Rectal bleeding is any blood that appears from the anus, whether you see it on the toilet paper, in the water, or streaked on the stool. Sometimes the blood is bright red; other times it may look darker or mixed into the stool.
Common causes include hemorrhoids, small tears in the skin (anal fissures), inflammation, diverticular disease, polyps, or, less often, colorectal cancer. Even though many causes are benign, it is always worth talking about bleeding with a digestive specialist so we can determine what’s going on and whether you need further testing.
Rectal bleeding can appear in different ways, from a few streaks of bright red blood on the tissue to darker blood mixed with stool. Some people notice itching, pain with bowel movements, or changes in bowel habits along with the bleeding.
Call our office promptly if rectal bleeding lasts more than a day or two, keeps coming back, or starts new at age 40+. Contact us sooner if you have a family history of colon polyps/cancer, bleeding with bowel changes, abdominal pain, or weight loss, or signs of anemia like unusual fatigue or weakness.
Call 911 or go to the nearest emergency room for heavy rectal bleeding, large clots, or black tarry stools. Seek emergency care if you feel dizzy, faint, or have a racing heartbeat, if you develop severe/worsening abdominal pain, or if bleeding occurs with fever, chills, or you feel very unwell.
We start by asking detailed questions about how the bleeding looks, how often it happens, and what other symptoms you have, such as pain, weight loss, or changes in bowel habits. A physical exam may include looking at the anal area and a gentle rectal exam.
Depending on your age, risk factors, and symptoms, we may recommend tests such as a colonoscopy to look at the entire colon and rectum, or in some cases a flexible sigmoidoscopy, CT scan, or lab work to check for iron deficiency anemia. The goal is to identify the source of bleeding, rule out polyps or cancer, and select the right treatment plan.
Management focuses on treating the underlying cause, whether benign (hemorrhoids) or more serious (IBD, polyps, cancer). Even when bleeding is mild, persistent or unexplained bleeding usually requires evaluation.
If your insurance requires a referral or prior authorization, our billing office will make every effort to obtain it before services are rendered. If you choose to proceed without required authorization, insurance may deny coverage. If you are a Medicare patient, you may be asked to sign an Advanced Beneficiary Notice (ABN) acknowledging financial responsibility if insurance does not pay. If you are enrolled in a commercial insurance plan you will be asked to sign a non-covered services form.