Rectal Bleeding – Risk Factors, Symptoms, and Treatment 

doctor talking to her male patient at office

Rectal bleeding is an indication of many underlying health issues. Nevertheless, bleeding from the anus is a concern that needs medical attention in most cases. Blood from the rectum in itself is not a disease but points to possible complications. There are several blood in stool causes, but primarily it is due to problems in the gastrointestinal tract.

Unlike other ailments, rectal bleeding in men and women is similar. In most cases, rectal bleeding results in abnormal stools, which are termed medically as melena or black stool or hematochezia or fresh blood in the stool.

Risk factors for rectal bleeding

Individuals with the following conditions are often identified as risk factors for rectal bleeding:

  • Constipation – Hard stools and straining can erode the rectum
  • Stomach gas – It increases pressure on the rectum, thereby resulting in hemorrhoids
  • Heavy intake of alcohol – Causes swollen veins in the esophagus that can rapture easily
  • Gastrointestinal diseases – Crohn’s and ulcerative colitis can cause bleeding
  • Old age – Seniors typically have weak blood vessels, especially in the intestinal tracts

Causes of rectal bleeding

Common causes of bleeding from the rectum include:

  • Hemorrhoids – Inflammed or swollen veins in the rectum or the anus
  • Constipation – Constipation may be due to an underlying hernia in the intestine, tumor, or intestinal obstruction that can cause a rupture in the anus.
  • Anal fissure – A tear or multiple tears in the anal canal can cause rectal bleeding. The underlying issue is primarily attributed to constipation.
  • Hard stool – Primarily due to a diet low in fiber but can damage the rectal tract.

Less common causes of bleeding from the rectum include:

  • Gastritis
  • Dysentery
  • Diverticulitis
  • Bleeding disorders
  • Bowel or anal or rectal cancer
  • Ischemic colitis
  • Radiation therapy
  • Colon polyps
  • Side effects of medication

Symptoms of rectal bleeding

Some individuals with rectal bleeding can exhibit life-threatening symptoms. In addition, symptoms of rectal bleeding can be regular or occasionally and can be mild to severe and including:

  • Blood in stool
  • Bloodstains on toilet paper
  • Dark or black stools
  • Bloodstains in the underwear
  • Diarrhea
  • Fever
  • Fatigue
  • Weakness
  • Nausea with or without vomiting
  • Pain in the abdomen
  • Lumps in the anus or perirectal area
  • Unexplained weight loss
  • Anemia


The right treatment for rectal bleeding is determined by identifying the underlying cause. But usually, the treatments for rectal bleeding may include:

  • Nitroglycerin treatment – A common treatment for anal fissures
  • Topical creams – These are anesthetic in nature and are prescribed to get temporary relief from pain
  • Blood pressure medications – These prescription medications are usually for hemorrhoids and anal fissures, which help to relax the anal sphincter.
  • Botox – Usually used for paralyzing the sphincter muscles to help accelerate the healing process after the rectal bleeding treatment.
  • Immunosuppressive drugs – In cases where the individual with rectal bleeding has bowel disease such as Crohn’s disease or ulcerative colitis, immunosuppressant drugs are used. These medications are sometimes used with sulfasalazine to treat the underlying cause of rectal bleeding.
  • Surgery – Surgical treatment for rectal bleeding is usually conducted when normal treatment methods are not effective. Instances, where surgery for rectal bleeding may take place, include tumors and bowel/peptic cancer.
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