In this Article

• What is rectal bleeding?
• Definition and description of rectal bleeding
• Origin of rectal bleeding
• Occult gastrointestinal bleeding
• What are the causes of rectal bleeding?
• Anal fissure
• Hemorrhoids
• Diverticulosis
• Colon cancer and polyps
• Polypectomy
• Angiodysplasias
• Colitis and proctitis
• Meckel's diverticulum
• Rare causes of rectal bleeding
• How is the cause and site of rectal bleeding determined?
• History and physical examination
• Anoscopy
• Flexible sigmoidoscopy
• Colonoscopy
• Radionuclide scans
• Visceral angiogram
• Blood tests
• How is rectal bleeding treated?
• Correcting low blood volume and anemia
• Determining the cause and site of bleeding
• Stopping bleeding and preventing rebleeding
• Rectal Bleeding At A Glance
• Rectal Bleeding Glossary
• Rectal Bleeding Index

Stopping bleeding and preventing rebleeding

Colonoscopy is more than just a diagnostic tool; it can also be used to stop bleeding by removing (snaring) bleeding polyps, by cauterizing (sealing with electrical current) bleeding angiodysplasias or postpolypectomy ulcers and, occasionally, by cauterizing actively bleeding blood vessels inside diverticula. Cauterization during colonoscopy is usually accomplished by inserting a long cauterizing probe through the colonoscope's channel for instruments. Colonoscopy with cauterization has been used to stop bleeding in many patients with bleeding from diverticula or angiodysplasias, thereby decreasing their need for blood transfusions, shortening their hospital stays, and avoiding surgery.

When colonoscopy cannot identify the site of bleeding or is unable to stop recurrent or continuous bleeding, visceral angiograms may be helpful. When a bleeding site is identified by angiogram, medications can be infused through the angiographic catheter to constrict the bleeding blood vessel and stop the bleeding, Microscopic coils also can be infused through the catheter to plug (embolize) the bleeding blood vessel, thereby stopping the bleeding.

If colonoscopy and visceral angiogram cannot stop continuous bleeding or prevent rebleeding, then surgery becomes necessary. Ideally, the site of bleeding has been identified by colonoscopy, nuclear scans, or visceral angiogram, so that the surgeon can target the site of bleeding for exploration and excision. For example, a surgeon can usually resect a colon cancer, a bleeding polyp, or a Meckel's diverticulum with precision. Sometimes, the exact site of bleeding cannot be established, and the surgeon will have to perform an extensive colon resection under the presumption that a diverticulum or angiodysplasia is the cause of the bleeding.

Mild rectal bleeding from anal fissures and hemorrhoids usually can be treated with local measures such as sitz baths, hemorrhoidal creams, and stool softeners. If these measures fail, then several nonsurgical and surgical treatments are available.

Rectal Bleeding - How Was Diagnosis Established

The MedicineNet physician editors ask:

How was the diagnosis of your rectal bleeding established?

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