What is Hematochezia?

Hematochezia, or simply known as rectal bleeding, does not always denote that there is bleeding from the rectum or the anus. Blood that comes from the rectus is usually associated from anywhere in that gastrointestinal (GI) tract, but mainly the lower GI tract, particularly the large intestine, rectum and anus.  The blood is least likely to come from the small intestine. The blood from hematochezia can appear on the stool, toilet paper or toilet bowl. The amount, color and consistency of the blood will depend on its site of origin and causes.

It should be noted that the closer the site of bleeding is to the anus, the brighter red blood appears to be. Hence, the bright red blood coating the stool is generally associated with the sigmoid colon, rectum, and anus. Hematochezia is generally red or maroon in color. Stool mixed with dark blood is typically associated to be from the first parts of the large intestine. On the other hand, melena, or black, tarry and foul-smelling stool is associated to be from the stomach and duodenum.

Although hematochezia is not serious, it is still highly recommended to seek medical attention to determine the cause and begin treatment.

Causes of Hematochezia

Hematochezia occurs sporadically but is actually quite common. Majority of the causes of hematochezia are not serious and do not require medical treatment. The following may lead to hematochezia:

  • Hemorrhoids, also known as piles: swelling of the rectal blood vessels
  • Anal fissure: tearing of the anal skin
  • Diverticulitis: small budges forming in the lining of the rectum
  • Proctitis: inflammation of the rectum
  • Colorectal cancer
  • Colon polyps
  • Anal cancer
  • Ulcer
  • Constipation
  • Diarrhea
  • Crohn’s Disease and other inflammatory bowel diseases
  • Gastroenteritis: bacterial or viral infection of the stomach

Associated Symptoms of Hematochezia

Although it doesn’t happen often, hematochezia can be a sign of a life-threatening disease, such as colorectal cancer. Thus, if the hematochezia is present with the following associated symptoms, it may be best to seek medical attention as it may be a medical emergency.

  • Slow, progressive bleeding
    • Pale skin
    • Shortness of breath
    • Fatigue
    • Lethargy
  • Sudden, heavy bleeding
    • Pale, clammy skin
    • Severe abdominal cramps
    • Diarrhea
    • Shortness of breath
    • Dizziness
    • Weakness
    • Fainting
Abdominal cramps

Abdominal cramps with hematochezia may indicate sudden, heavy bleeding

First Aid Treatment for Hematochezia

There are several tests that can be done to determine the source of the bleeding and its cause, such as colonoscopy and rectal exam. Once the cause is properly diagnosed, appropriate treatment can be given. The primary purpose of treatment for hematochezia is to control the bleeding and avoid the return of the bleeding.

If there is minor bleeding,

  • Seek medical attention.
  • Place over-the-counter rectal ointments for any swelling, although these are often prescribed.
  • Do not restrain bowel movements and take time while defecating.
  • Apply ice pack on the anus. This can help ease the swelling and pain. Do not apply ice directly on the skin.

If there is major bleeding, seek medical attention immediately. Monitor signs and symptoms.

To learn how to control hematochezia and other minor bleeding, enroll in First Aid Courses.

Hematochezia, or also known as rectal bleeding is bleeding from the anus that originates from anywhere in the gastrointestinal tract, particularly the lower colon or rectum. There are a variety of causes for hematochezia, which will also require different treatments.

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