As the name suggests, rectal bleeding is the passage of blood out of the rectum. It usually appears during defaecation and can be separate or mixed in with the stool.
This is bleeding that occurs without a person being aware. It usually means a very slow rate of bleeding or from a source in the upper gastrointestinal tract. It is diagnosed by a Faecal Occult Blood Test (FOBT) or may manifest as iron deficiency anaemia on blood tests. It warrants further investigation to exclude serious causes.
There are many causes of rectal bleeding. Fortunately, the majority is not cancer and is not serious.
Very common causes
Whilst most rectal bleeding is not serious, all cases should be investigated and NOT ignored.
In people under 40, a rectal examination and proctoscopy can be done in the rooms. If a cause is found, this can be treated often on the spot.
In people over 40 with new onset rectal bleeding, investigation should include a colonoscopy to visualise the entire colon and rectum to exclude significant causes. A gastroscopy visualising the oesophagus, stomach and duodenum may also be needed.If these tests are normal, then a PILCAM may be indicated to visualise the small intestine.