Rectal bleeding

Finding blood after having a bowel movement is a symptom that scares most people and especially when the bleeding is profuse.

Many times the bleeding is not so abundant and is attributed to hemorrhoids, however there are many diseases that can cause this and sometimes this is the first symptom of a malignant disease, so we should not assume that it is something mild and benign. We must seek medical opinion immediately. 

Generally the most common causes of lower digestive bleeding are:

  • The illness colon diverticular
  • Arteriovenous malformations of the colon (angiodysplasias)
  • Colonic neopiasias in third place.


La diverticular disease It is very common in our country, mainly due to the type of food we consume, low in fiber and high in fat; It is a benign disease that increases with age, mostly after 40 years. One of the complications is diverticular hemorrhage, which is painless and profuse, even causing significant hemodynamic alterations, requiring blood transfusions and sometimes emergency surgery to resect the segment of intestine that is bleeding.

The arteriovenous malformations of the colon They are the second cause of lower gastrointestinal bleeding, being more common in individuals over 60 years of age. These are degenerative lesions frequently smaller than 5 mm in diameter difficult to locate even in the surgical piece after surgery. Most of these lesions are found in the proximal part of the colon or ascending colon. The hemorrhage of this type of lesion is less profuse than that of diverticular disease, however, in 10-15%, significant hemorrhages occur.

generally the colon cancer It does not produce significant bleeding, however it produces chronic blood loss causing a decrease in hemoglobin.

Other causes of lower gastrointestinal bleeding are hemorrhoids that produce bright red bleeding at the time of defecation, without pain; colonic polyps; disease inflammatory bowel (ulcerative colitis, Crohn's disease), infectious colitis and others.

As we see, there are many causes of bleeding, so it is extremely important to go to your doctor and perform the appropriate diagnostic procedures to establish what the cause is and be able to treat it appropriately.

One of the most important diagnostic procedures is colonoscopy. It is a safe procedure, where the entire rectum and colon are visualized using a long, flexible and tubular instrument. Most of these studies are performed on an outpatient basis, causing minimal discomfort to the patient since it is performed with anesthetic help.

How is a colonoscopy performed?

The intestine must first be cleaned of all waste. This is done 1 to 2 days before the procedure. The colonoscope is introduced and reached where the small intestine inserts into the large intestine; Small amounts of air need to be instilled to dilate the colon and be able to clearly visualize the walls of the intestine. During the procedure, bleeding sites, pophyps, benign and malignant tumors can be detected, inflammatory diseases can be diagnosed, and biopsies can also be taken and polyps removed without any discomfort. The procedure lasts less than 1 hour, the pain is minimal and after the procedure there may be slight discomfort that quickly decreases as the air that is introduced is expelled. Most patients can resume their regular diet on the same day of the procedure.

In summary, there are different causes of transrectal bleeding which have different forms of treatment. The most important thing is to make an adequate diagnosis to offer specific treatment depending on the cause. In any patient who has blood in the stool, it is important to perform a colonoscopy, especially in those over 50 years of age since at this age the incidence of cancer increases, and if we detect it early it can be curable. 

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