with stool bulking agents that
soften the stool and reduce straining.
Fistula - A fistula is an abnormal, burrowing channel that usually
runs from the rectum to the skin around the anus. It often will drain a
whitish discharge, but it can also bleed. While it is usually just a local
problem, a fistula is often associated with chronic inflammation in other
parts of the intestinal tract. This disorder is called Crohn's disease.
Fistulas are treated with antibiotics and hot baths or certain medications
used for Crohn's disease. If they persist, surgery is usually required.
Fissure - The passage of a hard stool or severe diarrhea may tear
the lining tissue of the anus. This problem is similar to having cracked lips
in cold weather. Nerve endings and blood vessels are exposed so that pain and
bleeding occur with bowel movements. Frequent warm baths and bulking agents,
used to keep stools soft, usually correct this problem. Sometimes surgery is
needed.
Diverticulosis - Diverticula are pockets or sacs that project from
the bowel wall. They balloon out over the years due to recurrent, high
pressure spasm of the colon. Occasionally they can bleed. They usually produce
a lot of blood, and it comes all at one time. It normally does not persist in
small amounts with bowel movements over days or weeks. Serious, persistent
diverticular bleeding usually requires hospitalization and, at times, surgery.
Proctitis and Colitis - Either the rectum, colon, or both, can
become inflamed and ulcerated. There are a number of disorders which cause the
inside surface of the bowel to become ulcerated and bleed. There may be rectal
urgency, cramps or diarrhea associated with the bleeding. When the
inflammation is restricted to the rectum, the condition is called proctitis.
When the colon is involved, it is called colitis. It is important to identify
the specific cause of the inflammation so that appropriate treatment can be
started.
Polyps and Cancer - Of course, the greatest concern about rectal
bleeding is cancer. Polyps are benign growths in the colon. When polyps reach
a large size, they can bleed. And certain types of polyps turn into cancer.
Colon cancer is usually curable when discovered early. It most often occurs in
people over the age of 50, but it is not unheard of in younger individuals,
even in their 30's or younger. Because colon cancer is such a common cancer,
it is always considered as a possible diagnosis.
Protrusion of the Rectum - Some older individuals will have weakened
rectal support tissues. Part of the rectum then can project from the anus and
bleed. This condition is called rectal prolapse. It can be felt as an abnormal
bulging from the rectum when wiping. Surgery is the only effective treatment.
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Rectal
bleeding is a sign that something is wrong. It is usually something minor that
can be easily diagnosed, but not always. It is, therefore, important that the
specific cause of rectal bleeding be identified so appropriate treatment can be
started and the problem corrected. Even though rectal bleeding may not be
serious, an individual should never assume this to be the case. Most
importantly, rectal bleeding may be a sign of rectal cancer.