Should I be worried about my rectal bleeding?

Have you ever experienced rectal bleeding? It’s important to be aware of the main causes. Often, it has a benign cause but there’s still a chance it could be something like colorectal cancer. It has often been considered to only affect patients who are over 50, but it can affect younger people too. We spoke with leading consultant colorectal surgeon Mr Paul Ziprin to find out when bleeding should be a concern, if any bleeding is normal and what the likelihood is that rectal bleeding could be due to colorectal cancer.
 

How much rectal bleeding is normal?

Rectal bleeding isn’t normal. However, it is commonly due to simple benign conditions such as piles but it can be due to more worrying problems. It is not necessarily the quantity of blood that should be a concern, but whether it’s happening or not.
 

What causes rectal bleeding?

You could notice simple bleeding into the toilet or just on the paper after wiping, which could be related to haemorrhoids (piles) or anal fissure, which is a split at the anal margin, and associated with severe pain.
 

If the blood is darker red and mixed in with the stool it could be from something further up in the bowel and that could be a more worrying sign especially if accompanied by a change in your bowel habit.

What is the likelihood that blood in my stool is due to colorectal cancer?

If it is mixed in with the stool and/or associated with a change in your bowels, it could be colorectal cancer but there are other conditions that can cause bleeding. If the bleeding is very profuse and happening many times during the same day, then it’s most likely caused by diverticular disease and may require attending the emergency department for further investigations. There are inflammatory conditions of the bowel that can cause similar symptoms such as ulcerative colitis or Crohn’s disease.

So it may be related to cancer but it also it may be from several benign conditions. It is important that you report it to a doctor so it can be assessed and referred for further investigations as appropriate.
 

Why might rectal bleeding occur after a bowel movement?

If it drips or just seen on the toilet paper after wiping after a bowel movement it might be due to a fissure or piles as they bleed from the stool passing through them especially if associated with local anal discomfort or pain.
 

However, if the bleeding persists or is associated with abdominal pain, a change in bowel habit, urgency or weight loss, then it is important it is investigated. Bleeding should also be investigated if it’s persistent despite treatment for obvious haemorrhoids.
 

What other symptoms should I look for if experiencing rectal bleeding?
 

• Going more frequently to the toilet
• Passing of slime or mucus
• Feelings of incomplete defaecation
• Weight loss
• Abdominal pain
• Or if your GP has found you to be anaemic
   

Also, if there is a family history of bowel cancer that should also prompt early referral if someone develops any bleeding or the above symptoms.
 

If someone over the age of 40 has rectal bleeding that should also be investigated because although it's more common in older people, bowel cancer is increasing in younger people.
 

Why is it increasing in younger people?

It is still infrequent in younger people but getting more common. We don’t know why this is happening, but as it may go unrecognised as we expect it in older patients, it may present later when it's more advanced.
 

If you’re experiencing rectal bleeding and need further advice or investigations, you can schedule  a consultation with Mr Paul Ziprin by visiting his Top Doctors profile today.