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Blood that passes from your anus can be rectal bleeding, although rectal bleeding is bleeding from your rectum or lower colon specifically. The last few inches of the large intestine are referred to as the rectum. Rectal bleed is usually noticed after bowel movements. The patient may find blood in the toilet bowl, in the stool, or on the toilet paper.

Usually, fresh blood is indicative of bleeding from the lower parts of the gastrointestinal tract whereas black stools or dark brown stools are seen in cases that cause upper gastrointestinal tract bleeding.

Fresh or bright red blood is seen in the following cases:

  • Colon cancer: It is usually seen in people who are older than 45 years of age. Family history plays an important role in the correct diagnosis. People who abuse alcohol, smoke, or take drugs are more likely to develop colon cancer. Blood in the stool after drinking can be a sign of colon cancer, which is one of the main causes of painless rectal bleeding.

  • Hemorrhoid: Dilatation of a single vein or a group of veins is called hemorrhoids. It is the primary cause of rectal bleeding with severe pain. Hemorrhoids can be internal or external. In this case, patients usually complain of something coming out of their anus or they feel something just above the anus.

  • Ulcerative Colitis: An inflammation of the colon (large intestine) is known as ulcerative colitis which is a form of IBD (inflammatory bowel disease). The main symptom of this disease is bloody diarrhea.

  • Crohn's disease: This is also a form of inflammatory bowel disease. It may affect and cause an inflammation of the digestive tract anywhere from mouth to anus. It causes abdominal pain, bloody diarrhea, vomiting, or weight loss.

  • Anal fissure: This is a tear in the lining of the lower rectum which may cause pain during bowel movements. It is also one of the more common causes of bloody stools. Anal fissures can affect people of any age. However, people who eat unhealthy foods like junk food, fast food, spicy food, or fried food are prone to develop this disease. Anal sex is one of the main causes of anal fissures.

  • Diverticulitis: This is the formation of pouches within the large intestine. These pouches become inflamed and cause symptoms such as pain while passing stools and blood in stools. The diagnosis in this case is confirmed with a barium enema.

If you are experiencing blood in stools for a long time, you are advised to visit your doctor as soon as possible. Rectal bleeding should be taken seriously because it can be a sign of a fatal illnesses such as colon cancer or colorectal carcinoma. Long-term rectal blood may also cause anemia (deficiency of blood in the body).

Important investigations in such cases include:

  • Complete Blood Count (CBC): Helpful in diagnosis of anemia, bleeding disorder, etc.

  • Stool test for occult blood: This test is performed to find whether blood cells are present in the stool.

  • Endoscopy: This is the investigation of choice to confirm the diagnosis for most GI disorders.

  • Barium swallow (for upper GI tract), barium meal, (for small intestine) and barium enema (for colon) are very helpful.

  • Biopsy: Helps in the diagnosis of cancer.

It should be kept in mind that the rupture of small vessels in the rectum may also cause painless rectal blood. Such cases do not require any treatment. You are advised to keep a close eye on your condition. If the bleeding continues for more than 2 weeks, you must visit your doctor.

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