Do I Need to Worry About Blood in the Stool? (Rectal Bleeding)

Rectal bleeding

Do I Need to Worry About Blood in the Stool? (Rectal Bleeding) When anyone notices blood in the toilet, it brings panic and fear in most people's mind. It is rightly so. But what we have to know is that most of them do not suffer from dreaded Colo-rectal cancer.
What are causes of rectal bleeding?? What are likely symptoms?
1. Piles (Hemorrhoids) -- Painless, Recurrent, May be associated with constipation, recurrent, Usually self limiting lasting few days, Like a splash on pan. (separate blog)
2. Fissure -- Painful, few drops, few days.
3. Divericular -- Painless, large quantity, self limiting,
4. Colo-rectal cancer -- few mls, persistent, Associated with other symptoms (Separate blog), mixed with stool.
5. Inflammatory bowel disease -- Long standing, loose motion, slime/jelly
6. Infective colitis -- few days of loose motion and vomiting, settles when infection subsides.
When should one worry about rectal bleeding?
If it is happening for the first time in people above the age of 50 years then you are likely to need colonoscopy to rule out Colo-rectal cancer. Again, it is to rule out and incidence is low in India. But it is almost mandatory for this group of patients. If there is family history of cancer, then irrespective of age Colo-rectal cancer needs to be ruled out. When there are symptoms of Colo-rectal cancer or inflammatory bowel disease. (Both explained in separate blogs).
What is the common cause of rectal bleeding? What are its features?
Most of the times it is from piles (hemorrhoids). When one thinks of the following facts, it puts rectal bleeding in new light: A. Everyone is born with piles and dies with piles. It's normal part of the body. B. They will never cause cancer or turn into one. C. Almost never cause pain. D. Most times its is self limiting.

                                                 By
Dr. Maruthesh Gowda

MBBS , FRCS - Laproscopic Surgery , M.R.C.S-General Surgery
http://www.koshyshospital.com/gastroenterology

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