Patient Education

Minor Rectal Bleeding

Minor rectal bleeding refers to the passage of a few drops of bright red (fresh) blood from the rectum, which may appear on the stool, on the toilet paper or in the toilet bowl.

This brochure addresses minor rectal bleeding that occurs from time to time. Continuous passage of significantly greater amounts of blood from the rectum or stools that appear black, tarry or maroon in color can be caused by other diseases that will not be discussed here. Call your doctor immediately if these more serious conditions occur. Because there are several possible causes for minor rectal bleeding, a complete evaluation and early diagnosis by your doctor is very important. Rectal bleeding, whether it is minor or not, can be a symptom of colon cancer, a type of cancer that can be cured if detected early.

gastroenterology doctor and patient one on one discussion

What are hemorrhoids?

Hemorrhoids (also called piles) are swollen blood vessels in the anus and rectum that become engorged from increased pressure, similar to what occurs in varicose veins in the legs. Hemorrhoids can either be internal (inside the anus) or external (under the skin around the anus). Hemorrhoids are the most common cause of minor rectal bleeding, and are typically not associated with pain. Bleeding from hemorrhoids is usually associated with bowel movements, or it may also stain the toilet paper with blood. The exact cause of bleeding from hemorrhoids is not known, but it often seems to be related to constipation, diarrhea, sitting or standing for long periods, obesity, heavy lifting and pregnancy. Symptoms from hemorrhoids may run in some families. Hemorrhoids are also more common as we get older. Fortunately, this very common condition does not lead to cancer.

How are hemorrhoids treated?

Medical treatment of hemorrhoids includes treatment of any underlying constipation, taking warm baths and applying an over-the-counter cream or suppository that may contain hydrocortisone. If medical treatment fails there are a number of ways to reduce the size or eliminate internal hemorrhoids. Each method varies in its success rate, risks and recovery time. Your doctor will discuss these options with you. Rubber band ligation is the most common outpatient procedure for hemorrhoids in the United States. It involves placing rubber bands around the base of an internal hemorrhoid to cut off its blood supply. 

Gastroenterology Medical Hemorrhoid Conditions Chart

This causes the hemorrhoid to shrink, and in a few days both the hemorrhoid and the rubber band fall off during a bowel movement. Possible complications include pain, bleeding and infection. After band ligation, your doctor may prescribe medications, including pain medication and stool softeners, before sending you home. Contact your doctor immediately if you notice severe pain, fever or significant rectal bleeding. Laser or infrared coagulation and sclerotherapy (injection of medicine directly into the hemorrhoids) are also office-based treatment procedures, although they are less common. Surgery to remove hemorrhoids may be required in severe cases or if symptoms persist despite rubber band ligation, coagulation or sclerotherapy.

How is minor rectal bleeding evaluated?

Your doctor may examine the anus visually to look for anal fissures, cancer or external hemorrhoids, or the doctor may perform an internal examination with a gloved, lubricated finger to feel for abnormalities in the lower rectum and anal canal.If indicated, your doctor may also perform a procedure called colonoscopy. In this procedure, a flexible, lighted tube about the thickness of your finger is inserted into the anus to examine the entire colon. Sedative medications are typically given for colonoscopy to make you sleepy and decrease any discomfort. As an alternative, to evaluate your bleeding, your doctor may recommend a flexible sigmoidoscopy, which uses a shorter tube with a camera to examine the lower colon and rectum. To examine only the lower rectum and anal canal, an anoscope may be used. This very short (3 to 4 inch) tube is especially useful when your doctor suspects hemorrhoids, anal cancer or anal fissures.

What can I do to prevent further rectal bleeding?

This depends on the cause of the rectal bleeding. You should talk to your doctor about specific management options.

For Your Information:

 IMPROVING DIGESTIVE HEALTH THROUGH EXCELLENCE IN ENDOSCOPY Since its founding in 1941, ASGE has been dedicated to advancing patient care and digestive health by promoting excellence in gastrointestinal endoscopy. This information is the opinion of and provided by the American Society for Gastrointestinal Endoscopy. Gastrointestinal endoscopy helps patients through screening, diagnosis and treatment of digestive diseases. Visit www.asge.org to learn how you can support GI endoscopic research, education and public outreach through a donation to the ASGE Foundation.

Since its founding in 1941, ASGE has been dedicated to advancing patient care and digestive health by promoting excellence in gastrointestinal endoscopy. This information is the opinion of and provided by the American Society for Gastrointestinal Endoscopy.

Gastrointestinal endoscopy helps patients through screening, diagnosis and treatment of digestive diseases. Learn how you can support GI endoscopic research, education and public outreach through a donation to the ASGE Foundation.

For more information visit, www.asge.org or www.screen4coloncancer.org

Copyright © 2018 American Society for Gastrointestinal Endoscopy Important Reminder: This information is intended only to provide general guidance. It does not provide definitive medical advice. It is very important that you consult your doctor about your specific condition.

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